reglab/housing_qa huggingface dataset:
TX Ins Code § 1551.315 (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 1551 - Texas Employees Group Benefits Act|Subchapter G. Contributions and Costs|Section 1551.315. Required Contributions by State Agencies

Sec. 1551.315.  REQUIRED CONTRIBUTIONS BY STATE AGENCIES.  (a)  The governing board of each state agency participating in the group benefits program shall pay to the board of trustees an amount equal to the amount appropriated by the legislature for each employee's individual group coverages or dependents' group coverages for the agency's employees who are, and annuitants who were, compensated from funds not appropriated in the General Appropriations Act.(b)  The state agency shall:(1)  include the required contributions from funds not appropriated in the General Appropriations Act in its annual operating budget;(2)  ensure current participant coverages based on the records of the board of trustees;(3)  make timely payments of amounts due the board of trustees from all fund sources under the state agency's control;  and(4)  each month reconcile board of trustees and state agency records of coverages and payments.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.316 (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 1551 - Texas Employees Group Benefits Act|Subchapter G. Contributions and Costs|Section 1551.316. Allocation to Board of Trustees of Employer Contributions

Sec. 1551.316.  ALLOCATION TO BOARD OF TRUSTEES OF EMPLOYER CONTRIBUTIONS.  From the several funds from which employees receive their respective salaries, all employer contributions computed in accordance with this chapter and rules adopted under this chapter are allocated to the board of trustees as provided by this chapter.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.317 (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 1551 - Texas Employees Group Benefits Act|Subchapter G. Contributions and Costs|Section 1551.317. Payment of Employer Contributions Allocated by the State

Sec. 1551.317.  PAYMENT OF EMPLOYER CONTRIBUTIONS ALLOCATED BY THE STATE.  (a)  All money allocated by this state, including by institutions of higher education, to the board of trustees under this chapter shall be paid to the board in monthly installments based on the annual estimate by the board of the contributions to be received for all employees during the year.(b)  At the end of each fiscal year, the board of trustees shall make any adjustments required to cover the difference between:(1)  the annual estimate;  and(2)  the actual amount of the employer contributions during the year.(c)  Each monthly installment shall be paid to the appropriate fund created by this chapter in the amount certified by the board of trustees.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.318 (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 1551 - Texas Employees Group Benefits Act|Subchapter G. Contributions and Costs|Section 1551.318. Payment of Employer Contributions Not Allocated by the State

Sec. 1551.318.  PAYMENT OF EMPLOYER CONTRIBUTIONS NOT ALLOCATED BY THE STATE.  (a)  The board of trustees shall certify to the governing board of each state agency participating in the group benefits program that provides contributions for its employees' group coverages and dependents' group coverages from operating budgets provided from sources other than the General Appropriations Act the proportionate amounts required to pay its contributions.(b)  The board of trustees shall make the certification not later than the 30th day before the date of the meeting at which the governing board of the state agency adopts its operating budget.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.319 (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 1551 - Texas Employees Group Benefits Act|Subchapter G. Contributions and Costs|Section 1551.319. Amount of Contribution for Full-Time and Part-Time Employees

Sec. 1551.319.  AMOUNT OF CONTRIBUTION FOR FULL-TIME AND PART-TIME EMPLOYEES.  (a)  A full-time employee receives the benefits of a full state contribution for coverage under this chapter.(b)  A part-time employee receives the benefits of one-half of the amount of the state contribution received by a full-time employee.(c)  The superintendent of the Texas School for the Deaf and the superintendent of the Texas School for the Blind and Visually Impaired shall determine whether an educational professional employee under contract with the school under Section 30.024 or 30.055, Education Code, as applicable, is a full-time employee for purposes of this chapter.(d)  The executive head of the Windham School District shall determine whether an educational professional employee of the school is a full-time employee for purposes of this chapter.(e)  This section does not prohibit an institution of higher education from contributing, from money not appropriated from the general revenue fund, amounts in excess of the state contribution for a part-time employee described by Section 1551.101(e)(2).(f)  Notwithstanding any other provision of this section, if the board of trustees establishes a supplemental health coverage program under Section 1551.221, the amount of the contribution made for an individual who elects to receive supplemental health coverage under the program may be reduced, as provided in the General Appropriations Act, to reflect the reduced cost of the supplemental health coverage.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.  Amended by Acts 2003, 78th Leg., ch. 366, Sec. 2.12, eff. Sept. 1, 2003.Amended by: Acts 2005, 79th Leg., Ch. 178 (H.B. 417), Sec. 2, eff. May 27, 2005.|
TX Ins Code § 1551.3195 (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 1551 - Texas Employees Group Benefits Act|Subchapter G. Contributions and Costs|Section 1551.3195. Amount of Contribution for Annuitants Who Were Part-Time Employees

