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RS? If no, are you regularly scheduled to work 10 or more hours per week? ELIGIBILITY SECTION 1 ENROLLMENT EVENTS q Yes q No q Yes q No (If no to both, you are not eligible for TRS-ActiveCare coverage.) For Employer Use Only Check all that apply TRS Reporting Number District/Employer Name If you are a new hire, when do you want coverage to begin? q New Enrollee q Add Dependent Are you applying as a result of: Annual Enrollment? q Yes q No Special Enrollment Event? q Yes q No If yes,.

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