Sec. 1501.605. MINIMUM CONTRIBUTION OR PARTICIPATION REQUIREMENTS. (a) A large employer health benefit plan issuer may require a large employer to meet a minimum contribution or participation requirement as a condition of issuance or renewal in accordance with the issuer's usual and customary practices for all the issuer's employer health benefit plans in this state.
(b) A participation requirement may determine the percentage of eligible employees who meet the participation criteria and who must be enrolled in the health benefit plan.
(c) A large employer health benefit plan issuer may apply a participation requirement to a large employer's eligible employees, but may not apply the requirement to eligible dependents of those employees.
(d) A participation requirement must be stated in the health benefit plan contract and must be applied uniformly to each large employer offered or issued coverage by a large employer health benefit plan issuer in this state.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Subtitle G - Health Coverage Availability
Chapter 1501 - Health Insurance Portability and Availability Act
Subchapter M. Large Employer Health Benefit Plans
Section 1501.601. Participation Criteria
Section 1501.602. Coverage Requirements
Section 1501.603. Exclusion of Eligible Employee or Dependent Prohibited
Section 1501.604. Declining Coverage
Section 1501.605. Minimum Contribution or Participation Requirements
Section 1501.606. Employee Enrollment; Waiting Period
Section 1501.607. Coverage for Newborn Children
Section 1501.608. Coverage for Adopted Children
Section 1501.609. Coverage for Unmarried Children
Section 1501.610. Premium Rates; Adjustments
Section 1501.611. Marketing Requirements
Section 1501.612. Encouraging Exclusion of Employee Prohibited
Section 1501.615. Additional Reporting Requirements
Section 1501.616. Applicability to Third-Party Administrator