CHAPTER 1551. TEXAS EMPLOYEES GROUP BENEFITS ACT
INSURANCE CODE
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 A. GENERAL PROVISIONS
Sec. 1551.001. SHORT TITLE. This chapter may be cited as the
Texas Employees Group Benefits Act.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.002. PURPOSES. The purposes of this chapter are to:
(1) provide uniformity in life, accident, and health benefit
coverages for all state officers and employees and their
dependents;
(2) enable the state to attract and retain competent and able
employees by providing employees and their dependents with life,
accident, and health benefit coverages at least equal to those
commonly provided in private industry;
(3) foster, promote, and encourage employment by and service to
the state as a career profession for individuals of high
standards of competence and ability;
(4) recognize and protect the state's investment in each
permanent employee by promoting and preserving economic security
and good health among employees and their dependents;
(5) foster and develop high standards of employer-employee
relationships between the state and its employees;
(6) recognize the long and faithful service and dedication of
state officers and employees and encourage them to remain in
state service until eligible for retirement by providing health
benefits for them and their dependents; and
(7) recognize the service to the state by employees and retired
employees of community supervision and corrections departments by
extending to them and their dependents the same life, accident,
and health benefit coverages as those provided under this chapter
to state employees, retired state employees, and their
dependents.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003. Amended by Acts 2003, 78th Leg., ch. 1030, Sec. 1.01, eff.
Sept. 1, 2003.
Sec. 1551.003. GENERAL DEFINITIONS. In this chapter:
(1) "Administering firm" means a firm designated by the board of
trustees to administer coverages, services, benefits, or
requirements in accordance with this chapter and the rules
adopted by the board of trustees under this chapter.
(2) "Annuitant" means an individual eligible to participate in
the group benefits program under Section 1551.102.
(3) "Basic coverage" means the group coverage plans determined
by the board of trustees in which each eligible full-time
employee and annuitant participates automatically unless
participation is specifically waived.
(4) "Board of trustees" means the board of trustees established
under Chapter 815, Government Code, to administer the Employees
Retirement System of Texas.
(5) "Cafeteria plan" means a plan defined and authorized by
Section 125, Internal Revenue Code of 1986.
(6) "Employee" means an individual eligible to participate in
the group benefits program under Section 1551.101.
(7) "Employer" means this state and its agencies.
(8) "Executive director" means the executive director of the
Employees Retirement System of Texas.
(9) "Full-time employee" means an employee designated as a
full-time employee under Section 1551.319(c) or (d) or an
employee designated by the employer as working 40 or more hours a
week.
(9-a) "Good cause" means that a person's failure to act was not
because of a lack of due diligence the exercise of which would
have caused a reasonable person to take prompt and timely action.
A failure to act based on ignorance of the law or facts
reasonably discoverable through the exercise of due diligence
does not constitute good cause.
(10) "Group benefits program" means the state employees group
benefits program provided by this chapter.
(10-a) "Participant" means an eligible individual who
participates in the group benefits program.
(11) "Part-time employee" means an employee designated by the
employer as working less than 40 hours a week. For purposes of
this chapter, an individual described by Section 1551.101(e)(2)
is considered a part-time employee.
(12) "Serious mental illness" has the meaning assigned by
Section 1355.001.
(13) "Service" means personal service to the state creditable in
accordance with rules adopted by the board of trustees.
(14) "State agency" means a commission, board, department,
division, institution of higher education, or other agency of
this state created by the constitution or statutes of this state.
The term also includes the Texas Municipal Retirement System and
the Texas County and District Retirement System.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003. Amended by Acts 2003, 78th Leg., ch. 366, Sec. 2.01, eff.
Sept. 1, 2003.
Amended by:
Acts 2005, 79th Leg., Ch.
347, Sec. 24, eff. September 1, 2005.
Acts 2007, 80th Leg., R.S., Ch.
730, Sec. 2G.018, eff. April 1, 2009.
Acts 2009, 81st Leg., R.S., Ch.
1308, Sec. 31, eff. September 1, 2009.
Sec. 1551.004. DEFINITION OF DEPENDENT. (a) In this chapter,
"dependent" with respect to an individual eligible to participate
in the group benefits program under Section 1551.101 or 1551.102
means the individual's:
(1) spouse;
(2) unmarried child younger than 25 years of age;
(3) child of any age who the board of trustees determines lives
with or has the child's care provided by the individual on a
regular basis if:
(A) the child is mentally retarded or physically incapacitated
to the extent that the child is dependent on the individual for
care or support, as determined by the board of trustees;
(B) the child's coverage under this chapter has not lapsed; and
(C) the child is at least 25 years old and was enrolled as a
participant in the health benefits coverage under the group
benefits program on the date of the child's 25th birthday;
(4) child of any age who is unmarried, for purposes of health
benefit coverage under this chapter, on expiration of the child's
continuation coverage under the Consolidated Omnibus Budget
Reconciliation Act of 1985 (Pub. L. No. 99-272) and its
subsequent amendments; and
(5) ward, as that term is defined by Section 601, Texas Probate
Code.
