Texas Statutes
Subtitle H - Health Benefits and Other Coverages for Governmental Employees
Chapter 1579 - Texas School Employees Uniform Group Health Coverage

Section 1579.001. Short Title - Sec. 1579.001. SHORT TITLE. This chapter may be cited as...

Section 1579.002. General Definitions - Sec. 1579.002. GENERAL DEFINITIONS. In this chapter: (1) "Administering firm"...

Section 1579.003. Definition of Employee - Sec. 1579.003. DEFINITION OF EMPLOYEE. In this chapter, "employee" means...

Section 1579.004. Definition of Dependent - Sec. 1579.004. DEFINITION OF DEPENDENT. In this chapter, "dependent" means:...

Section 1579.005. Confidentiality - Sec. 1579.005. CONFIDENTIALITY. (a) Section 825.507, Government Code, applies to...

Section 1579.006. Exemption From Process - Sec. 1579.006. EXEMPTION FROM PROCESS. (a) The following are exempt...

Section 1579.007. Exemption From State Taxes and Fees - Sec. 1579.007. EXEMPTION FROM STATE TAXES AND FEES. A premium...

Section 1579.008. Coverage Exempt From Insurance Law - Sec. 1579.008. COVERAGE EXEMPT FROM INSURANCE LAW. A coverage plan...

Section 1579.009. Balance Billing Prohibition Notice - Sec. 1579.009. BALANCE BILLING PROHIBITION NOTICE. (a) The administrator of...

Section 1579.010. Information Regarding Appeals - Sec. 1579.010. INFORMATION REGARDING APPEALS. The trustee shall develop and...

Subchapter B. Administration

Section 1579.051. Administration of Group Program - Sec. 1579.051. ADMINISTRATION OF GROUP PROGRAM. The Teacher Retirement System...

Section 1579.052. Authority to Adopt Rules; Other Authority - Sec. 1579.052. AUTHORITY TO ADOPT RULES; OTHER AUTHORITY. (a) The...

Section 1579.053. Personnel - Sec. 1579.053. PERSONNEL. The trustee may hire and compensate employees...

Section 1579.054. Competitive Bidding Requirements; Rules - Sec. 1579.054. COMPETITIVE BIDDING REQUIREMENTS; RULES. A contract to provide...

Section 1579.055. Contract Award; Considerations - Sec. 1579.055. CONTRACT AWARD; CONSIDERATIONS. (a) In awarding a contract...

Section 1579.057. Pharmacy Benefit Manager Contracts - Sec. 1579.057. PHARMACY BENEFIT MANAGER CONTRACTS. (a) In awarding a...

Subchapter C. Coverages

Section 1579.101. Plans of Group Coverages - Sec. 1579.101. PLANS OF GROUP COVERAGES. (a) The trustee by...

Section 1579.102. Catastrophic Care Coverage Plan - Sec. 1579.102. CATASTROPHIC CARE COVERAGE PLAN. The coverage provided under...

Section 1579.104. Optional Coverages - Sec. 1579.104. OPTIONAL COVERAGES. The trustee may not offer optional...

Section 1579.1045. Alternative Group Health Coverage Prohibited - Sec. 1579.1045. ALTERNATIVE GROUP HEALTH COVERAGE PROHIBITED. Notwithstanding any other...

Section 1579.105. Preexisting Condition Limitation - Sec. 1579.105. PREEXISTING CONDITION LIMITATION. During the initial period of...

Section 1579.106. Prior Authorization for Certain Drugs - Sec. 1579.106. PRIOR AUTHORIZATION FOR CERTAIN DRUGS. (a) In this...

Section 1579.1061. Exemption From Preauthorization Requirements for Physicians and Health Care Providers Providing Certain Health Care Services - Sec. 1579.1061. EXEMPTION FROM PREAUTHORIZATION REQUIREMENTS FOR PHYSICIANS AND HEALTH...

Section 1579.107. Disease Management Services - Sec. 1579.107. DISEASE MANAGEMENT SERVICES. (a) In this section, "disease...

Section 1579.108. Limitations - Sec. 1579.108. LIMITATIONS. The trustee may not contract for or...

