All codes › Insurance Code › Title 8
Chapter 1551
Texas Employees Group Benefits Act
Subchapter A. General Provisions
1551.001
Short Title
1551.002
Purposes
1551.003
General Definitions
1551.004
Definition of Dependent
1551.005
Definition of Health Benefit Plan
1551.006
Definition of Institution of Higher Education
1551.007
Definition of Carrier
1551.008
Applicability of Definitions
1551.009
Board of Trustees May Define Other Words
1551.010
Board of Trustees Approval for Payroll Deductions or Reductions
1551.011
Exemption from Execution
1551.012
Exemption from State Taxes and Fees
1551.013
Combining of Carriers Not Restraint of Trade
1551.014
Exclusive Remedies
1551.015
Balance Billing Prohibition Notice
Subchapter B. Administration and Implementation
1551.051
Administration and Implementation
1551.052
Authority for Rules, Plans, Procedures, and Orders
1551.053
Authority to Hire Employees
1551.055
General Powers of Board of Trustees Regarding Coverage Plans
1551.056
Independent Administrator
1551.057
Compensation of Person Employed by Board of Trustees
1551.058
Electronic Authorizations
1551.059
Certificate of Coverage
1551.060
Identification Cards
1551.061
Annual Report
1551.062
Information on Operation and Administration of Chapter
1551.063
Confidentiality of Certain Records
1551.064
Certain Group Health and Accident Policies or Contracts
1551.065
Disclosure of Social Security Number
1551.066
Information Relating to Misconduct
1551.067
Pharmacy Benefit Manager Contracts
1551.068
Qualification of Group Benefits Program
Subchapter C. Coverage and Participation
1551.101
Participation Eligibility: State Officers and Employees
1551.102
Participation Eligibility: Annuitants
1551.1021
Participation Eligibility: Certain Faculty of Institutions of Higher Education
1551.1022
Participation Eligibility: Certain Postdoctoral Fellows and Graduate Students
1551.103
Right to Coverage
1551.104
Automatic Coverage
1551.1045
Waiver
1551.105
Date Automatic Coverage Begins
1551.1055
Date Eligibility Begins; Waiting Period
1551.106
Group Coverage Plan Purchased to Provide for Automatic Coverage
1551.107
Contingent Coverage
1551.108
Continuing Eligibility of Certain Persons with Legislative Service or Employment
1551.109
Continuing Eligibility of Certain Members of Boards, Commissions, and Institutions of Higher Education
1551.1095
Eligibility of State Board of Education Members
1551.110
Ineligibility of Certain Junior College Employees
1551.111
Participation by Certain Retirement Systems
1551.112
Participation by Texas Turnpike Authority
1551.113
Participation by Certain Employees Whose Positions Are Privatized or Eliminated
1551.114
Participation by Community Supervision and Corrections Departments
1551.115
Participation by Wrongfully Imprisoned Persons
Subchapter D. Coverage for Dependents
1551.151
Entitlement to Coverage
1551.152
Eligibility of Foster Child
1551.153
Participant Residing Outside of Service Area
1551.154
Employee Payments
1551.155
Coverage Options for Surviving Spouse
1551.156
Coverage Options for Surviving Dependent
1551.157
Coverage Options After Expiration of Annuity Option
1551.158
Reinstatement of Health Benefit Plan Coverage by Certain Dependents
Subchapter E. Group Coverages
1551.201
Establishment
1551.2011
Employee Awareness and Education
1551.202
Authority to Define Basic Coverages
1551.203
Authority to Define Optional Coverages
1551.204
Authority to Define Voluntary Coverages
1551.205
Limitations
1551.206
Cafeteria Plan
1551.207
Premium Conversion Benefit Portion of Cafeteria Plan
1551.208
Determination to Self-Fund
1551.209
Coverage Exempt from Insurance Law
1551.210
Actuarial Advice for Self-Funded Coverage
1551.211
Contingency Reserve Fund for Self-Funded Coverage
1551.212
Firms to Administer Self-Funded Coverage
1551.213
Bids for Purchased Coverage
1551.214
Selection of Bids for Purchased Coverage
1551.215
Accounting by Carrier Providing Purchased Coverage
1551.216
Special Contingency Reserve
1551.217
Use of Employee's Salary in Computation of Premium or Coverage
1551.218
Prior Authorization for Certain Drugs
1551.2181