(b) In this section, "child" includes:
(1) a natural child, adopted child, stepchild, or foster child;
or
(2) a child who is related by blood or marriage and was claimed
as a dependent on the federal income tax return of an individual
who is eligible to participate in the group benefits program
under Section 1551.101 or 1551.102 for the calendar year
preceding the plan year in which the child is first enrolled as a
dependent under Subchapter D, and for each subsequent year in
which the child is enrolled as a dependent.
(c) The requirement in Subsection (b)(2) that a child must be
claimed as a dependent on a federal income tax return in the
calendar year preceding the child's enrollment does not apply if:
(1) the child is born in the year in which the child is first
enrolled; or
(2) the participant can demonstrate good cause for not claiming
the child as a dependent in the preceding calendar year.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003. Amended by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.401(a),
eff. Sept. 1, 2003.
Amended by:
Acts 2009, 81st Leg., R.S., Ch.
1308, Sec. 32, eff. September 1, 2009.
Sec. 1551.005. DEFINITION OF HEALTH BENEFIT PLAN. (a) In this
chapter, "health benefit plan" means a plan that provides, pays
for, or reimburses expenses for health care services, including
comparable health care services for participants who rely solely
on spiritual means through prayer for healing in accordance with
the teaching of a well-recognized church or denomination.
(b) A health benefit plan shall be provided on a group basis
through:
(1) a policy or contract;
(2) a medical, dental, or hospital service agreement;
(3) a membership or subscription contract;
(4) a salary continuation plan;
(5) a health maintenance organization agreement;
(6) a preferred provider arrangement; or
(7) any other similar group arrangement or a combination of
policies, plans, contracts, agreements, or arrangements described
by this subsection.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.006. DEFINITION OF INSTITUTION OF HIGHER EDUCATION.
(a) In this chapter, except as provided by Subsection (b),
"institution of higher education" means a public junior college,
a senior college or university, or any other agency of higher
education within the meaning and jurisdiction of Chapter 61,
Education Code.
(b) In this chapter, "institution of higher education" does not
include:
(1) an entity in The University of Texas System, as described by
Section 65.02, Education Code; and
(2) an entity in The Texas A&M University System, as
described by Subtitle D, Title 3, Education Code, including the
Texas Veterinary Medical Diagnostic Laboratory.
(c) Notwithstanding Subsection (b), The Texas A&M University
System, including the Texas Veterinary Medical Diagnostic
Laboratory, participates in the group benefits program if, not
later than November 1, 2004, the system notifies the board of
trustees of the system's election to participate. If notice is
provided as required by this subsection, the employees and
annuitants of the system, including the veterinary medical
laboratory, and the dependents of those employees and annuitants,
participate in the group benefits program effective not later
than September 1, 2005.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003. Amended by Acts 2003, 78th Leg., ch. 366, Sec. 2.02, eff.
Sept. 1, 2003.
Sec. 1551.007. DEFINITION OF CARRIER. In this chapter,
"carrier" means:
(1) an insurance company that is authorized by the department
under this code or another insurance law of this state to provide
any of the types of insurance coverages, benefits, or services
provided for in this chapter and that:
(A) has a surplus of $1 million;
(B) has a successful operating history; and
(C) has had successful experience, as determined by the
department, in providing and servicing any of the types of group
coverage provided for in this chapter;
(2) a corporation operating under Chapter 842 or 843 that
provides any of the types of coverage, benefits, or services
provided for in this chapter and that:
(A) has a successful operating history; and
(B) has had successful experience, as determined by the
department, in providing and servicing any of the types of group
coverage provided for in this chapter; or
(3) any combination of carriers described by Subdivisions (1)
and (2) on terms the board of trustees prescribes.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003. Amended by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.402,
eff. Sept. 1, 2003.
Sec. 1551.008. APPLICABILITY OF DEFINITIONS. The definition of
a term defined by this subchapter and the use of the terms
"employee" and "annuitant" to refer to individuals eligible to
participate in the group benefits program under Sections 1551.101
and 1551.102 apply to this chapter unless a different meaning is
plainly required by the context in which the term appears.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.009. BOARD OF TRUSTEES MAY DEFINE OTHER WORDS. The
board of trustees may define by rule a word in terms necessary in
the administration of this chapter.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.010. BOARD OF TRUSTEES APPROVAL FOR PAYROLL DEDUCTIONS
OR REDUCTIONS. A state agency may not establish, continue, or
authorize payroll deductions or reductions for any benefit or
coverage as provided by this chapter without the express approval
of the board of trustees.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.011. EXEMPTION FROM EXECUTION. All benefit payments,
contributions of employees and annuitants, and optional benefit
payments, any rights, benefits, or payments accruing to a person
under this chapter, and all money in a fund created by this
chapter:
(1) are exempt from execution, attachment, garnishment, or any
other process; and
(2) may not be assigned, except:
(A) for direct payment that a participant may assign to a
provider of health care services; and
(B) as specifically provided by this chapter.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.012. EXEMPTION FROM STATE TAXES AND FEES. Any
coverage established under this chapter, including a policy, an
insurance contract, a certificate of coverage, an evidence of
coverage, and an agreement with a health maintenance organization
or a plan administrator, is not subject to any state tax,
regulatory fee, or surcharge, including a premium or maintenance
tax or fee.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.013. COMBINING OF CARRIERS NOT RESTRAINT OF TRADE.
