reglab/housing_qa huggingface dataset:
TX Ins Code § 1601.059 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle H - Health Benefits and Other Coverages for Governmental Employees|Chapter 1601 - Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System|Subchapter B. Administration and Implementation|Section 1601.059. Certificate of Coverage

Sec. 1601.059.  CERTIFICATE OF COVERAGE.  A system shall ensure that each employee and retired employee participating under this chapter is issued a certificate of coverage that states:(1)  the benefits to which the participant is entitled;(2)  to whom the benefits are payable;(3)  to whom a claim must be submitted;  and(4)  the provisions of the plan document, in summary form, that principally affect the participant.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1601.060 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle H - Health Benefits and Other Coverages for Governmental Employees|Chapter 1601 - Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System|Subchapter B. Administration and Implementation|Section 1601.060. Accounting by Carrier Providing Purchased Coverage

Sec. 1601.060.  ACCOUNTING BY CARRIER PROVIDING PURCHASED COVERAGE.  (a)  A carrier providing coverage purchased under this chapter to a system shall provide an accounting for each line of coverage to the system not later than the 120th day after the end of each plan year.(b)  The accounting must be in a form acceptable to the system.(c)  The accounting for each line of coverage must state:(1)  the cumulative amount of contributions remitted to the carrier under the coverage;(2)  the total of all mortality and other claims, charges, losses, costs, contingency reserve for pending and unreported claims, and expenses incurred;  and(3)  the amounts of the allowance for a reasonable profit, contingency reserve, and all other administrative charges.(d)  Information provided under Subsection (c) must be provided:(1)  for the period from the coverage's date of issue to the end of the plan year;  and(2)  for the plan year covered by the report.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1601.061 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle H - Health Benefits and Other Coverages for Governmental Employees|Chapter 1601 - Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System|Subchapter B. Administration and Implementation|Section 1601.061. Special Reserve

Sec. 1601.061.  SPECIAL RESERVE.  (a)  A carrier issuing a group coverage plan under this chapter may hold as a special reserve for a system an amount that equals the amount by which the total amount described by Section 1601.060(c)(1) exceeds the sum of the corresponding amounts described by Sections 1601.060(c)(2) and (3).(b)  The system may use money in the special reserve at its discretion, including for:(1)  providing additional coverage for participating employees or retired employees;(2)  offsetting necessary rate increases;  or(3)  reducing contributions to the coverage by participating employees or retired employees.(c)  A special reserve held by a carrier for a system earns interest at a rate determined each plan year by the carrier and approved by the system as consistent with the rate generally used by the carrier for similar funds held under other group coverages.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1601.062 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle H - Health Benefits and Other Coverages for Governmental Employees|Chapter 1601 - Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System|Subchapter B. Administration and Implementation|Section 1601.062. Reports and Records by Administering Carrier

Sec. 1601.062.  REPORTS AND RECORDS BY ADMINISTERING CARRIER.  Each contract entered into under this chapter between a system and an administering carrier must:(1)  require the administering carrier to provide reasonable reports that the system determines are necessary for the system to perform its functions under this chapter;  and(2)  permit the system and representatives of the state auditor to examine records of the administering carrier as necessary to accomplish the purposes of this chapter.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1601.063 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle H - Health Benefits and Other Coverages for Governmental Employees|Chapter 1601 - Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System|Subchapter B. Administration and Implementation|Section 1601.063. Assistance in Requesting Money

Sec. 1601.063.  ASSISTANCE IN REQUESTING MONEY.  The Legislative Budget Board and the Governor's Budget and Planning Office shall:(1)  establish procedures to ensure that each system requests appropriate money to support its uniform program;  and(2)  present appropriate budget recommendations to the legislature.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1601.064 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle H - Health Benefits and Other Coverages for Governmental Employees|Chapter 1601 - Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System|Subchapter B. Administration and Implementation|Section 1601.064. Pharmacy Benefit Manager Contracts