Exemption from Preauthorization Requirements for Physicians and Health Care Providers Providing Certain Health Care Services
1551.219
Disease Management Services
1551.220
Beneficiary Causing Death of Participant or Beneficiary of Participant
1551.222
Incentive Payments
1551.224
Mail Order Requirement for Prescription Drug Coverage Prohibited
1551.225
Bariatric Surgery Coverage
1551.226
Tobacco Cessation Coverage
1551.227
Tricare Military Health System Supplemental Plan
1551.228
Emergency Care Payments
1551.229
Out-of-Network Facility-Based Provider Payments
1551.230
Out-of-Network Diagnostic Imaging Provider or Laboratory Service Provider Payments
1551.231
Out-of-Network Emergency Medical Services Provider Payments
Subchapter F. Group Life and Accidental Death and Dismemberment Insurance Coverage Plan
1551.251
Group Life Insurance Coverage Plan
1551.252
Additional Term Life Insurance
1551.253
Determination of Annual Salary
1551.254
Accelerated Life Insurance Benefits
1551.255
Inclusion of Provisions for Viatical Settlements
1551.256
Optional Term Life Insurance Coverage After Retirement
1551.257
Eligibility of Annuitant for Extended Insurance Benefits
1551.258
Termination of Accidental Death and Dismemberment Insurance Coverage on Retirement
1551.259
Order of Precedence of Payment to Survivors
Subchapter G. Contributions and Costs
1551.301
Funding of Basic Coverage
1551.3015
Cost Assessment for Certain Participants
1551.302
Allocation of Employer Contributions
1551.303
Funding of Optional Coverages
1551.304
Funding of Voluntary Coverages
1551.305
Cost of Basic Coverage Exceeding Employer Contributions
1551.306
Payment of Excess Cost Over Basic Coverage Contribution
1551.307
Payment for Voluntary Coverages
1551.3075
Tobacco User Premium Differential
1551.3076
Employer Enrollment Fee
1551.308
No Contribution on Refusal of Coverage
1551.309
Employee Payments for Participation in Cafeteria Plan
1551.310
State Contribution Required
1551.311
Amount of State Contribution
1551.3111
Amount of State Contribution for Certain Junior College Employees
1551.313
Amount of State Contribution for Certain Surviving Dependents
1551.314
Certain State Contributions Prohibited
1551.315
Required Contributions by State Agencies
1551.316
Allocation to Board of Trustees of Employer Contributions
1551.317
Payment of Employer Contributions Allocated by the State
1551.318
Payment of Employer Contributions Not Allocated by the State
1551.319
Amount of Contribution for Full-Time and Part-Time Employees
1551.3195
Amount of Contribution for Annuitants Who Were Part-Time Employees
1551.3196
Amount of Contribution for Certain Annuitants
1551.320
Certain Costs
1551.323
Cost of Certain Annuitants
1551.324
Reduction in Contribution for Certain Active Employees and Annuitants; Incentive Payments
Subchapter H. Sanctions and Adjudication of Claims
1551.351
Administrative Process and Sanctions for Program Violations
1551.352
Executive Director Determines Questions Relating to Enrollment or Payment of Claims
1551.354
Double or Multiple Liability
1551.355
Appeal of Executive Director's Determination
1551.356
Standing
1551.357
Determination of Appeal by Board of Trustees
1551.358
Negotiation
1551.359
Judicial Review
1551.360
Delegation
1551.361
Diligent Prosecution of Suit
1551.362
Subpoena
1551.363
Precedent Manual
Subchapter I. Funds
1551.401
Employees Life, Accident, and Health Insurance and Benefits Fund
1551.402
State Employees Cafeteria Plan Trust Fund
1551.403
Fees for State Employees Cafeteria Plan Trust Fund
1551.404
Insufficient Earnings for Employee to Participate in Cafeteria Fund
1551.405
Employees' Health Care Stabilization Trust Fund
1551.406
Investment of Funds
1551.407
Management of Assets
Subchapter J. State Consumer-Directed Health Plan
1551.451
Definitions
1551.452
Establishment of State Consumer-Directed Health Plan
1551.453
Account Administrator
1551.454
Participation in Program
1551.455
Coverage for Dependents; Required Contributions
1551.456
State Contribution
1551.457
Plan Enrollee Contributions
1551.458
Coordination with Cafeteria Plan
1551.459
Exemption from Execution; Unassignability
1551.460
Single Undivided Risk Pool