Sec. 1501.058. POWERS AND DUTIES OF COOPERATIVES. (a) A cooperative shall:
(1) arrange for small or large employer health benefit plan coverage for small employer groups, large employer groups, and, subject to Section 1501.0581, eligible single-employee businesses that participate in the cooperative by contracting with small or large employer health benefit plan issuers that meet the requirements established by Section 1501.061;
(2) collect premiums to cover the cost of:
(A) small or large employer health benefit plan coverage purchased through the cooperative; and
(B) the cooperative's administrative expenses;
(3) establish administrative and accounting procedures for the operation of the cooperative;
(4) establish procedures under which an applicant for or participant in coverage issued through the cooperative may have a grievance reviewed by an impartial person;
(5) contract with small or large employer health benefit plan issuers to provide services to small or large employers covered through the cooperative; and
(6) develop and implement a plan to maintain public awareness of the cooperative and publicize the eligibility requirements for, and the procedures for enrollment in, coverage through the cooperative.
(b) A cooperative may:
(1) contract with agents to market coverage issued through the cooperative;
(2) contract with a small or large employer health benefit plan issuer or third-party administrator to provide administrative services to the cooperative;
(3) negotiate the premiums paid by its members; and
(4) offer other ancillary products and services to its members that are customarily offered in conjunction with health benefit plans.
(c) A cooperative shall comply with:
(1) federal laws applicable to cooperatives and health benefit plans issued through cooperatives, to the extent required by state law or rules adopted by the commissioner; and
(2) state laws applicable to cooperatives and health benefit plans issued through cooperatives.
(d) To be eligible to exercise the authority granted under Subsection (a)(1), a health group cooperative must have at least 10 participating employers.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Amended by:
Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.053(a), eff. September 1, 2005.
Acts 2011, 82nd Leg., R.S., Ch. 1067 (S.B. 859), Sec. 2, eff. June 17, 2011.
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