Sec. 1575.153. HEALTH BENEFIT PLAN COVERAGE FOR RETIREES. (a) A retiree who applies for coverage during an enrollment period may not be denied coverage in a health benefit plan provided under this chapter for which the retiree is eligible unless the trustee finds under Subchapter K that the retiree defrauded or attempted to defraud the group program.
(b) A retiree who has coverage under a health benefit plan offered under the group program shall pay a monthly contribution, as determined by the trustee.
(c) As a condition of electing coverage under a health benefit plan, the retiree must, in writing, authorize the trustee to deduct the amount of the contribution from the retiree's monthly annuity payment. The trustee shall deduct the contribution in the manner and form determined by the trustee.
(d) Notwithstanding Subsection (b), a retiree is not required to pay a monthly contribution under this section until the 2022 plan year if the retiree:
(1) has taken a disability retirement under the Teacher Retirement System of Texas on or before January 1, 2017;
(2) is receiving disability retirement benefits from the Teacher Retirement System of Texas; and
(3) is not eligible to enroll in Medicare.
(e) This subsection and Subsection (d) expire at the end of the 2021 plan year on December 31, 2021.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1, 2003. Amended by Acts 2003, 78th Leg., ch. 201, Sec. 49(a), eff. Sept. 1, 2003; Acts 2003, 78th Leg., ch. 1231, Sec. 3(a), eff. Sept. 1, 2004; Acts 2003, 78th Leg., ch. 1276, Sec. 10A.426(a), eff. Sept. 1, 2003.
Amended by:
Acts 2017, 85th Leg., R.S., Ch. 712 (H.B. 3976), Sec. 6, eff. September 1, 2017.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Subtitle H - Health Benefits and Other Coverages for Governmental Employees
Chapter 1575 - Texas Public School Employees Group Benefits Program
Subchapter D. Coverages and Participation
Section 1575.151. Types of Coverages
Section 1575.152. Health Benefit Plan Must Cover Preexisting Conditions
Section 1575.153. Health Benefit Plan Coverage for Retirees
Section 1575.155. Coverage for Dependents of Retiree
Section 1575.156. Coverage for Surviving Spouse or Dependents of Surviving Spouse
Section 1575.157. Coverage for Surviving Dependent Child
Section 1575.158. Group Health Benefit Plans
Section 1575.1582. Eligibility for Group Health Benefit Plans
Section 1575.159. Coverage for Prostate-Specific Antigen Test
Section 1575.160. Group Life or Accidental Death and Dismemberment Insurance: Payment of Claim
Section 1575.161. Enrollment Periods
Section 1575.162. Special Enrollments
Section 1575.164. Disease Management Services
Section 1575.170. Prior Authorization for Certain Drugs
Section 1575.171. Emergency Care Payments
Section 1575.172. Out-of-Network Facility-Based Provider Payments
Section 1575.173. Out-of-Network Diagnostic Imaging Provider or Laboratory Service Provider Payments