Carriers combining to bid, underwrite, or both bid and underwrite
for the group benefits program are not in violation of Chapter
15, Business & Commerce Code.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.014. EXCLUSIVE REMEDIES. The remedies provided under
this chapter are the exclusive remedies available to an employee,
participant, annuitant, or dependent.
Added by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.403(a), eff.
Sept. 1, 2003.
SUBCHAPTER B. ADMINISTRATION AND IMPLEMENTATION
Sec. 1551.051. ADMINISTRATION AND IMPLEMENTATION. The
administration and implementation of this chapter are vested
solely in the board of trustees.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.052. AUTHORITY FOR RULES, PLANS, PROCEDURES, AND
ORDERS. (a) The board of trustees may adopt rules consistent
with this chapter as it considers necessary to implement this
chapter and its purposes, including rules that provide standards
for determining eligibility for participation in the group
benefits program, including standards for determining disability.
(b) The board of trustees may adopt a plan, procedure, or order
reasonably necessary to implement this chapter and its purposes.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.053. AUTHORITY TO HIRE EMPLOYEES. (a) The board of
trustees may hire employees as the board considers necessary to
ensure the proper administration of this chapter and the
coverages, services, and benefits provided for or authorized by
this chapter.
(b) The board of trustees shall determine and assign the
compensation and duties of the employees.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.055. GENERAL POWERS OF BOARD OF TRUSTEES REGARDING
COVERAGE PLANS. The board of trustees may:
(1) prepare specifications for a coverage provided under this
chapter;
(2) prescribe the time and conditions under which an employee,
annuitant, or dependent is eligible for a coverage provided under
this chapter;
(3) determine the methods and procedures of claims
administration;
(4) determine the amount of payroll deductions and reductions
applicable to employees and annuitants and establish procedures
to implement those deductions and reductions;
(5) establish procedures for the board of trustees to decide
contested cases arising from a coverage provided under this
chapter;
(6) study, on an ongoing basis, the operation of all coverages
provided under this chapter, including gross and net costs,
administration costs, benefits, utilization of benefits, and
claims administration;
(7) administer the employees life, accident, and health
insurance and benefits fund;
(8) provide the beginning and ending dates of coverages of
participants under all benefit plans;
(9) develop basic group coverage plans applicable to all
individuals eligible to participate in the group benefits program
under Sections 1551.101 and 1551.102;
(10) provide for optional group coverage plans in addition to
the basic group coverage plans;
(11) provide, as the board of trustees determines is
appropriate, either additional statewide optional coverage plans
or individual agency coverage plans;
(12) develop health benefit plans that permit access to
high-quality, cost-effective health care;
(13) design, implement, and monitor health benefit plan features
intended to discourage excessive utilization, promote efficiency,
and contain costs;
(14) develop and refine, on an ongoing basis, a health benefit
strategy consistent with evolving benefit delivery systems;
(15) develop a funding strategy that efficiently uses employer
contributions to achieve the purposes of this chapter and that is
reasonable and ensures participants a fair choice among health
benefit plans as provided by Section 1551.302; and
(16) appoint an advisory committee for the group benefits
program under the terms provided by Section 815.509, Government
Code.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003. Amended by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.406(a),
eff. Sept. 1, 2003.
Sec. 1551.056. INDEPENDENT ADMINISTRATOR. (a) The board of
trustees may, on a competitive bid basis, contract with an entity
to act for the board as an independent administrator or manager
of the coverages, services, and benefits authorized under this
chapter.
(b) The entity must be a qualified, experienced firm of group
insurance specialists or an administering firm and shall assist
the board of trustees in ensuring the proper administration of
this chapter and the coverages, services, and benefits provided
for or authorized by this chapter.
(c) The board of trustees shall pay an independent administrator
selected under this section.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.057. COMPENSATION OF PERSON EMPLOYED BY BOARD OF
TRUSTEES. The board of trustees shall pay the compensation and
expenses of a person employed by the board at the rate or in the
amount approved by the board. The rate or amount may not exceed
the rate or amount paid for similar services.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.058. ELECTRONIC AUTHORIZATIONS. (a) The board of
trustees may develop a system for a participant to electronically
authorize:
(1) enrollment in a coverage or benefit;
(2) contributions to a coverage or benefit; and
(3) deductions or reductions to the participant's compensation
or annuity for participation in a coverage or benefit.
(b) Notwithstanding any other law, the board of trustees may
permit or require an authorization covered by Subsection (a) to
be made electronically.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.059. CERTIFICATE OF COVERAGE. The board of trustees
shall provide for issuance to each employee or annuitant
participating in the group benefits program a certificate of
coverage that states:
(1) the benefits to which the participant is entitled;
(2) to whom the benefits are payable;
(3) to whom a claim must be submitted; and
(4) the provisions of the plan document, in summary form, that
principally affect the participant.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.060. IDENTIFICATION CARDS. (a) The board of trustees
may issue a single identification card to a participant in a
health benefit plan and separately administered coverage under
this chapter that offers pharmacy benefits.
