UT Benefits for Retired Employees: Plan Year 2013-2014

Eligibility

Retired Employees

1. An individual who was employed at a UT System institution in a benefits-eligible position on August 31, 2003, and subsequently retires from the System is eligible for benefits as a retired employee if:

  1. The individual meets the Rule of 80 (total of age plus years of creditable state service equals or exceeds 80), or the individual is at least age 55 with five (5) years of creditable state service; and
  2. The individual has at least three (3) years of service with the System for which the individual was eligible to participate in the Program; and
  3. The individualís last place of state employment before retirement was with a System institution; and
  4. The individual retires from System under the jurisdiction of the Teacher Retirement System of Texas (TRS); the Employees Retirement System of Texas (ERS); or the Optional Retirement Program (ORP) established by Chapter 830, Government Code or any other federal or state statutory retirement program to which the System has made employer contributions.

2. An individual whose first date of employment at a UT System institution in a benefits-eligible position was on or after September 1, 2003 is eligible for benefits as a retired employee if:

  1. The individual meets the Rule of 80 (total of age plus years of state service credit equals or exceeds 80) with at least ten (10) years of creditable state service, or is at least age 65 with ten (10) years of total state service credit; and
  2. The individual has at least ten (10) years of service with the System; and
  3. The individualís last state employment before retirement was with an institution of the System; and
  4. The individual retires under the jurisdiction of the Teacher Retirement System of Texas (TRS); the Employees Retirement System of Texas (ERS); or the Optional Retirement Program (ORP) established by Chapter 830, Government Code or any other federal or state statutory retirement program to which the System has made employer contributions.

Individuals, regardless of age and years of service credit, who worked in a benefits-eligible position with UT and are members of the Teacher Retirement System of Texas (TRS) and qualify for disability retirement may also qualify to participate in the UT Benefits program. Individuals who are participants in the Optional Retirement Program (ORP) may also qualify for disability retirement.

The criteria above cover most, but not all, of the situations under which someone is eligible for retired employee benefits. For more information about retired employee benefits eligibility, refer to the Office of Employee Benefits Administrative Manual, Policy 220.

Dependents

You may also enroll your eligible dependents for certain UT Benefits coverage.

Eligibility to participate in certain UT Benefits coverage as a dependent is determined by law. Because of changes made by the federal Affordable Care Act (ACA), your children (including stepchildren and adopted children) are eligible for the UT SELECT Medical plan, regardless of marital status, until they reach the age of 26. Eligibility of dependents who do not qualify as your spouse or child (such as eligible grandchildren), ends at age 25 for all UT Benefits coverage, including the UT SELECT Medical plan. Eligible dependents are:

  • Your spouse, as defined by Texas Family Code;
  • Your children, including stepchildren and adopted children, who are:
    • under age 26 regardless of marital status for the UT SELECT Medical plan,
    • unmarried and under age 25 for other UT Benefits (Dental, Vision, Life);
  • Your unmarried grandchild(ren) under age 25, provided the child meets the requirements which includes proof that you claim the child as your dependent for federal tax purposes;
  • Certain children over age 25 (over age 26 for the UT SELECT Medical plan), who are determined by OEB to be medically incapacitated and are unable to provide their own support; and
  • Children for whom you are named a legal guardian by a court or who are the subject of a medical support order requiring such coverage.

Examples of dependents that are not eligible for UT Benefits include:

 

  • your former spouse;
  • your married child (for coverage other than UT SELECT Medical);
  • your child over age 25 (age 26 for UT SELECT Medical), if not medically incapacitated and unable to provide their own support;
  • your grandchild, if they are married or over age 25;
  • foster children covered by another government program, unless coverage is required by law or court order;
  • any dependent insured by another UT employee or retired employee;
  • any dependent insured by another plan that receives State of Texas premium contributions; or
  • any dependent who is on active duty in the armed forces of any country (for coverage other than UT SELECT Medical).

Surviving Dependent Benefits

The surviving spouse or other benefits-eligible dependent of an employee or retired employee who, on the date of the employee’s death, had at least five (5) years of Teacher Retirement System of Texas (TRS) or Texas Optional Retirement Program (ORP) creditable service, including at least three (3) years with UT as a benefits-eligible employee at the time of death, is eligible for benefits as a surviving dependent if the dependent had been participating in UT Benefits at the time of the employee or retired employee’s death.

A surviving spouse may continue UT Benefits coverage for the remainder of the surviving spouse’s life. A dependent child may continue until the child loses his or her status as a dependent child. The dependent of an individual who has not met the service requirements at the time of death may elect COBRA coverage for a period not to exceed 36 months.

Dependent Documentation

UT requires supporting documentation when you request to add a dependent to your plan. Be prepared to provide proof of eligibility such as your marriage certificate, your child(ren)’s birth certificates, appropriate adoption paperwork, federal tax forms or other documents that support the dependent relationship. For medically incapacitated dependents, proof of the incapacitating condition and dependency must be submitted within 31 days of initial eligibility for enrollment and an incapacitated dependent. This paperwork is required not only to support the coverage of eligible dependents but also to support a mid-year change of status such as marriage or birth of a child.

During Annual Enrollment, completed dependent documentation must be submitted electronically by August 15. If youíve added a dependent and you are not able to complete electronic dependent documentation, you may submit the documentation to your local HR/Benefits office by the same deadline of August 15.

Misrepresentation of benefit eligibility requirements constitutes a violation of OEB’s official policy. A verified misrepresentation by an employee or retired employee shall be reported by OEB to the appropriate institution for investigation and possible sanctions. Possible sanctions for such a violation range from a reprimand to dismissal. In addition, reimbursement may be required for any benefits paid to an ineligible individual. Deliberate misrepresentation of dependent eligibility by an employee or retired employee may constitute criminal fraud and may result in a referral to a law enforcement office. Any ineligible dependent may be terminated from plan participation upon discovery of ineligibility.

 

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