Sec. 1551.3195.  AMOUNT OF CONTRIBUTION FOR ANNUITANTS WHO WERE PART-TIME EMPLOYEES.  An annuitant who as an employee received the benefits of a state contribution under Section 1551.319(b) for coverage during any portion of the annuitant's last employment by a state agency is not eligible to receive more than the state contribution provided under Section 1551.319(b) unless the annuitant was designated by the annuitant's employer as a full-time employee during the three-consecutive-month period before retirement.|Added by Acts 2005, 79th Leg., Ch. 347 (S.B. 1176), Sec. 29, eff. January 1, 2006.|
TX Ins Code § 1551.3196 (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 1551 - Texas Employees Group Benefits Act|Subchapter G. Contributions and Costs|Section 1551.3196. Amount of Contribution for Certain Annuitants

Sec. 1551.3196.  AMOUNT OF CONTRIBUTION FOR CERTAIN ANNUITANTS.  (a)  An annuitant receives the benefits of a state contribution for coverage under this chapter based on the annuitant's eligible service credit, as follows:(1)  for an annuitant with 20 years or more of eligible service credit, a full state contribution;(2)  for an annuitant with at least 15 years but less than 20 years of eligible service credit, 75 percent of a full state contribution; and(3)  for an annuitant with less than 15 years of eligible service credit, 50 percent of a full state contribution.(b)  An annuitant receiving a reduced state contribution under Subsection (a) shall have any state contribution for dependent coverage reduced in an amount proportional to the reduction under Subsection (a).(c)  This section does not apply to an individual who:(1)  receives or is eligible to receive an annuity that is based on eligibility under Section 814.002, 814.102, 834.101, or 839.101, Government Code; or(2)  is eligible to participate in the group benefits program under:(A)  Section 1551.102(d) because of a disability; or(B)  Section 1551.102(f).|Added by Acts 2013, 83rd Leg., R.S., Ch. 618 (S.B. 1459), Sec. 25, eff. September 1, 2014.|
TX Ins Code § 1551.320 (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 1551 - Texas Employees Group Benefits Act|Subchapter G. Contributions and Costs|Section 1551.320. Certain Costs

Sec. 1551.320.  CERTAIN COSTS.  The Texas Higher Education Coordinating Board shall pay all costs incurred in determining whether an individual is disabled if:(1)  the individual is an annuitant under the optional retirement program established by Chapter 830, Government Code;  and(2)  the individual's last state employment was as an officer or employee of the coordinating board.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.323 (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 1551 - Texas Employees Group Benefits Act|Subchapter G. Contributions and Costs|Section 1551.323. Cost of Certain Annuitants

Sec. 1551.323.  COST OF CERTAIN ANNUITANTS.  (a)  An annuitant eligible to participate under Section 1551.102(i), 1551.111(e), or 1551.112(c) is, except as provided by this subsection, required to pay the total cost, as determined by the board, attributable to the participation of that individual and the dependents of that individual until the date the individual is 65 years of age.  If the General Appropriations Act or other similar legislation addresses the payment of those costs, those costs shall be paid in the manner specified by that legislation.(b)  This section applies only to an individual who is eligible to participate as an annuitant under Section 1551.102(i), 1551.111(e), or 1551.112(c) and who is not eligible to participate under another provision of Section 1551.102, 1551.111, or 1551.112.|Added by Acts 2003, 78th Leg., 3rd C.S., ch. 3, Sec. 16.04, eff. Jan. 11, 2004.|
TX Ins Code § 1551.324 (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 1551 - Texas Employees Group Benefits Act|Subchapter G. Contributions and Costs|Section 1551.324. Reduction in Contribution for Certain Active Employees and Annuitants; Incentive Payments

Sec. 1551.324.  REDUCTION IN CONTRIBUTION FOR CERTAIN ACTIVE EMPLOYEES AND ANNUITANTS; INCENTIVE PAYMENTS.  (a)  Notwithstanding any other provision of this subchapter, the state contribution for an employee's coverage or an annuitant's coverage under this chapter may be reduced, as provided in the General Appropriations Act, to reflect the reduced cost of coverage for an employee or annuitant who elects to waive basic coverage as provided by Section 1551.1045(b) or (c).(b)  Instead of the full state contribution for an employee or annuitant who makes an election described by Subsection (a), the state may contribute, as specified by the General Appropriations Act, an amount for the incentive payment authorized by Section 1551.222.|Added by Acts 2005, 79th Leg., Ch. 899 (S.B. 1863), Sec. 4.04, eff. August 29, 2005.|
TX Ins Code § 1551.352 (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 1551 - Texas Employees Group Benefits Act|Subchapter H. Sanctions and Adjudication of Claims|Section 1551.352. Executive Director Determines Questions Relating to Enrollment or Payment of Claims