Sec. 1601.064.  PHARMACY BENEFIT MANAGER CONTRACTS.  (a)  In awarding a contract to provide pharmacy benefit manager services under this chapter, a system is not required to select the lowest bid but must select a contract that meets the criteria established by this section.(b)  The contract must state that:(1)  the system is entitled to audit the pharmacy benefit manager to verify costs and discounts associated with drug claims, pharmacy benefit manager compliance with contract requirements, and services provided by subcontractors;(2)  the audit must be conducted by an independent auditor in accordance with established auditing standards; and(3)  to conduct the audit, the system and the independent auditor are entitled access to information related to the services and the costs associated with the services performed under the contract, including access to the pharmacy benefit manager's facilities, records, contracts, medical records, and agreements with subcontractors.(c)  The contract must define the information that the pharmacy benefit manager is required to provide to the system concerning the audit of the retail, independent, and mail order pharmacies performing services under the contract and describe how the results of these audits must be reported to the system, including how often the results must be reported.  The contract must state whether the pharmacy benefit manager is required to return recovered overpayments to the system.(d)  The contract must state that any audit of a mail order pharmacy owned by the pharmacy benefit manager must be conducted by an independent auditor selected by the system in accordance with established auditing standards.|Added by Acts 2009, 81st Leg., R.S., Ch. 1207 (S.B. 704), Sec. 8, eff. September 1, 2009.|
TX Ins Code § 1601.101 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle H - Health Benefits and Other Coverages for Governmental Employees|Chapter 1601 - Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System|Subchapter C. Coverage and Participation|Section 1601.101. Participation Eligibility: Employees

Sec. 1601.101.  PARTICIPATION ELIGIBILITY:  EMPLOYEES.  (a)  An individual who is employed by the governing board of a system, who performs service, other than as an independent contractor, for the system, and who is described by this section is eligible to participate as an employee in the uniform program on the date specified by Section 1601.1045.(b)  An individual is eligible to participate in the uniform program as provided by Subsection (a) if the individual receives compensation for services performed for the system, is eligible to be a member of the Teacher Retirement System of Texas, and either:(1)  is expected to work at least 20 hours per week and to continue in the employment for a term of at least 4-1/2 months;  or(2)  is appointed for at least 50 percent of a standard full-time appointment.(c)  An individual is eligible to participate in the uniform program as provided by Subsection (a) if the individual:(1)  receives compensation for services performed for the system;(2)  is employed at least 20 hours a week; and(3)  is not permitted to be a member of the Teacher Retirement System of Texas because the individual is solely employed by the system in a position that as a condition of employment requires the individual to be enrolled as a student in the system in graduate-level courses.(d)  Repealed by Acts 2011, 82nd Leg., R.S., Ch. 1198, Sec. 5, eff. January 1, 2012.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.  Amended by Acts 2003, 78th Leg., ch. 366, Sec. 4.02, eff. Sept. 1, 2003;  Acts 2003, 78th Leg., ch. 1266, Sec. 2.11, eff. Sept. 1, 2003.Amended by: Acts 2011, 82nd Leg., R.S., Ch. 91 (S.B. 1303), Sec. 14.002, eff. September 1, 2011.Acts 2011, 82nd Leg., R.S., Ch. 1198 (S.B. 29), Sec. 5, eff. January 1, 2012.|
TX Ins Code § 1601.1021 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle H - Health Benefits and Other Coverages for Governmental Employees|Chapter 1601 - Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System|Subchapter C. Coverage and Participation|Section 1601.1021. Participation Eligibility: Certain Postdoctoral Fellows and Graduate Students

Sec. 1601.1021.  PARTICIPATION ELIGIBILITY:  CERTAIN POSTDOCTORAL FELLOWS AND GRADUATE STUDENTS.  (a)  An individual who is not eligible to participate in the uniform program under Section 1601.101 is eligible to participate in the uniform program under this section if the individual, at an institution in a system:(1)  holds:(A)  a postdoctoral fellowship; or(B)  one or more graduate student fellowships awarded to the individual on a competitive basis that, either singly or in combination, are valued at not less than $10,000 per year; and(2)  is currently receiving a stipend from an applicable fellowship.(b)  An individual who is eligible to participate in the uniform program under this section shall pay all contributions required under this chapter for the coverage selected by the individual, except that an institution of higher education may make contributions for the individual from available funds other than money appropriated to the institution from the general revenue fund.(c)  An institution of higher education shall determine which individuals are eligible to participate in the uniform program under this section and, at the time of initial eligibility, shall notify each individual of the individual's eligibility to participate in the program.(d)  An individual who participates in the uniform program under this section is not considered an employee of an institution of higher education solely as a result of the individual's participation in the program.|Added by Acts 2011, 82nd Leg., R.S., Ch. 1198 (S.B. 29), Sec. 3, eff. September 1, 2011.|
TX Ins Code § 1601.103 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle H - Health Benefits and Other Coverages for Governmental Employees|Chapter 1601 - Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System|Subchapter C. Coverage and Participation|Section 1601.103. Right to Coverage

