Texas Insurance Code Title 8, Chapter 1579 - Texas School Employees Uniform Group Health Coverage
SUBCHAPTER A GENERAL PROVISIONS
- Texas Section 1579.001 - Short Title
This chapter may be cited as the Texas School Employees Uniform Group Health Coverage Act. Added by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.471(a),...
- Texas Section 1579.002 - General Definitions
In this chapter: (1) "Administering firm" means any entity designated by the trustee to administer any coverages, services, benefits, or requirements under this chapter and...
- Texas Section 1579.003 - Definition Of Employee
In this chapter, "employee" means a participating member of the Teacher Retirement System of Texas who is employed by a participating entity and who is...
- Texas Section 1579.004 - Definition Of Dependent
In this chapter, "dependent" means: (1) a spouse of a full-time employee or part-time employee; (2) a child of a full-time or part-time employee if...
- Texas Section 1579.005 - Confidentiality
(a) Section 825.507, Government Code, applies to records relating to an employee or dependent under the program and in the custody of the Teacher Retirement...
- Texas Section 1579.006 - Exemption From Process
(a) The following are exempt from execution, attachment, garnishment, or any other process: (1) benefit payments, including optional benefit payments; (2) contributions of active employees,...
- Texas Section 1579.007 - Exemption From State Taxes And Fees
A premium or contribution on a policy, insurance contract, or agreement authorized by this chapter is not subject to any state tax, regulatory fee, or...
SUBCHAPTER B ADMINISTRATION
- Texas Section 1579.008 - 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...
- Texas Section 1579.051 - Administration Of Group Program
The Teacher Retirement System of Texas, as trustee, shall implement and administer the uniform group coverage program described by this chapter. Added by Acts 2003,...
- Texas Section 1579.052 - Authority To Adopt Rules; Other Authority
(a) The trustee may adopt rules relating to the program as considered necessary by the trustee. (b) The trustee may adopt rules to administer the...
- Texas Section 1579.053 - Personnel
The trustee may hire and compensate employees as necessary to implement the program. Added by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.471(a), eff. Sept....
- Texas Section 1579.054 - Competitive Bidding Requirements; Rules
A contract to provide group health coverage under this chapter may be awarded only through competitive bidding under rules adopted by the trustee. Added by...
- Texas Section 1579.055 - Contract Award; Considerations
(a) In awarding a contract to provide group benefits under this chapter, the trustee is not required to select the lowest bid and may consider...
SUBCHAPTER C COVERAGES
- Texas Section 1579.057 - Pharmacy Benefit Manager Contracts
(a) In awarding a contract to provide pharmacy benefit manager services under this chapter, the trustee is not required to select the lowest bid but...
- Texas Section 1579.101 - Plans Of Group Coverages
(a) The trustee by rule shall establish plans of group coverages for employees participating in the program and their dependents. (b) The plans must include...
- Texas Section 1579.102 - Catastrophic Care Coverage Plan
The coverage provided under the catastrophic care coverage plan shall be prescribed by the trustee by rule and must provide coverage at least as extensive...
- Texas Section 1579.104 - Optional Coverages
The trustee may not offer optional coverages, other than optional permanent life insurance, optional long-term care insurance, and optional disability insurance, to employees participating in...
- Texas Section 1579.105 - Preexisting Condition Limitation
During the initial period of eligibility, coverage provided under the program may not be made subject to a preexisting condition limitation. Added by Acts 2003,...
- Texas Section 1579.106 - Prior Authorization For Certain Drugs
(a) In this section, "drug formulary" means a list of drugs preferred for use and eligible for coverage by a health coverage plan. (b) A...
- Texas Section 1579.107 - Disease Management Services
(a) In this section, "disease management services" means services to assist an individual manage a disease or other chronic health condition, such as heart disease,...
SUBCHAPTER D PARTICIPATING ENTITIES
- Texas Section 1579.108 - Limitations
The trustee may not contract for or provide a health coverage plan that excludes from participation in the network a general hospital that: (1) is...
- Texas Section 1579.151 - Required Participation Of School Districts With 500 Or Fewer Employees
(a) Each school district with 500 or fewer employees and each regional education service center is required to participate in the program. (b) Notwithstanding Subsection...
- Texas Section 1579.152 - Participation Of Other School Districts
Effective September 1, 2005, a school district with more than 500 employees may elect to participate in the program. A school district that elects to...
- Texas Section 1579.153 - Participation By Certain Risk Pools
(a) In determining the number of employees of a school district for purposes of Sections 1579.151 and 1579.152, school districts that, on January 1, 2001,...
SUBCHAPTER E PARTICIPATION BY EMPLOYEE
- Texas Section 1579.154 - Participation By Charter Schools; Eligibility
(a) A charter school is eligible to participate in the program if the school agrees: (1) that all records of the school relating to participation...
- Texas Section 1579.201 - Definition
In this subchapter, "full-time employee" and "part-time employee" have the meanings assigned by rules adopted by the trustee. Added by Acts 2003, 78th Leg., ch....
- Texas Section 1579.202 - Eligible Employees
(a) Except as provided by Section 1579.204, participation in the program is limited to employees of participating entities who are full-time employees and to part-time...
- Texas Section 1579.203 - Selection Of Coverage
(a) A participating employee may select coverage in any coverage plan offered by the trustee. (b) The employee is not required to continue participation in...
- Texas Section 1579.204 - Certain Part-time Employees
A part-time employee of a participating entity who is not a participating member in the Teacher Retirement System of Texas is eligible to participate in...
SUBCHAPTER F CONTRIBUTIONS
- Texas Section 1579.205 - Payment By Participating Entity
Notwithstanding Section 1579.204, a participating entity may pay any portion of what otherwise would be the employee share of premiums and other costs associated with...
- Texas Section 1579.251 - State Assistance
(a) The state shall assist employees of participating school districts and charter schools in the purchase of group health coverage under this chapter by providing...
- Texas Section 1579.252 - Contribution By Participating Entities
A participating entity shall make contributions for the program as provided by Chapter 1581. Added by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.471(a), eff....
- Texas Section 1579.253 - Contribution By Employee
(a) An employee covered by the program shall pay that portion of the cost of coverage selected by the employee that exceeds the amount of...
- Texas Section 1579.254 - Contributions Held In Trust For Fund
A participating entity: (1) shall hold contributions required by this subchapter in trust for the Texas school employees uniform group coverage trust fund and its...
SUBCHAPTER G TEXAS SCHOOL EMPLOYEES UNIFORM GROUP COVERAGE TRUST FUND
- Texas Section 1579.255 - Interest Assessed On Late Payment Of Contributions By Participating Entities
(a) A participating entity that does not remit to the trustee all contributions required by this subchapter before the seventh day after the last day...
- Texas Section 1579.301 - Fund; Administration
The Texas school employees uniform group coverage trust fund is a trust fund with the comptroller. Added by Acts 2003, 78th Leg., ch. 1276, Sec....
- Texas Section 1579.302 - Composition Of Fund
The fund is composed of: (1) all contributions made to the fund under this chapter from employees, participating entities, and the state; (2) contributions made...
- Texas Section 1579.303 - Payments From Fund
The trustee may use amounts in the fund only to provide group coverages under this chapter and to pay the expenses of administering the program....
- Texas Section 1579.304 - Investment Of Fund
The trustee may invest assets of the fund in the manner provided by Section 67(a)(3), Article XVI, Texas Constitution. Added by Acts 2003, 78th Leg.,...
Last modified: September 28, 2016