Sec. 1551.352.  EXECUTIVE DIRECTOR DETERMINES QUESTIONS RELATING TO ENROLLMENT OR PAYMENT OF CLAIMS.  The executive director has exclusive authority to determine all questions relating to enrollment in or payment of a claim arising from group coverages or benefits provided under this chapter other than questions relating to payment of a claim by a health maintenance organization.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.354 (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 1551 - Texas Employees Group Benefits Act|Subchapter H. Sanctions and Adjudication of Claims|Section 1551.354. Double or Multiple Liability

Sec. 1551.354.  DOUBLE OR MULTIPLE LIABILITY.  (a)  The executive director may determine that a claim arising under any group coverage plan administered by the board of trustees may expose the plan to double or multiple liability.(b)  The executive director may cause the filing of an action for interpleader concerning the claim in a district court in Travis County on behalf of the Employees Retirement System of Texas to protect the group coverage plan from double or multiple liability.(c)  A person may not pursue a counterclaim or other cause of action against the Employees Retirement System of Texas, a trustee, officer, or employee of the retirement system, or a carrier or administering firm for the retirement system in connection with a transaction or occurrence related to the interpleader action.(d)  A person who violates Subsection (c) is liable for the costs and attorney's fees incurred by the Employees Retirement System of Texas, a trustee, officer, or employee of the retirement system, or a carrier or administering firm for the retirement system as a result of the violation.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.Amended by: Acts 2009, 81st Leg., R.S., Ch. 1308 (H.B. 2559), Sec. 38, eff. September 1, 2009.|
TX Ins Code § 1551.355 (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 1551 - Texas Employees Group Benefits Act|Subchapter H. Sanctions and Adjudication of Claims|Section 1551.355. Appeal of Executive Director's Determination

Sec. 1551.355.  APPEAL OF EXECUTIVE DIRECTOR'S DETERMINATION.  (a)  Subject to Subsection (b), an appeal of a determination of the executive director under this subchapter is only to the board of trustees.(b)  On behalf of the board of trustees and notwithstanding any other law, including Section 2003.021, Government Code, the executive director may:(1)  refer an appeal to the State Office of Administrative Hearings for a hearing;  or(2)  employ, select, or contract for the services of an administrative law judge or other hearing examiner not affiliated with the State Office of Administrative Hearings to conduct the hearing of an appeal.(c)  The appeal is a contested case under Chapter 2001, Government Code.(d)  The board of trustees shall develop and implement a process to allow an employee, participant, annuitant, or covered dependent affected by a determination described by Section 1551.352 to participate directly in the process of appealing the determination.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.  Amended by Acts 2003, 78th Leg., ch. 1111, Sec. 37, eff. Sept. 1, 2003.Amended by: Acts 2017, 85th Leg., R.S., Ch. 530 (S.B. 301), Sec. 11, eff. September 1, 2017.|
TX Ins Code § 1551.356 (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 1551 - Texas Employees Group Benefits Act|Subchapter H. Sanctions and Adjudication of Claims|Section 1551.356. Standing

Sec. 1551.356.  STANDING.  (a)  A person has standing to appeal a determination of the executive director under this subchapter only if the person is:(1)  an employee, participant, annuitant, or covered dependent participating in the group benefits program;  or(2)  after the death of an employee, participant, annuitant, or covered dependent, the person's estate, personal representative, heir at law, or designated beneficiary.(b)  A person has no standing to appeal a determination of the executive director under this subchapter or to pursue a private cause of action against the state, the board of trustees, the retirement system, the executive director, an administering firm, or an employee of any of those persons based on a determination or the implementation by the board or executive director of the type or scope of plan design features under the group benefits program.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.  Amended by Acts 2003, 78th Leg., ch. 1111, Sec. 38, eff. Sept. 1. 2003;  Acts 2003, 78th Leg., ch. 1276, Sec. 10A.411(a), eff. Sept. 1, 2003.|
TX Ins Code § 1551.357 (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 1551 - Texas Employees Group Benefits Act|Subchapter H. Sanctions and Adjudication of Claims|Section 1551.357. Determination of Appeal by Board of Trustees

