reglab/housing_qa huggingface dataset:
TX Ins Code § 1551.056 (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 B. Administration and Implementation|Section 1551.056. Independent Administrator

Sec. 1551.056.  INDEPENDENT ADMINISTRATOR.  (a)  The board of trustees may, on a competitive bid basis, contract with an entity to act for the board as an independent administrator or manager of the coverages, services, and benefits authorized under this chapter.(b)  The entity must be a qualified, experienced firm of group insurance specialists or an administering firm and shall assist the board of trustees in ensuring the proper administration of this chapter and the coverages, services, and benefits provided for or authorized by this chapter.(c)  The board of trustees shall pay an independent administrator selected under this section.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.057 (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 B. Administration and Implementation|Section 1551.057. Compensation of Person Employed by Board of Trustees

Sec. 1551.057.  COMPENSATION OF PERSON EMPLOYED BY BOARD OF TRUSTEES.  The board of trustees shall pay the compensation and expenses of a person employed by the board at the rate or in the amount approved by the board.  The rate or amount may not exceed the rate or amount paid for similar services.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.058 (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 B. Administration and Implementation|Section 1551.058. Electronic Authorizations

Sec. 1551.058.  ELECTRONIC AUTHORIZATIONS.  (a)  The board of trustees may develop a system for a participant to electronically authorize:(1)  enrollment in a coverage or benefit;(2)  contributions to a coverage or benefit;  and(3)  deductions or reductions to the participant's compensation or annuity for participation in a coverage or benefit.(b)  Notwithstanding any other law, the board of trustees may permit or require an authorization covered by Subsection (a) to be made electronically.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.059 (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 1551 - Texas Employees Group Benefits Act|Subchapter B. Administration and Implementation|Section 1551.059. Certificate of Coverage

Sec. 1551.059.  CERTIFICATE OF COVERAGE.  The board of trustees shall provide for issuance to each employee or annuitant participating in the group benefits program 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 § 1551.060 (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 1551 - Texas Employees Group Benefits Act|Subchapter B. Administration and Implementation|Section 1551.060. Identification Cards

Sec. 1551.060.  IDENTIFICATION CARDS.  (a)  The board of trustees may issue a single identification card to a participant in a health benefit plan and separately administered coverage under this chapter that offers pharmacy benefits.(b)  The card may contain information regarding both health and pharmacy benefits.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.061 (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 1551 - Texas Employees Group Benefits Act|Subchapter B. Administration and Implementation|Section 1551.061. Annual Report

Sec. 1551.061.  ANNUAL REPORT.  The board of trustees shall submit a written report not later than February 1 of each year to the governor, lieutenant governor, speaker of the house of representatives, and Legislative Budget Board concerning the coverages provided and the benefits and services being received by all participants under this chapter.  The report must include:(1)  information about the effectiveness and efficiency of:(A)  managed care cost containment practices; and(B)  fraud detection and prevention procedures;(2)  basic information about each group coverage plan provided under this chapter, including the number of participants in each plan and the claims amounts and administrative expenses incurred under each plan;(3)  a summary of recent changes to the benefits provided under this chapter that highlights any key benefits the board of trustees evaluated but did not implement;(4)  a discussion of trends in claims under group coverage plans as well as other areas of interest identified by the board of trustees;(5)  recommendations for any statutory changes the board of trustees determines necessary to achieve its goals for the group benefits program; and(6)  any other information the board of trustees determines appropriate.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.Amended by: Acts 2017, 85th Leg., R.S., Ch. 530 (S.B. 301), Sec. 10, eff. September 1, 2017.|
TX Ins Code § 1551.062 (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 1551 - Texas Employees Group Benefits Act|Subchapter B. Administration and Implementation|Section 1551.062. Information on Operation and Administration of Chapter

Sec. 1551.062.  INFORMATION ON OPERATION AND ADMINISTRATION OF CHAPTER.  (a)  The board of trustees shall:(1)  conduct a continuing study of the operation and administration of this chapter, including:(A)  conducting surveys and preparing reports on group coverages and benefits available to participants;  and(B)  studying experience relating to group coverages and benefits available to participants;  and(2)  maintain statistics on the number, type, and disposition of fraudulent claims for benefits under this chapter.(b)  A contract entered into under this chapter must require a carrier to:(1)  furnish any reasonable report the board of trustees determines is necessary to enable the board to perform its functions under this chapter;  and(2)  permit the board and a representative of the state auditor to examine records of the carrier as necessary to accomplish the purposes of this chapter.(c)  Each state agency shall keep records, make certifications, and furnish the board of trustees with information and reports necessary to enable the board to perform its functions under this chapter.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|
TX Ins Code § 1551.064 (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 1551 - Texas Employees Group Benefits Act|Subchapter B. Administration and Implementation|Section 1551.064. Certain Group Health and Accident Policies or Contracts

