reglab/housing_qa huggingface dataset:
TX Ins Code § 1551.156 (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 D. Coverage for Dependents|Section 1551.156. Coverage Options for Surviving Dependent

Sec. 1551.156.  COVERAGE OPTIONS FOR SURVIVING DEPENDENT.  (a)  A surviving dependent of an annuitant who was receiving monthly benefits paid by a retirement system named in this chapter may, following the death of the annuitant if there is not a surviving spouse, elect to retain any coverage previously secured by the annuitant until the dependent becomes ineligible for coverage for a reason other than the death of the member of the group.(b)  The coverage is at the group rate for other participants.(c)  A dependent who elects to retain coverage under this section and who is entitled to monthly benefits from a retirement system named in this chapter based on the service of the deceased annuitant must direct the retirement system to deduct required contributions for the coverage from the monthly benefits paid the surviving dependent by the retirement system.(d)  A person who is a surviving dependent of an annuitant may secure group health coverage after the death of the annuitant without evidence of the person's insurability if the annuitant was eligible to participate in the group benefits program of a retirement system named in this chapter but was not participating at the time of the individual's death.(e)  A surviving dependent seeking group coverage under Subsection (d):(1)  must apply for the coverage not later than the 30th day after the date on which the individual who was eligible to participate in the group benefits program dies; and(2)  shall pay for the coverage at the group rate as provided by Subsection (b).|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. 36, eff. September 1, 2009.Acts 2009, 81st Leg., R.S., Ch. 1308 (H.B. 2559), Sec. 37, eff. September 1, 2009.|
TX Ins Code § 1551.157 (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 D. Coverage for Dependents|Section 1551.157. Coverage Options After Expiration of Annuity Option

Sec. 1551.157.  COVERAGE OPTIONS AFTER EXPIRATION OF ANNUITY OPTION.  The surviving spouse or dependent of an employee or annuitant may retain authorized coverages after expiration of a time-certain annuity option selected by the employee or annuitant.  To retain the coverages, the surviving spouse or dependent must make advance payment of contributions to the Employees Retirement System of Texas under rules adopted by the board of trustees.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.158 (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 D. Coverage for Dependents|Section 1551.158. Reinstatement of Health Benefit Plan Coverage by Certain Dependents

Sec. 1551.158.  REINSTATEMENT OF HEALTH BENEFIT PLAN COVERAGE BY CERTAIN DEPENDENTS.  (a)  A dependent child who is unmarried and whose coverage under this chapter ends when the child becomes 26 years of age may, on expiration of continuation coverage under the Consolidated Omnibus Budget Reconciliation Act of 1985 (Pub. L. No. 99-272), reinstate health benefit plan coverage under this chapter if the child, or the child's participating parent, pays the full cost of the health benefit plan coverage.(b)  A state contribution is not payable for coverage under this section.(c)  Coverage under this section terminates at the end of the month in which the child marries.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.Amended by: Acts 2013, 83rd Leg., R.S., Ch. 618 (S.B. 1459), Sec. 24, eff. September 1, 2013.|
TX Ins Code § 1551.201 (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 E. Group Coverages|Section 1551.201. Establishment

Sec. 1551.201.  ESTABLISHMENT.  (a)  The board of trustees by rule shall establish group coverage plans for individuals eligible to participate in the group benefits program.(b)  The group coverage plans may, in the board of trustees' discretion, include:(1)  life coverage;(2)  accidental death and dismemberment coverage;(3)  health benefit coverage, including coverage for:(A)  hospital care and benefits;(B)  surgical care and treatment;(C)  medical care and treatment;(D)  dental care;(E)  obstetrical benefits;(F)  prescribed drugs, medicines, and prosthetic devices;  and(G)  supplemental benefits, supplies, and services in accordance with this chapter;(4)  coverage providing protection against either long-term or short-term loss of salary;  and(5)  any other group coverage that the board of trustees, in consultation with the advisory committee, considers advisable.(c)  The group coverage plans for annuitants may, at the discretion of the board of trustees, be separate or a part of the group coverage plans for employees.  If the trustee establishes separate group coverage plans for annuitants, the separate group coverage plans must include both full benefits and supplemental coverage options.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.  Amended by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.412(b), eff. Sept. 1, 2003.|
TX Ins Code § 1551.2011 (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 E. Group Coverages|Section 1551.2011. Employee Awareness and Education

Sec. 1551.2011.  EMPLOYEE AWARENESS AND EDUCATION.  (a)  The board of trustees by rule shall ensure that employees receive information about life coverage, accidental death and dismemberment coverage, and long-term and short-term loss of salary coverage, if those coverages are included in a group coverage plan established under Section 1551.201.(b)  The information must contain descriptions of:(1)  probabilities of death and disability; and(2)  policy exclusions and limitations, including:(A)  limitations based on multiple sources of benefits;(B)  preexisting condition exclusions; and(C)  required waiting periods for benefits.(c)  The board of trustees by rule may provide the information described by Subsections (a) and (b) in printed materials for new employees distributed on the first day of employment.  The board of trustees may consider using printed materials, online presentations, and educational presentations to ensure the information described by Subsections (a) and (b) is provided to employees.(d)  If applicable, the board of trustees shall annually review the materials and presentations described by Subsection (c) to determine if changes to the contents of the materials or presentations are necessary.  If applicable, the department shall adopt rules necessary for considering and making changes to the materials or presentations.(e)  The board of trustees shall publish the information described by Subsections (a) and (b) on the Employees Retirement System of Texas website.|Added by Acts 2013, 83rd Leg., R.S., Ch. 296 (H.B. 1265), Sec. 1, eff. June 14, 2013.|
TX Ins Code § 1551.202 (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 E. Group Coverages|Section 1551.202. Authority to Define Basic Coverages

