Section 2170.250  Other Responsibilities

a)         CMS will offer an annual Benefit Choice Period for TRS Benefit Recipients to:

1)         Initially enroll into the Program;

2)         Add a Dependent Beneficiary, pursuant to enrollment policies;

3)         Change health plans.

b)         CMS will provide information regarding benefits and requirements of the Program in a TRIP Benefits Handbook and an annual Benefit Choice Options booklet.

            1)         The TRIP Benefits Handbook shall embrace the following topics:

A)        Eligibility guidelines pursuant to the definitions of Benefit Recipient and Dependent Beneficiary in Section 2170.130.

B)        Enrollment opportunities pursuant to Section 2170.210.

C)        Termination guidelines.

i)          Coverage for a Benefit Recipient terminates on the last day of the month when:

•    eligibility requirements are no longer met;

•    the TRIP program is terminated;

•     a written request is received by TRS that coverage should be terminated; or

•     the Benefit Recipient becomes eligible for and enrolls in the State of Illinois Employees Group Insurance Program.

ii)         Coverage for a Benefit Recipient terminates on the date of death. 

iii)        Coverage for a Dependent Beneficiary terminates:

•     on the last day of the month simultaneously with termination of a Benefit Recipient's coverage;

•     at the end of the month in which the enrolled Dependent Beneficiary no longer meets eligibility requirements;

•     on the date of death; or

•     on the first day of the month following receipt of the written request to terminate Dependent Beneficiary coverage.

D)        Covered Benefits under TCHP.

E)        TCHP claims filing deadlines and procedures.

2)         The Benefit Choice Options booklet shall detail information not provided in the Benefits Handbook (e.g., premium amounts, coverage changes, managed care plan availability and preferred provider information).

c)                 CMS will provide training seminars for TRS regarding benefits under TRIP.

(Source:  Amended at 34 Ill. Reg. 838, effective December 31, 2009)