Sec. 1551.064.  CERTAIN GROUP HEALTH AND ACCIDENT POLICIES OR CONTRACTS.  (a)  This section applies only to a group policy or contract described by Section 1251.301.  A policy or contract executed under this chapter must provide that:(1)  premium payments must be:(A)  paid directly to the Employees Retirement System of Texas; and(B)  postmarked or received not later than the 10th day of the month for which the premium is due;(2)  the premium for group continuation coverage under Subchapter G, Chapter 1251, may not exceed the level established for other surviving dependents of deceased employees and annuitants;(3)  at the time the group policy or contract is delivered, issued for delivery, renewed, amended, or extended, the Employees Retirement System of Texas shall give notice of the continuation option to each state agency covered by the group benefits program; and(4)  each state agency shall give written notice of the continuation option to each employee and dependent of an employee who is covered by the group benefits program.(b)  A group policy or contract executed under this chapter must provide that, not later than the 15th day after the date of any severance of the family relationship that might activate the continuation option under Subchapter G, Chapter 1251, the group member shall give written notice of the severance to the employing state agency.(c)  On receipt of notice under Subsection (b) or on the death of an employee, the employing state agency shall give written notice of the continuation option to each affected dependent.  The notice must state the amount of the premium to be charged and must be accompanied by any necessary enrollment forms.(d)  A covered dependent must exercise the continuation option not later than the 45th day after the date of:(1)  the severance of the family relationship;  or(2)  the retirement or death of the group member.(e)  A covered dependent must provide written notice of the exercise of the continuation option to the employing state agency within the time prescribed by Subsection (d).  Coverage under the policy or contract remains in effect during the period prescribed by Subsection (d) if the premiums are paid.(f)  Any period of previous coverage under the policy or contract must be used in full or partial satisfaction of any required probationary or waiting periods provided in the policy or contract for dependent coverage.|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.019, eff. April 1, 2009.|
TX Ins Code § 1551.065 (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 B. Administration and Implementation|Section 1551.065. Disclosure of Social Security Number

Sec. 1551.065.  DISCLOSURE OF SOCIAL SECURITY NUMBER.  The board of trustees may require an individual to disclose the individual's social security number as the board considers necessary to properly administer this chapter and any coverage, service, or benefit authorized by this chapter or as otherwise required by state or federal law.|Added by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.404(b), eff. Sept. 1, 2003.|
TX Ins Code § 1551.066 (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 B. Administration and Implementation|Section 1551.066. Information Relating to Misconduct

Sec. 1551.066.  INFORMATION RELATING TO MISCONDUCT.  (a)  This section applies to:(1)  the Employees Retirement System of Texas;(2)  a carrier or other insurance company or health maintenance organization;(3)  an administering firm or other insurance support organization that provides information or services to the group benefits program or the Employees Retirement System of Texas;(4)  an agent or third-party administrator authorized under this chapter or licensed under this code;(5)  a regulatory authority or department;  and(6)  a board member, executive director, employee, auditor, or actuary of an entity described by this section.(b)  A person may collect from, furnish to, or exchange with another person information, including medical records or other confidential information, to the extent the person considers necessary to detect or to impose a sanction for a criminal act, a misrepresentation, or nondisclosure that is related to an attempt to obtain coverage, payment, reimbursement, or a benefit under this chapter.(c)  A person who acts under Subsection (b) is immune from suit and criminal or civil liability unless the person acts with malice or intent to defraud.|Added by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.405(a), eff. Sept. 1, 2003.|
TX Ins Code § 1551.067 (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 B. Administration and Implementation|Section 1551.067. Pharmacy Benefit Manager Contracts

Sec. 1551.067.  PHARMACY BENEFIT MANAGER CONTRACTS.  (a)  In awarding a contract to provide pharmacy benefit manager services under this chapter, the board of trustees 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 board of trustees 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 board of trustees 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 board of trustees 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 board of trustees, 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 board of trustees.(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 board of trustees in accordance with established auditing standards.|Added by Acts 2009, 81st Leg., R.S., Ch. 1207 (S.B. 704), Sec. 3, eff. September 1, 2009.|
TX Ins Code § 1551.068 (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 B. Administration and Implementation|Section 1551.068. Qualification of Group Benefits Program

Sec. 1551.068.  QUALIFICATION OF GROUP BENEFITS PROGRAM.  Notwithstanding any provision of this chapter or any other law, it is intended that the provisions of this chapter be construed and administered in a manner that coverages under the group benefits program will be considered in compliance with applicable federal law.  The board of trustees may adopt rules that modify the coverage provided under the program by adding, deleting, or changing a provision of the program, including rules that modify eligibility and enrollment requirements and the benefits available under the program.|Added by Acts 2011, 82nd Leg., R.S., Ch. 1249 (S.B. 1664), Sec. 18, eff. September 1, 2011.|
TX Ins Code § 1551.101 (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 1551 - Texas Employees Group Benefits Act|Subchapter C. Coverage and Participation|Section 1551.101. Participation Eligibility: State Officers and Employees