Sec. 1551.202.  AUTHORITY TO DEFINE BASIC COVERAGES.  (a)  The board of trustees may define the basic coverage applicable to each individual for whom coverage is automatic unless participation is specifically waived.(b)  The board of trustees may define different basic coverage plans for individuals eligible to participate in the uniform program under Section 1551.101 and for individuals eligible to participate in the group benefits program under Section 1551.102.(c)  Basic coverage must include basic health coverage.  The coverage may be offered through any health benefit plan.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.203 (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 E. Group Coverages|Section 1551.203. Authority to Define Optional Coverages

Sec. 1551.203.  AUTHORITY TO DEFINE OPTIONAL COVERAGES.  The board of trustees may define optional coverages for which the board may make available employer contributions under Section 1551.303.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.204 (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 E. Group Coverages|Section 1551.204. Authority to Define Voluntary Coverages

Sec. 1551.204.  AUTHORITY TO DEFINE VOLUNTARY COVERAGES.  Subject to Section 1551.304, the board of trustees may define voluntary coverages.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.205 (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 E. Group Coverages|Section 1551.205. Limitations

Sec. 1551.205.  LIMITATIONS.  The board of trustees may not contract for or provide a coverage plan 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;(2)  provides coverage for serious mental illness that is less extensive than the coverage provided for any physical illness;  or(3)  may provide coverage for prescription drugs to assist in stopping smoking at a lower benefit level than is provided for other prescription drugs.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.  Amended by Acts 2003, 78th Leg., ch. 213, Sec. 1, eff. Sept. 1, 2003.|
TX Ins Code § 1551.206 (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 E. Group Coverages|Section 1551.206. Cafeteria Plan

Sec. 1551.206.  CAFETERIA PLAN.  (a)  The board of trustees may develop, implement, and administer a cafeteria plan if the board determines that establishment of the plan:(1)  is feasible;(2)  would be beneficial to the state and to employees who would be eligible to participate in the plan;  and(3)  would not adversely affect the coverage plans provided under the group benefits program.(b)  The board of trustees may include in the cafeteria plan any benefit that may be included in a cafeteria plan under federal law.(c)  The board of trustees may enter into a contract or agreement with an independent and qualified agency, individual, or entity to:(1)  develop, implement, or administer a cafeteria plan;  or(2)  assist in those activities.(d)  The board of trustees may adopt an order terminating the cafeteria plan and providing a procedure for the orderly withdrawal of the state and its employees from the plan if the board determines that a cafeteria plan established under this section is no longer advantageous to the state or its employees.(e)  The board of trustees may adopt rules for the use of a debit card or other similar technology for claims administration under this section.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.  Amended by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.408(a), eff. Sept. 1, 2003.|
TX Ins Code § 1551.207 (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 E. Group Coverages|Section 1551.207. Premium Conversion Benefit Portion of Cafeteria Plan

Sec. 1551.207.  PREMIUM CONVERSION BENEFIT PORTION OF CAFETERIA PLAN.  Each employee must be enrolled in the premium conversion benefit portion of a cafeteria plan established under Section 1551.206.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.208 (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 E. Group Coverages|Section 1551.208. Determination to Self-Fund

Sec. 1551.208.  DETERMINATION TO SELF-FUND.  (a)  The board of trustees, in the board's sole discretion, shall determine those coverage plans that the board does not intend to purchase but intends to provide directly from the employees life, accident, and health insurance and benefits fund.(b)  The board of trustees, in the board's sole discretion and under conditions the board approves, may reinsure any coverage the board determines will be provided directly from the employees life, accident, and health insurance and benefits fund under Subsection (a).|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.209 (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 E. Group Coverages|Section 1551.209. Coverage Exempt From Insurance Law

Sec. 1551.209.  COVERAGE EXEMPT FROM INSURANCE LAW.  A coverage plan provided under this chapter is exempt from any other insurance law, including common law, that does not expressly apply to the plan or this chapter.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.  Amended by Acts 2003, 78th Leg., ch. 1111, Sec. 35, eff. Sept. 1, 2003.|
TX Ins Code § 1551.210 (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 E. Group Coverages|Section 1551.210. Actuarial Advice for Self-Funded Coverage

Sec. 1551.210.  ACTUARIAL ADVICE FOR SELF-FUNDED COVERAGE.  A qualified actuary selected by the board of trustees shall advise the board regarding an actuarially sound level of contributions required to provide coverage directly from the employees life, accident, and health insurance and benefits fund.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.211 (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 E. Group Coverages|Section 1551.211. Contingency Reserve Fund for Self-Funded Coverage

