Sec. 1551.216. SPECIAL CONTINGENCY RESERVE. (a) A carrier issuing a group coverage plan under this chapter shall hold as a special contingency reserve an amount that equals the amount by which the amount described by Section 1551.215(c)(1) exceeds the sum of the amounts described by Sections 1551.215(c)(2) and (3).
(b) The carrier may use the special contingency reserve only for charges, claims, and expenses under the plan.
(c) The special contingency reserve earns interest at a rate determined before each plan year by the carrier and approved by the board of trustees as consistent with the rates generally used by the carrier for similar funds held under other group coverage plans.
(d) On a determination by the board of trustees that the special contingency reserve has attained an amount estimated by the board to make satisfactory provision for adverse fluctuations in future charges, claims, or expenses under the plan, any further excess shall be deposited to the credit of the employees life, accident, and health insurance and benefits fund.
(e) On discontinuation of a plan, any balance remaining in the special contingency reserve after all charges have been made shall be deposited to the credit of the employees life, accident, and health insurance and benefits fund. The carrier may make the deposit in equal monthly installments over a period of not more than two years.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003.
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
Section 1551.201. Establishment
Section 1551.2011. Employee Awareness and Education
Section 1551.202. Authority to Define Basic Coverages
Section 1551.203. Authority to Define Optional Coverages
Section 1551.204. Authority to Define Voluntary Coverages
Section 1551.206. Cafeteria Plan
Section 1551.207. Premium Conversion Benefit Portion of Cafeteria Plan
Section 1551.208. Determination to Self-Fund
Section 1551.209. Coverage Exempt From Insurance Law
Section 1551.210. Actuarial Advice for Self-Funded Coverage
Section 1551.211. Contingency Reserve Fund for Self-Funded Coverage
Section 1551.212. Firms to Administer Self-Funded Coverage
Section 1551.213. Bids for Purchased Coverage
Section 1551.214. Selection of Bids for Purchased Coverage
Section 1551.215. Accounting by Carrier Providing Purchased Coverage
Section 1551.216. Special Contingency Reserve
Section 1551.217. Use of Employee's Salary in Computation of Premium or Coverage
Section 1551.218. Prior Authorization for Certain Drugs
Section 1551.219. Disease Management Services
Section 1551.220. Beneficiary Causing Death of Participant or Beneficiary of Participant
Section 1551.222. Incentive Payments
Section 1551.224. Mail Order Requirement for Prescription Drug Coverage Prohibited
Section 1551.225. Bariatric Surgery Coverage
Section 1551.226. Tobacco Cessation Coverage
Section 1551.227. Tricare Military Health System Supplemental Plan
Section 1551.228. Emergency Care Payments
Section 1551.229. Out-of-Network Facility-Based Provider Payments
Section 1551.230. Out-of-Network Diagnostic Imaging Provider or Laboratory Service Provider Payments