Sec. 1601.103.  RIGHT TO COVERAGE.  An individual eligible to participate in the uniform program under Section 1601.101 or 1601.102 may not be denied enrollment in any coverage provided under this chapter.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1601.104 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle H - Health Benefits and Other Coverages for Governmental Employees|Chapter 1601 - Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System|Subchapter C. Coverage and Participation|Section 1601.104. Automatic Coverage

Sec. 1601.104.  AUTOMATIC COVERAGE.  (a)  A system shall automatically provide the basic coverage to each full-time employee unless the employee has:(1)  waived participation in the basic coverage;  or(2)  selected an optional coverage plan.(b)  An employee or retired employee who is automatically covered under this section may subsequently:(1)  retain the basic coverage or waive participation in the basic coverage;  and(2)  apply for any other coverage provided under this chapter within applicable standards.(c)  Automatic coverage as described under this section begins on the first date of employment.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1601.1045 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle H - Health Benefits and Other Coverages for Governmental Employees|Chapter 1601 - Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System|Subchapter C. Coverage and Participation|Section 1601.1045. Date Eligibility Begins; Waiting Period

Sec. 1601.1045.  DATE ELIGIBILITY BEGINS;  WAITING PERIOD.  (a)  Except as provided by Subsection (c), (d), or (e), eligibility under Section 1601.101 begins on the first day of the calendar month that begins after the 90th day after the date the employee performs services for a system.(b)  Except as provided by Subsection (c), eligibility under Section 1601.102, for an individual who does not retire at the end of the last month for which the individual is on the payroll of a system before retirement, begins on the first day of the calendar month that begins after the 90th day after the date the individual retires.(c)  The waiting period established by Subsections (a) and (b) applies only to the determination of initial eligibility to participate in the group health benefits program and does not apply to the determination of initial eligibility to participate in optional coverages under the uniform program.(d)  Notwithstanding Subsection (a), eligibility under Section 1601.101 may not begin earlier than the first day that an employee performs services for a system if any amount paid for premium incurred before the date specified under Subsection (a) for the employee and any dependents of the employee is paid from money not appropriated from the general revenue fund, in accordance with policies and procedures established by the system.(e)  Eligibility under Section 1601.101 for an employee reemployed under Chapter 613, Government Code, begins on the first day of reemployment on which the employee performs services for a system. |Added by Acts 2003, 78th Leg., ch. 366, Sec. 4.05, eff. Sept. 1, 2003.Amended by: Acts 2015, 84th Leg., R.S., Ch. 150 (H.B. 437), Sec. 2, eff. September 1, 2015.|
TX Ins Code § 1601.105 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle H - Health Benefits and Other Coverages for Governmental Employees|Chapter 1601 - Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System|Subchapter C. Coverage and Participation|Section 1601.105. Waiver

Sec. 1601.105.  WAIVER.  An employee or retired employee may waive in writing any coverage provided under this chapter.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1601.106 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle H - Health Benefits and Other Coverages for Governmental Employees|Chapter 1601 - Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System|Subchapter C. Coverage and Participation|Section 1601.106. Optional Coverage

Sec. 1601.106.  OPTIONAL COVERAGE.  A system shall provide optional coverage in accordance with Section 1601.201.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1601.1065 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle H - Health Benefits and Other Coverages for Governmental Employees|Chapter 1601 - Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System|Subchapter C. Coverage and Participation|Section 1601.1065. Optional Basic Coverage Plan for Graduate Students

Sec. 1601.1065.  OPTIONAL BASIC COVERAGE PLAN FOR GRADUATE STUDENTS.  The system may design and offer a separate optional basic coverage plan for employees who are graduate students.  The system shall determine the participation eligibility, coverage, payments, contributions, and costs of a plan offered under this section.|Added by Acts 2017, 85th Leg., R.S., Ch. 1106 (H.B. 4035), Sec. 7, eff. June 15, 2017.|
TX Ins Code § 1601.107 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle H - Health Benefits and Other Coverages for Governmental Employees|Chapter 1601 - Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System|Subchapter C. Coverage and Participation|Section 1601.107. Coverage for Dependents