(b) The card may contain information regarding both health and
pharmacy benefits.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.061. ANNUAL REPORT. The board of trustees shall
submit a written report not later than January 1 of each year to
the governor, lieutenant governor, speaker of the house of
representatives, and Legislative Budget Board concerning the
coverages provided and the benefits and services being received
by all participants under this chapter. The report must include
information about the effectiveness and efficiency of:
(1) managed care cost containment practices; and
(2) fraud detection and prevention procedures.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.062. INFORMATION ON OPERATION AND ADMINISTRATION OF
CHAPTER. (a) The board of trustees shall:
(1) conduct a continuing study of the operation and
administration of this chapter, including:
(A) conducting surveys and preparing reports on group coverages
and benefits available to participants; and
(B) studying experience relating to group coverages and benefits
available to participants; and
(2) maintain statistics on the number, type, and disposition of
fraudulent claims for benefits under this chapter.
(b) A contract entered into under this chapter must require a
carrier to:
(1) furnish any reasonable report the board of trustees
determines is necessary to enable the board to perform its
functions under this chapter; and
(2) permit the board and a representative of the state auditor
to examine records of the carrier as necessary to accomplish the
purposes of this chapter.
(c) Each state agency shall keep records, make certifications,
and furnish the board of trustees with information and reports
necessary to enable the board to perform its functions under this
chapter.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.063. CONFIDENTIALITY OF CERTAIN RECORDS. (a) The
records of a participant in the group benefits program in the
custody of the Employees Retirement System of Texas, or of an
administering firm, carrier, or another governmental entity
acting on behalf of the retirement system, are confidential and
not subject to disclosure, and the retirement system,
administering firm, carrier, or governmental entity is not
required to accept or comply with a request for a record or
information about a record or to seek an opinion from the
attorney general, because the records are exempt from the
provisions of Chapter 552, Government Code, except as provided by
this section.
(b) The records may be released to a participant or to an
authorized attorney, family member, or representative acting on
behalf of the participant.
(c) To accomplish the purposes of this chapter, the board of
trustees may release the records to:
(1) an administering firm, carrier, agent, or attorney acting on
behalf of the board;
(2) another governmental entity having a legitimate need for the
information to perform a function of the board of trustees;
(3) an authorized medical provider of the participant; or
(4) a party in response to a subpoena issued under applicable
law.
(d) The records of a participant remain confidential after
release to a person as authorized by this section.
(d-1) A record released or received by the Employees Retirement
System of Texas under this section may be transmitted
electronically, including through the use of an electronic
signature or certification in a form acceptable to the retirement
system. An unintentional disclosure to, or unauthorized access
by, a third party related to the transmission or receipt of
information under this section is not a violation by the
retirement system of any law, including a law or rule relating to
the protection of confidential information.
(e) The records of a participant may become part of the public
record of an administrative or judicial proceeding related to a
contested case under this chapter unless the records are closed
to public access by a protective order issued under applicable
law. If a participant's records have become part of the public
record of a proceeding and the records are not the subject of a
protective order, the participant is considered to have waived
the privacy of the participant's records.
(f) The Employees Retirement System of Texas has sole discretion
in determining if a record is subject to this section. For
purposes of this section, a record includes any identifying
information about a person, living or deceased, who is or was an
employee, annuitant, dependent, or participant in the group
benefits program.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003. Amended by Acts 2003, 78th Leg., ch. 1111, Sec. 33, eff.
Sept. 1, 2003; Acts 2003, 78th Leg., ch. 1276, Sec. 10A.404(a),
eff. Sept. 1, 2003.
Amended by:
Acts 2005, 79th Leg., Ch.
347, Sec. 25, eff. September 1, 2005.
Acts 2009, 81st Leg., R.S., Ch.
1308, Sec. 33, eff. September 1, 2009.
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, Sec. 2G.019, eff. April 1, 2009.
Sec. 1551.065. DISCLOSURE OF SOCIAL SECURITY NUMBER. The board
of trustees may require an individual to disclose the
individual's social security number as the board considers
necessary to properly administer this chapter and any coverage,
service, or benefit authorized by this chapter or as otherwise
required by state or federal law.
Added by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.404(b), eff.
Sept. 1, 2003.
Sec. 1551.066. INFORMATION RELATING TO MISCONDUCT. (a) This
section applies to:
(1) the Employees Retirement System of Texas;
(2) a carrier or other insurance company or health maintenance
organization;
(3) an administering firm or other insurance support
organization that provides information or services to the group
benefits program or the Employees Retirement System of Texas;
(4) an agent or third-party administrator authorized under this
chapter or licensed under this code;
(5) a regulatory authority or department; and
(6) a board member, executive director, employee, auditor, or
actuary of an entity described by this section.
(b) A person may collect from, furnish to, or exchange with
another person information, including medical records or other
confidential information, to the extent the person considers
necessary to detect or to impose a sanction for a criminal act, a
misrepresentation, or nondisclosure that is related to an attempt
to obtain coverage, payment, reimbursement, or a benefit under
this chapter.
(c) A person who acts under Subsection (b) is immune from suit
and criminal or civil liability unless the person acts with
malice or intent to defraud.
Added by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.405(a), eff.
Sept. 1, 2003.