Sec. 1551.101.  PARTICIPATION ELIGIBILITY:  STATE OFFICERS AND EMPLOYEES.  (a)  An elected or appointed officer or employee who performs service, other than as an independent contractor, for this state, including an institution of higher education, and who is described by this section is eligible to participate in the group benefits program as an employee on the date specified by Section 1551.1055.(b)  An individual is eligible to participate in the group benefits program as provided by Subsection (a) if the individual receives compensation for service performed for this state pursuant to a payroll certified by a state agency, other than an institution of higher education, or by an elected or appointed officer of this state, including a payment made from:(1)  an amount appropriated by the legislature from a state fund;(2)  a trust fund held by the comptroller;  or(3)  money paid under the official budget of a state agency, other than money appropriated under a general appropriations act.(c), (d) Repealed by Acts 2003, 78th Leg., ch. 366, Sec. 2.14.(e)  An individual is eligible to participate in the group benefits program as provided by Subsection (a) if the individual receives compensation for service performed for an institution of higher education pursuant to a payroll certified by an institution of higher education or by an elected or appointed officer of this state and either:(1)  is eligible to become a member of the Teacher Retirement System of Texas after any waiting period provided by law before membership in that retirement system; or(2)  is employed at least 20 hours a week and is not permitted to be a member of the Teacher Retirement System of Texas because the individual is employed by an institution of higher education only in a position that as a condition of employment requires the individual to be enrolled as a student in the institution in graduate-level courses.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.  Amended by Acts 2003, 78th Leg., ch. 366, Sec. 2.03, 2.14, eff. Sept. 1, 2003.Amended by: Acts 2005, 79th Leg., Ch. 347 (S.B. 1176), Sec. 26, eff. September 1, 2005.|
TX Ins Code § 1551.1021 (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 1551 - Texas Employees Group Benefits Act|Subchapter C. Coverage and Participation|Section 1551.1021. Participation Eligibility: Certain Faculty of Institutions of Higher Education

Sec. 1551.1021.  PARTICIPATION ELIGIBILITY:  CERTAIN FACULTY OF INSTITUTIONS OF HIGHER EDUCATION.  (a)  An adjunct faculty member at a public institution of higher education is eligible to participate in the group benefits program as an employee if the faculty member:(1)  receives compensation for services rendered to a public institution of higher education as an adjunct faculty member;(2)  was employed as a faculty member by the same public institution of higher education and taught at least one course in the regular fall and spring semester at the public institution of higher education in the preceding academic year; and(3)  is under contract or is scheduled to teach at least 12 semester credit hours in the academic year of coverage or, if the person is also employed by the public institution of higher education to perform nonteaching duties, is under contract or is scheduled to teach at least six semester credit hours in the academic year of coverage and has been approved by the public institution of higher education to participate in the group benefits program.(a-1)  Notwithstanding Subsection (a)(3), an adjunct faculty member at a public institution of higher education who is a professional librarian is eligible to participate in the group benefits program as an employee if the faculty member receives compensation for services rendered to a public institution of higher education as an adjunct faculty member.(b)  From money appropriated from a fund other than the general revenue fund or from money available from local sources, a public institution of higher education may, for an adjunct faculty member eligible to receive benefits under this section, contribute:(1)  not more than 50 percent of the cost of basic coverage for the employee;  and(2)  not more than 25 percent of the cost of dependent coverage.(c)  Subsection (b) does not prohibit a public institution of higher education from contributing, from money other than money appropriated from the general revenue fund, amounts that exceed the amount specified in Subsection (b) to provide coverage for a person employed by a public institution of higher education who meets the criteria for eligibility under Subsection (a).|Added by Acts 2003, 78th Leg., ch. 366, Sec. 4.04, eff. Sept. 1, 2003.Amended by: Acts 2013, 83rd Leg., R.S., Ch. 343 (H.B. 2127), Sec. 1, eff. September 1, 2013.|
TX Ins Code § 1551.1022 (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 C. Coverage and Participation|Section 1551.1022. Participation Eligibility: Certain Postdoctoral Fellows and Graduate Students

Sec. 1551.1022.  PARTICIPATION ELIGIBILITY:  CERTAIN POSTDOCTORAL FELLOWS AND GRADUATE STUDENTS.  (a)  An individual who is not eligible to participate in the group benefits program under Section 1551.101 is eligible to participate in the group benefits program under this section if the individual, at an institution of higher education:(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 group benefits 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 group benefits 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 group benefits 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. 1, eff. September 1, 2011.|
TX Ins Code § 1551.103 (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 1551 - Texas Employees Group Benefits Act|Subchapter C. Coverage and Participation|Section 1551.103. Right to Coverage

Sec. 1551.103.  RIGHT TO COVERAGE.  Subject to Section 1551.351, an individual eligible to participate in the group benefits program under Section 1551.101 or 1551.102 may not be denied any group coverage under this chapter.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.|