Sec. 1551.211.  CONTINGENCY RESERVE FUND FOR SELF-FUNDED COVERAGE.  (a)  Before the first day of each state fiscal biennium, the board of trustees shall estimate for an average 60-day period during the biennium the expenditures from the employees life, accident, and health insurance and benefits fund anticipated for self-funded coverage plans, considering projected claims and administrative expenses for those plans.(b)  The board of trustees shall place the estimated amount in a contingency reserve fund to provide for adverse fluctuations in claims or administrative expenses.(c)  The board of trustees shall include in each request for legislative appropriations to the group benefits program the amount the board determines to be necessary to maintain the contingency reserve fund at the level required by this section.(d)  The board of trustees may invest and reinvest any portion of the contingency reserve fund under the standard of care provided by Section 815.307, Government Code, considering the functional need to provide for adverse fluctuations in claims or administrative expenses.(e)  The interest on, earnings of, and proceeds from the sale of investments of assets in the contingency reserve fund shall be credited to the fund.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.212 (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 E. Group Coverages|Section 1551.212. Firms to Administer Self-Funded Coverage

Sec. 1551.212.  FIRMS TO ADMINISTER SELF-FUNDED COVERAGE.  (a)  For those coverage plans that the board of trustees funds from the employees life, accident, and health insurance and benefits fund, the board may contract with one or more qualified and experienced administering firms to administer the plans in the best interest of the participants in the group benefits program.(b)  The contract may be awarded only after a competitive bid process.  The board of trustees is not required to select the lowest bid but shall take into consideration other relevant criteria, including ability to service large group programs and past experience.(c)  If the board of trustees selects a firm whose bid was not the lowest or whose bid differs from that specified, the board shall fully justify and explain the reasons for the action in the minutes of the next meeting of the board.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.213 (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 E. Group Coverages|Section 1551.213. Bids for Purchased Coverage

Sec. 1551.213.  BIDS FOR PURCHASED COVERAGE.  (a)  For those coverage plans for which the board of trustees determines to purchase coverage, the board shall notify eligible carriers:(1)  that competitive bidding will be conducted;  and(2)  of the date by which an eligible carrier must submit a bid on the contract to the board.(b)  The board of trustees shall submit the group coverages provided by the group benefits program for competitive bidding at least every six years.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.214 (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 E. Group Coverages|Section 1551.214. Selection of Bids for Purchased Coverage

Sec. 1551.214.  SELECTION OF BIDS FOR PURCHASED COVERAGE.  (a)  An actuary selected by the board of trustees shall advise the board as to the actuarial soundness of the bids received under Section 1551.213.(b)  The board of trustees:(1)  shall select carriers to provide services that will be in the best interest of participants;  and(2)  is not required to select the lowest bid but shall take into consideration other relevant criteria, including ability to service contracts, past experience, and financial ability.(c)  If the board of trustees selects a carrier whose bid differs from that advertised, the board shall record the deviation and shall fully justify and explain the reasons for the deviation in the minutes of the next meeting of the board.(d)  The board of trustees shall notify the carriers that submitted bids of the results of the bidding.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.215 (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 E. Group Coverages|Section 1551.215. Accounting by Carrier Providing Purchased Coverage

Sec. 1551.215.  ACCOUNTING BY CARRIER PROVIDING PURCHASED COVERAGE.  (a)  A carrier providing a coverage purchased under this chapter shall provide an accounting to the board of trustees not later than the 90th day after the end of each plan year.(b)  The accounting must be in a form approved by the board of trustees.(c)  The accounting must state for the period from the coverage's date of issue to the end of the plan year:(1)  the amounts of contributions accrued under the coverage;(2)  the total of mortality and other claims, charges, losses, and expenses incurred;  and(3)  the amounts of the carrier's allowance for a reasonable profit and contingencies.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.216 (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 E. Group Coverages|Section 1551.216. Special Contingency Reserve

Sec. 1551.216.  SPECIAL CONTINGENCY RESERVE.  (a)  A carrier issuing a group coverage plan under this chapter shall hold as a special contingency reserve an amount that equals the amount by which the amount described by Section 1551.215(c)(1) exceeds the sum of the amounts described by Sections 1551.215(c)(2) and (3).(b)  The carrier may use the special contingency reserve only for charges, claims, and expenses under the plan.(c)  The special contingency reserve earns interest at a rate determined before each plan year by the carrier and approved by the board of trustees as consistent with the rates generally used by the carrier for similar funds held under other group coverage plans.(d)  On a determination by the board of trustees that the special contingency reserve has attained an amount estimated by the board to make satisfactory provision for adverse fluctuations in future charges, claims, or expenses under the plan, any further excess shall be deposited to the credit of the employees life, accident, and health insurance and benefits fund.(e)  On discontinuation of a plan, any balance remaining in the special contingency reserve after all charges have been made shall be deposited to the credit of the employees life, accident, and health insurance and benefits fund.  The carrier may make the deposit in equal monthly installments over a period of not more than two years.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|