Sec. 1551.067. PHARMACY BENEFIT MANAGER CONTRACTS. (a) In
awarding a contract to provide pharmacy benefit manager services
under this chapter, the board of trustees is not required to
select the lowest bid but must select a contract that meets the
criteria established by this section.
(b) The contract must state that:
(1) the board of trustees is entitled to audit the pharmacy
benefit manager to verify costs and discounts associated with
drug claims, pharmacy benefit manager compliance with contract
requirements, and services provided by subcontractors;
(2) the audit must be conducted by an independent auditor in
accordance with established auditing standards; and
(3) to conduct the audit, the board of trustees and the
independent auditor are entitled access to information related to
the services and the costs associated with the services performed
under the contract, including access to the pharmacy benefit
manager's facilities, records, contracts, medical records, and
agreements with subcontractors.
(c) The contract must define the information that the pharmacy
benefit manager is required to provide to the board of trustees
concerning the audit of the retail, independent, and mail order
pharmacies performing services under the contract and describe
how the results of these audits must be reported to the board of
trustees, including how often the results must be reported. The
contract must state whether the pharmacy benefit manager is
required to return recovered overpayments to the board of
trustees.
(d) The contract must state that any audit of a mail order
pharmacy owned by the pharmacy benefit manager must be conducted
by an independent auditor selected by the board of trustees in
accordance with established auditing standards.
Added by Acts 2009, 81st Leg., R.S., Ch.
1207, Sec. 3, eff. September 1, 2009.
SUBCHAPTER C. COVERAGE AND PARTICIPATION
Sec. 1551.101. PARTICIPATION ELIGIBILITY: STATE OFFICERS AND
EMPLOYEES. (a) An elected or appointed officer or employee who
performs service, other than as an independent contractor, for
this state, including an institution of higher education, and who
is described by this section is eligible to participate in the
group benefits program as an employee on the date specified by
Section 1551.1055.
(b) An individual is eligible to participate in the group
benefits program as provided by Subsection (a) if the individual
receives compensation for service performed for this state
pursuant to a payroll certified by a state agency, other than an
institution of higher education, or by an elected or appointed
officer of this state, including a payment made from:
(1) an amount appropriated by the legislature from a state fund;
(2) a trust fund held by the comptroller; or
(3) money paid under the official budget of a state agency,
other than money appropriated under a general appropriations act.
(c), (d) Repealed by Acts 2003, 78th Leg., ch. 366, Sec. 2.14.
(e) An individual is eligible to participate in the group
benefits program as provided by Subsection (a) if the individual
receives compensation for service performed for an institution of
higher education pursuant to a payroll certified by an
institution of higher education or by an elected or appointed
officer of this state and either:
(1) is eligible to become a member of the Teacher Retirement
System of Texas after any waiting period provided by law before
membership in that retirement system; or
(2) is employed at least 20 hours a week and is not permitted to
be a member of the Teacher Retirement System of Texas because the
individual is employed by an institution of higher education only
in a position that as a condition of employment requires the
individual to be enrolled as a student in the institution in
graduate-level courses.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003. Amended by Acts 2003, 78th Leg., ch. 366, Sec. 2.03, 2.14,
eff. Sept. 1, 2003.
Amended by:
Acts 2005, 79th Leg., Ch.
347, Sec. 26, eff. September 1, 2005.
Sec. 1551.102. PARTICIPATION ELIGIBILITY: ANNUITANTS. (a) An
individual who has at least 10 years of service credit, as
determined by the board of trustees, for which the individual was
eligible to participate in the group benefits program under
Section 1551.101 or who has at least five years of membership and
five years of military service credited in the Employees
Retirement System of Texas and who retires in a manner described
by this section is eligible, subject to Section 1551.1055, to
participate as an annuitant in the group benefits program.
(b) An individual is eligible to participate in the group
benefits program as provided by Subsection (a) if:
(1) the individual retires under the jurisdiction of the
Employees Retirement System of Texas; and
(2) the individual:
(A) receives or is eligible to receive an annuity under Section
814.104(a)(2), Government Code, and has at least 10 years of
eligible service credit;
(B) receives or is eligible to receive an annuity under Chapter
803 or Section 814.104(a)(1), Government Code, has at least 10
years of eligible service credit, and is at least 65 years of
age; or
(C) receives or is eligible to receive an annuity that is based
on eligibility under Section 814.002, 814.102, 814.104(b),
814.107(a), 834.101, or 839.101, Government Code.
(c) An individual is eligible to participate in the group
benefits program as provided by Subsection (a) if:
(1) the individual retires under the jurisdiction of the Teacher
Retirement System of Texas and has at least 10 years of eligible
service credit, including not more than five years of military
service credited in the Employees Retirement System of Texas, or
has five years of eligible service credit and is the sole
surviving spouse of military personnel who was killed in action;
(2) the individual:
(A) has accumulated eligible service credit in an amount so that
the sum of the person's age and amount of service credit,
including months of age and credit, equals or exceeds the number
80; or
(B) is at least 65 years of age; and
(3) the individual was employed, as the last state employment
before retirement, including employment by a public junior
college, by a state agency whose employees are authorized to
participate in the group benefits program.