Sec. 1601.107.  COVERAGE FOR DEPENDENTS.  An individual who is eligible to participate in the uniform program under Section 1601.101, 1601.102, or 1601.1021 is entitled to secure for a dependent of the individual any group coverages provided under this chapter for dependents under rules adopted by the applicable system.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.Amended by: Acts 2011, 82nd Leg., R.S., Ch. 1198 (S.B. 29), Sec. 4, eff. September 1, 2011.|
TX Ins Code § 1601.108 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle H - Health Benefits and Other Coverages for Governmental Employees|Chapter 1601 - Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System|Subchapter C. Coverage and Participation|Section 1601.108. Coverage Options for Certain Surviving Spouses

Sec. 1601.108.  COVERAGE OPTIONS FOR CERTAIN SURVIVING SPOUSES.  (a)  This section applies only to the surviving spouse of:(1)  an individual eligible to participate in the uniform program under Section 1601.101 who had at least five years of service on the date of the individual's death, including at least three years of service as an eligible employee with the employing system;  or(2)  an individual eligible to participate in the uniform program under Section 1601.102.(b)  A surviving spouse to whom this section applies may elect to retain any of the following coverages in effect on the date of the participant's death:(1)  the surviving spouse's authorized coverages;  and(2)  authorized coverages for any eligible dependent of the deceased participant.(c)  The coverage is at the group rate for other participants.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1601.109 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle H - Health Benefits and Other Coverages for Governmental Employees|Chapter 1601 - Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System|Subchapter C. Coverage and Participation|Section 1601.109. Coverage for Aids, Hiv, or Serious Mental Illness

Sec. 1601.109.  COVERAGE FOR AIDS, HIV, OR SERIOUS MENTAL ILLNESS.  (a)  In this section, "serious mental illness" has the meaning assigned by Section 1355.001.(b)  A system may not contract for or provide for group insurance or HMO coverage or provide self-insured coverage, that:(1)  excludes or limits coverage or services for acquired immune deficiency syndrome, as defined by the Centers for Disease Control and Prevention of the United States Public Health Service, or human immunodeficiency virus infection;  or(2)  provides coverage for serious mental illness that is less extensive than the coverage provided for any other physical illness.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.Amended by: Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2G.020, eff. April 1, 2009.|
TX Ins Code § 1601.110 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle H - Health Benefits and Other Coverages for Governmental Employees|Chapter 1601 - Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System|Subchapter C. Coverage and Participation|Section 1601.110. Disease Management Services

Sec. 1601.110.  DISEASE MANAGEMENT SERVICES.  (a)  In this section, "disease management services" means services to assist an individual manage a disease or other chronic health condition, such as heart disease, diabetes, respiratory illness, end-stage renal disease, HIV infection, or AIDS, and with respect to which the governing board of a system identifies populations requiring disease management.(b)  A health benefit plan provided under this chapter must provide disease management services or coverage for disease management services in the manner required by the governing board of a system, including:(1)  patient self-management education;(2)  provider education;(3)  evidence-based models and minimum standards of care;(4)  standardized protocols and participation criteria;  and(5)  physician-directed or physician-supervised care.|Added by Acts 2003, 78th Leg., ch. 589, Sec. 5, eff. June 20, 2003.|
TX Ins Code § 1601.111 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle H - Health Benefits and Other Coverages for Governmental Employees|Chapter 1601 - Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System|Subchapter C. Coverage and Participation|Section 1601.111. Programs Promoting Disease Prevention, Wellness, and Health

Sec. 1601.111.  PROGRAMS PROMOTING DISEASE PREVENTION, WELLNESS, AND HEALTH.  A system may establish premium discounts, surcharges, rebates, or a revision in otherwise applicable copayments, coinsurance, or deductibles, or any combination of those incentives, for an individual who participates in system-approved programs promoting disease prevention, wellness, and health.|Added by Acts 2011, 82nd Leg., R.S., Ch. 1049 (S.B. 5), Sec. 3.02, eff. June 17, 2011.|