Section 1579.109. Emergency Care Payments - Sec. 1579.109. EMERGENCY CARE PAYMENTS. (a) In this section, "emergency...

Section 1579.110. Out-of-Network Facility-Based Provider Payments - Sec. 1579.110. OUT-OF-NETWORK FACILITY-BASED PROVIDER PAYMENTS. (a) In this section,...

Section 1579.111. Out-of-Network Diagnostic Imaging Provider or Laboratory Service Provider Payments - Sec. 1579.111. OUT-OF-NETWORK DIAGNOSTIC IMAGING PROVIDER OR LABORATORY SERVICE PROVIDER...

Subchapter D. Participating Entities

Section 1579.151. Required Participation of School Districts With 500 or Fewer Employees - Sec. 1579.151. REQUIRED PARTICIPATION OF SCHOOL DISTRICTS WITH 500 OR...

Section 1579.152. Participation of Other School Districts - Sec. 1579.152. PARTICIPATION OF OTHER SCHOOL DISTRICTS. Effective September 1,...

Section 1579.153. Participation by Certain Risk Pools - Sec. 1579.153. PARTICIPATION BY CERTAIN RISK POOLS. (a) In determining...

Section 1579.154. Participation by Charter Schools; Eligibility - Sec. 1579.154. PARTICIPATION BY CHARTER SCHOOLS; ELIGIBILITY. (a) A charter...

Section 1579.155. Program Participation: Election - Sec. 1579.155. PROGRAM PARTICIPATION: ELECTION. (a) Effective September 1, 2022,...

Subchapter E. Participation by Employee

Section 1579.201. Definition - Sec. 1579.201. DEFINITION. In this subchapter, "full-time employee" and "part-time...

Section 1579.202. Eligible Employees - Sec. 1579.202. ELIGIBLE EMPLOYEES. (a) Except as provided by Section...

Section 1579.203. Selection of Coverage - Sec. 1579.203. SELECTION OF COVERAGE. (a) A participating employee may...

Section 1579.204. Certain Part-Time Employees - Sec. 1579.204. CERTAIN PART-TIME EMPLOYEES. A part-time employee of a...

Section 1579.205. Payment by Participating Entity - Sec. 1579.205. PAYMENT BY PARTICIPATING ENTITY. Notwithstanding Section 1579.204, a...

Subchapter F. Contributions

Section 1579.251. State Assistance - Sec. 1579.251. STATE ASSISTANCE. (a) The state shall assist employees...

Section 1579.252. Contribution by Participating Entities - Sec. 1579.252. CONTRIBUTION BY PARTICIPATING ENTITIES. A participating entity shall...

Section 1579.253. Contribution by Employee - Sec. 1579.253. CONTRIBUTION BY EMPLOYEE. (a) An employee covered by...

Section 1579.254. Contributions Held in Trust for Fund - Sec. 1579.254. CONTRIBUTIONS HELD IN TRUST FOR FUND. A participating...

Section 1579.255. Interest Assessed on Late Payment of Contributions by Participating Entities - Sec. 1579.255. INTEREST ASSESSED ON LATE PAYMENT OF CONTRIBUTIONS BY...

Subchapter G. Texas School Employees Uniform Group Coverage Trust Fund

Section 1579.301. Fund; Administration - Sec. 1579.301. FUND; ADMINISTRATION. The Texas school employees uniform group...

Section 1579.302. Composition of Fund - Sec. 1579.302. COMPOSITION OF FUND. The fund is composed of:...

Section 1579.303. Payments From Fund - Sec. 1579.303. PAYMENTS FROM FUND. The trustee may use amounts...

Section 1579.304. Investment of Fund - Sec. 1579.304. INVESTMENT OF FUND. The trustee may invest assets...

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Texas Statutes Subtitle H - Health Benefits and Other Coverages for Governmental Employees Chapter 1579 - Texas School Employees Uniform Group Health Coverage

Texas Statutes
Subtitle H - Health Benefits and Other Coverages for Governmental Employees
Chapter 1579 - Texas School Employees Uniform Group Health Coverage