(d) An individual is eligible to participate in the group
benefits program as provided by Subsection (a) if:
(1) the individual retires under the optional retirement program
established by Chapter 830, Government Code;
(2) the individual has at least 10 years of eligible service
credit; and
(3) the individual:
(A) is at least 65 years of age, or would have been eligible to
retire and receive a service or disability retirement annuity
from the Teacher Retirement System of Texas or the Employees
Retirement System of Texas in an amount such that the sum of the
person's age and amount of service credit, including months of
age and credit, equals or exceeds the number 80 or would have
been eligible to retire and receive a disability retirement
annuity from the Teacher Retirement System of Texas or the
Employees Retirement System of Texas, if the individual had not
elected to participate in the optional retirement program, and is
eligible to receive an annuity or periodic distribution of funds
from an account under the optional retirement program; or
(B) is disabled as determined by the Employees Retirement System
of Texas based on at least 10 years of eligible service credit,
and is receiving an annuity or periodic distribution of funds
from an account under the optional retirement program.
(e) An individual is eligible to participate in the group
benefits program as provided by Subsection (a) if the individual
retired under Subtitle C, Title 8, Government Code, before
September 1, 1991, with at least five and less than 10 years of
service credit.
(f) An individual is eligible to participate in the group
benefits program if the individual is certified and qualified as
disabled and receives or is eligible to receive an annuity under
Section 814.202, 814.207, 824.302, only as to higher education,
834.201, or 839.201, Government Code.
(g) An individual is eligible to participate in the group
benefits program as provided by Subsection (a) if the individual
is at least 65 years of age and retires under a federal or state
statutory retirement program not described by another provision
of this section, to which an institution of higher education has
made employer contributions, and the individual has met service
requirements, age requirements, and other applicable requirements
comparable to the requirements for retirement under the Teacher
Retirement System of Texas, based on at least 10 years of service
credit.
(h) A person eligible to participate and participating in the
group benefits program as an annuitant on September 1, 2003, may
continue to participate in the program as an annuitant if a lapse
in coverage has not occurred.
(i) Subject to Section 1551.323, an individual and the
individual's dependents are eligible to participate in the group
benefits program as an annuitant and the dependents of an
annuitant if the individual:
(1) served in a position for which the individual was eligible
to participate in the group benefits program under Section
1551.101 on or before August 31, 2003; and
(2) at the time of retirement meets the requirements for
eligibility for participation in the program as an annuitant as
those requirements existed on August 31, 2003.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003. Amended by Acts 2003, 78th Leg., ch. 366, Sec. 2.04, 2.05,
eff. Sept. 1, 2003; Acts 2003, 78th Leg., ch. 1111, Sec. 34, eff.
Sept. 1, 2003; Acts 2003, 78th Leg., ch. 1276, Sec. 10A.401(b),
eff. Sept. 1, 2003; Acts 2003, 78th Leg., 3rd C.S., ch. 3, Sec.
16.01, eff. Jan. 11, 2004.
Amended by:
Acts 2009, 81st Leg., R.S., Ch.
1308, Sec. 34, eff. September 1, 2009.
Sec. 1551.1021. PARTICIPATION ELIGIBILITY: CERTAIN FACULTY OF
INSTITUTIONS OF HIGHER EDUCATION. (a) An adjunct faculty member
at a public institution of higher education is eligible to
participate in the group benefits program as an employee if the
faculty member:
(1) receives compensation for services rendered to a public
institution of higher education as an adjunct faculty member;
(2) has been employed as a faculty member by the same public
institution of higher education and has taught at least one
course in each regular fall and spring semester at the public
institution of higher education in each of the preceding three
academic years; and
(3) is under contract or is scheduled to teach at least 12
semester credit hours in the academic year of coverage or, if the
person is also employed by the public institution of higher
education to perform nonteaching duties, is under contract or is
scheduled to teach at least six semester credit hours in the
academic year of coverage and has been approved by the public
institution of higher education to participate in the group
benefits program.
(b) From money appropriated from a fund other than the general
revenue fund or from money available from local sources, a public
institution of higher education may, for an adjunct faculty
member eligible to receive benefits under this section,
contribute:
(1) not more than 50 percent of the cost of basic coverage for
the employee; and
(2) not more than 25 percent of the cost of dependent coverage.
(c) Subsection (b) does not prohibit a public institution of
higher education from contributing, from money other than money
appropriated from the general revenue fund, amounts that exceed
the amount specified in Subsection (b) to provide coverage for a
person employed by a public institution of higher education who
meets the criteria for eligibility under Subsection (a).
Added by Acts 2003, 78th Leg., ch. 366, Sec. 4.04, eff. Sept. 1,
2003.
Sec. 1551.103. RIGHT TO COVERAGE. Subject to Section 1551.351,
an individual eligible to participate in the group benefits
program under Section 1551.101 or 1551.102 may not be denied any
group coverage under this chapter.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.104. AUTOMATIC COVERAGE. (a) Subject to Sections
1551.101 and 1551.102, each full-time employee is covered
automatically by the basic coverage plan for employees and each
annuitant is covered by the basic coverage plan for annuitants
unless:
(1) participation is specifically waived as provided by Section
1551.1045;
(2) the employee or annuitant is expelled from the program under
Section 1551.351; or
(3) eligibility is otherwise limited by this chapter.
