Sec. 1551.064. CERTAIN GROUP HEALTH AND ACCIDENT POLICIES OR CONTRACTS. (a) This section applies only to a group policy or contract described by Section 1251.301. A policy or contract executed under this chapter must provide that:
(1) premium payments must be:
(A) paid directly to the Employees Retirement System of Texas; and
(B) postmarked or received not later than the 10th day of the month for which the premium is due;
(2) the premium for group continuation coverage under Subchapter G, Chapter 1251, may not exceed the level established for other surviving dependents of deceased employees and annuitants;
(3) at the time the group policy or contract is delivered, issued for delivery, renewed, amended, or extended, the Employees Retirement System of Texas shall give notice of the continuation option to each state agency covered by the group benefits program; and
(4) each state agency shall give written notice of the continuation option to each employee and dependent of an employee who is covered by the group benefits program.
(b) A group policy or contract executed under this chapter must provide that, not later than the 15th day after the date of any severance of the family relationship that might activate the continuation option under Subchapter G, Chapter 1251, the group member shall give written notice of the severance to the employing state agency.
(c) On receipt of notice under Subsection (b) or on the death of an employee, the employing state agency shall give written notice of the continuation option to each affected dependent. The notice must state the amount of the premium to be charged and must be accompanied by any necessary enrollment forms.
(d) A covered dependent must exercise the continuation option not later than the 45th day after the date of:
(1) the severance of the family relationship; or
(2) the retirement or death of the group member.
(e) A covered dependent must provide written notice of the exercise of the continuation option to the employing state agency within the time prescribed by Subsection (d). Coverage under the policy or contract remains in effect during the period prescribed by Subsection (d) if the premiums are paid.
(f) Any period of previous coverage under the policy or contract must be used in full or partial satisfaction of any required probationary or waiting periods provided in the policy or contract for dependent coverage.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2G.019, eff. April 1, 2009.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Subtitle H - Health Benefits and Other Coverages for Governmental Employees
Chapter 1551 - Texas Employees Group Benefits Act
Subchapter B. Administration and Implementation
Section 1551.051. Administration and Implementation
Section 1551.052. Authority for Rules, Plans, Procedures, and Orders
Section 1551.053. Authority to Hire Employees
Section 1551.055. General Powers of Board of Trustees Regarding Coverage Plans
Section 1551.056. Independent Administrator
Section 1551.057. Compensation of Person Employed by Board of Trustees
Section 1551.058. Electronic Authorizations
Section 1551.059. Certificate of Coverage
Section 1551.060. Identification Cards
Section 1551.061. Annual Report
Section 1551.062. Information on Operation and Administration of Chapter
Section 1551.063. Confidentiality of Certain Records
Section 1551.064. Certain Group Health and Accident Policies or Contracts
Section 1551.065. Disclosure of Social Security Number
Section 1551.066. Information Relating to Misconduct