Sec. 1551.357.  DETERMINATION OF APPEAL BY BOARD OF TRUSTEES.  (a)  Notwithstanding any other law, in a proceeding considered to be a contested case under Chapter 2001, Government Code, the board of trustees in its sole discretion may modify, refuse to accept, or delete any proposed finding of fact or conclusion of law contained in a proposal for decision submitted by an administrative law judge or other hearing examiner, or make alternative findings of fact and conclusions of law.(b)  The board of trustees shall state in writing the specific reason for the board's determination.(c)  The board of trustees may adopt rules to implement this section.(d)  The appellant in a contested case under this subchapter has the burden of proof on all issues, including issues in the nature of an affirmative defense.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.  Amended by Acts 2003, 78th Leg., ch. 1111, Sec. 39, eff. Sept. 1, 2003.|
TX Ins Code § 1551.358 (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 1551 - Texas Employees Group Benefits Act|Subchapter H. Sanctions and Adjudication of Claims|Section 1551.358. Negotiation

Sec. 1551.358.  NEGOTIATION.  (a)  Notwithstanding any other provision of this subchapter, the board of trustees and a person who has standing to pursue an administrative appeal under this subchapter may at any time informally negotiate an award of benefits.(b)  Negotiated benefits may not exceed the maximum benefits otherwise available or required by law.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.359 (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 1551 - Texas Employees Group Benefits Act|Subchapter H. Sanctions and Adjudication of Claims|Section 1551.359. Judicial Review

Sec. 1551.359.  JUDICIAL REVIEW.  A person aggrieved by a final decision of the Employees Retirement System of Texas in a contested case under this subchapter is entitled to judicial review of the decision.  Venue of an appeal under this subchapter is only in a district court in Travis County.  The standard of review for the appeal of a determination made by the board of trustees under this subchapter is by substantial evidence.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.  Amended by Acts 2003, 78th Leg., ch. 1111, Sec. 40, eff. Sept. 1, 2003.|
TX Ins Code § 1551.360 (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 1551 - Texas Employees Group Benefits Act|Subchapter H. Sanctions and Adjudication of Claims|Section 1551.360. Delegation

Sec. 1551.360.  DELEGATION.  (a)  The board of trustees may delegate its duty to hear an appeal to the executive director.(b)  The executive director may delegate the director's duty under this subchapter to another employee of the Employees Retirement System of Texas.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.361 (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 1551 - Texas Employees Group Benefits Act|Subchapter H. Sanctions and Adjudication of Claims|Section 1551.361. Diligent Prosecution of Suit

Sec. 1551.361.  DILIGENT PROSECUTION OF SUIT.  The plaintiff shall prosecute with reasonable diligence any suit brought under Section 1551.359.  If the plaintiff does not secure proper service of process or does not prosecute the suit within one year after it is filed, the court shall presume that the suit has been abandoned.  The court shall dismiss the suit on a motion for dismissal made on or behalf of the Employees Retirement System of Texas, unless the plaintiff, after receiving appropriate notice, shows good cause for the delay.|Added by Acts 2005, 79th Leg., Ch. 347 (S.B. 1176), Sec. 31, eff. September 1, 2005.|
TX Ins Code § 1551.362 (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 1551 - Texas Employees Group Benefits Act|Subchapter H. Sanctions and Adjudication of Claims|Section 1551.362. Subpoena

Sec. 1551.362.  SUBPOENA.  Notwithstanding any other law, the Employees Retirement System of Texas may issue a subpoena that conforms to Rule 176, Texas Rules of Civil Procedure, including a preappeal investigative subpoena or any subpoena otherwise authorized by the Texas Rules of Civil Procedure, that the retirement system determines necessary to protect the interests of a program or system administered by the retirement system.|Added by Acts 2009, 81st Leg., R.S., Ch. 1308 (H.B. 2559), Sec. 39, eff. September 1, 2009.|
TX Ins Code § 1551.363 (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 1551 - Texas Employees Group Benefits Act|Subchapter H. Sanctions and Adjudication of Claims|Section 1551.363. Precedent Manual

Sec. 1551.363.  PRECEDENT MANUAL.  (a)  The board of trustees shall develop and maintain a precedent manual relating to the enrollment and claims determinations under Section 1551.352 and appeals of those determinations.  The precedent manual:(1)  must be composed of precedent-establishing determinations made by the board, executive director, or other staff, initially and on appeal, and include examples of previous determinations that are consistent with the identified precedent; and(2)  may include other information identified by the board.(b)  The board of trustees shall make the precedent manual available to appropriate staff and to employees, participants, annuitants, and covered dependents.(c)  The board of trustees and staff involved in the claims appeal process are not bound by a decision in the manual.|Added by Acts 2017, 85th Leg., R.S., Ch. 530 (S.B. 301), Sec. 12, eff. September 1, 2017.|