(b) This section does not apply to an employee described by
Section 1551.101(e)(2).
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003. Amended by Acts 2003, 78th Leg., ch. 366, Sec. 2.06, eff.
Sept. 1, 2003.
Amended by:
Acts 2005, 79th Leg., Ch.
899, Sec. 4.01, eff. August 29, 2005.
Sec. 1551.1045. WAIVER. (a) Subject to Subsections (b) and
(c), an employee or annuitant may waive in writing any coverage
provided under this chapter.
(b) To waive coverage under the basic coverage plan for
employees, a full-time employee must demonstrate, in the manner
required by the board of trustees, that the employee is:
(1) covered by another health benefit plan that provides
substantially equivalent coverage, as determined by the board of
trustees, to the coverage provided to employees by the basic
coverage plan; or
(2) eligible for benefits under the TRICARE Military Health
System.
(c) To waive coverage under the basic coverage plan for
annuitants for the purpose of eligibility for an incentive
payment under Section 1551.222, an annuitant must demonstrate, in
the manner required by the board of trustees, that the annuitant
is:
(1) covered by another health benefit plan that provides
substantially equivalent coverage, as determined by the board of
trustees, to the coverage provided to annuitants by the basic
coverage plan; or
(2) eligible for benefits under the TRICARE Military Health
System.
Added by Acts 2005, 79th Leg., Ch.
899, Sec. 4.02, eff. August 29, 2005.
Sec. 1551.105. DATE AUTOMATIC COVERAGE BEGINS. Automatic
coverage under this subchapter begins on the date an employee or
annuitant becomes eligible for coverage.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.1055. DATE ELIGIBILITY BEGINS; WAITING PERIOD. (a)
Except as provided by Subsection (c) or (d), eligibility under
Section 1551.101 begins on the first day of the calendar month
that begins after the 90th day after the date the employee
performs services for a state agency or is qualified for and
begins to hold elected or appointed office.
(b) Except as provided by Subsection (c), eligibility under
Section 1551.102, for an individual who does not retire at the
end of the last month for which the individual is on the payroll
of a state agency before retirement, begins on the first day of
the calendar month that begins after the 90th day after the date
the individual retires.
(c) The waiting period established by Subsections (a) and (b)
applies only to the determination of initial eligibility to
participate in the group benefits program and does not apply to
the determination of initial eligibility to participate in
optional and voluntary insurance coverages under the group
benefits program.
(d) This subsection applies only to an employee of an
institution of higher education or a dependent of the employee.
Notwithstanding Subsection (a), eligibility under Section
1551.101 may not begin earlier than the first day that an
employee performs services for an institution of higher education
if any amount paid for premium incurred before the date specified
under Subsection (a) for the employee and any dependents of the
employee is paid from money not appropriated from the general
revenue fund, in accordance with policies and procedures
established by the governing body of the institution of higher
education.
Added by Acts 2003, 78th Leg., ch. 366, Sec. 2.07, eff. Sept. 1,
2003.
Sec. 1551.106. GROUP COVERAGE PLAN PURCHASED TO PROVIDE FOR
AUTOMATIC COVERAGE. A group coverage plan purchased by the board
of trustees must provide for the automatic coverage described by
this subchapter.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.107. CONTINGENT COVERAGE. (a) Each part-time
employee or employee eligible to participate in the group
benefits program under Section 1551.101(e)(2) may participate in
the program on execution of an appropriate application for
coverage unless the employee is:
(1) ineligible for the group benefits program under Section
1551.110; or
(2) expelled from the group benefits program under Section
1551.351.
(b) An institution of higher education shall, at the time of
employment, notify each of the institution's employees eligible
to participate in the group benefits program under Section
1551.101(e)(2) of the employee's eligibility to participate.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.108. CONTINUING ELIGIBILITY OF CERTAIN PERSONS WITH
LEGISLATIVE SERVICE OR EMPLOYMENT. Subject to Section 1551.351,
on application to the board of trustees and on arrangement for
payment of contributions and postage:
(1) an individual who has at least eight years of service credit
in the Employees Retirement System of Texas for service as a
member of the legislature, on ending the individual's service in
the legislature, remains eligible for participation in the group
benefits program; and
(2) an individual who has at least 10 years of service credit in
the Employees Retirement System of Texas as an employee of the
legislature, on ending the individual's service for the
legislature, remains eligible for participation in the group
benefits program.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.109. CONTINUING ELIGIBILITY OF CERTAIN MEMBERS OF
BOARDS, COMMISSIONS, AND INSTITUTIONS OF HIGHER EDUCATION. (a)
Subject to Section 1551.351, on application to the board of
trustees and arrangement for payment of contributions, an
individual participating in the group benefits program on August
31, 2003, as a current or former member of a governing body with
administrative responsibility over a state agency created under a
statute of this state that has statewide jurisdiction and whose
employees are covered by this chapter or as a current or former
member of the State Board of Education or the governing body of
an institution of higher education remains eligible for
participation in a health benefit plan offered under this chapter
if a lapse in coverage has not occurred.
(b) A participant described by this section may not receive a
state contribution for premiums. The governing body of an
institution of higher education may pay from local funds part or
all of the contributions the state would pay for similar coverage
of other participants in the group benefits program.
(c) The participant's contribution for coverage under a health
benefit plan may not be greater than the contribution for
continuation coverage under the Consolidated Omnibus Budget
Reconciliation Act of 1985 (Pub. L. No. 99-272).
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003. Amended by Acts 2003, 78th Leg., ch. 366, Sec. 2.09, eff.
Sept. 1, 2003.
Sec. 1551.110. INELIGIBILITY OF CERTAIN JUNIOR COLLEGE
EMPLOYEES. (a) Except as provided by Subsections (c) and (d),
an employee of a public junior college who is employed to perform
services outside this state is not eligible to participate in the
group benefits program unless the college elects, under
procedures adopted by the board of trustees, to permit the
employee to participate in the group benefits program.
(b) For purposes of this section, an employee is employed to
perform services outside this state if 75 percent or more of the
services performed by the employee are performed outside this
state.
(c) This section does not apply to an individual employed by a
public junior college on August 31, 1999. That individual remains
eligible to participate in the group benefits program in the same
manner as other employees of the college even if the individual's
employment by the college is not continuous.
(d) An employee of a public junior college who is employed to
perform services outside this state and who is employed after
June 18, 1999, is eligible to participate in a group coverage
provided under this chapter if the coverage is provided under an
insurance policy, contract, or other agreement that:
(1) is in effect on June 18, 1999; and
(2) requires that the employee be eligible to participate in the
coverage provided under the agreement.
(e) Eligibility to participate in a coverage under Subsection
(d) ends on the date the insurance policy, contract, or other
agreement is terminated or renewed.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.111. PARTICIPATION BY CERTAIN RETIREMENT SYSTEMS. (a)
The Texas Municipal Retirement System and the Texas County and
District Retirement System shall participate in the group
benefits program in the manner described by this section.
(b) Participation is limited to:
(1) an officer or employee of either system who has been an
officer or employee of either system following completion of the
waiting period described by Section 1551.1055;
(2) an eligible dependent of an officer or employee of either
system described by Subdivision (1);
(3) an individual who:
(A) was an officer or employee of either system;
(B) has retired from either system, subject to Section
1551.1055;
(C) receives or is eligible to receive an annuity from either
system or under Chapter 803, Government Code, based on at least
10 years of service credit and is at least 65 years of age; and
(D) has at least 10 years of service credit with a state agency
whose employees are authorized to participate in the group
benefits program; and
(4) an eligible dependent of a retired officer or employee
described by Subdivision (3).
(c) Except as provided by Section 1551.114, participation in the
group benefits program does not extend to:
(1) the governing body of either system;
(2) a municipality or subdivision participating in either
system; or
(3) a trustee, officer, or employee, or a dependent of a
trustee, officer, or employee, of a participating municipality or
subdivision.
(d) A participant described by this section may not receive a
state contribution for premiums.
(e) Subject to Section 1551.323, an individual and the
individual's dependents are eligible to participate in the group
benefits program as an annuitant and the dependents of an
annuitant as described under this section if the individual:
(1) served as an officer or employee as described by Subsection
(b)(1) on or before August 31, 2003; and
(2) at the time of retirement meets the requirements for
eligibility for participation in the program as an annuitant as
those requirements existed on August 31, 2003.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003. Amended by Acts 2003, 78th Leg., ch. 366, Sec. 2.10, eff.
Sept. 1, 2003; Acts 2003, 78th Leg., ch. 1030, Sec. 1.02, eff.
Sept. 1, 2003; Acts 2003, 78th Leg., 3rd C.S., ch. 3, Sec. 16.02,
eff. Jan. 11, 2004.
Sec. 1551.112. PARTICIPATION BY TEXAS TURNPIKE AUTHORITY. (a)
An individual may participate in the group benefits program as an
annuitant, subject to Section 1551.1055, and may obtain coverage
for the individual's dependents as any other participating
annuitant if the individual:
(1) began employment with, or became an officer of, the Texas
Turnpike Authority within the three-year period preceding August
31, 1997;
(2) was an officer or employee of the Texas Turnpike Authority
on August 31, 1997;
(3) became an officer or employee of the North Texas Tollway
Authority on September 1, 1997; and
(4) retires or is eligible to retire with at least 10 years of
service credit under the proportionate retirement program
established by Chapter 803, Government Code, or under a public
retirement system to which Chapter 803 applies and is at least 65
years of age.
(b) The North Texas Tollway Authority is responsible for payment
of the contributions the state would make if the annuitant were a
state employee.
(c) Subject to Section 1551.323, an individual and the
individual's dependents are eligible to participate in the group
benefits program as an annuitant and the dependents of an
annuitant as described under this section if the individual:
(1) served in a position described by Subsection (a) on or
before August 31, 2003; and
(2) at the time of retirement meets the requirements for
eligibility for participation in the program as an annuitant as
those requirements existed on August 31, 2003.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003. Amended by Acts 2003, 78th Leg., ch. 366, Sec. 2.11, eff.
Sept. 1, 2003; Acts 2003, 78th Leg., 3rd C.S., ch. 3, Sec. 16.03,
eff. Jan. 11, 2004.
Sec. 1551.113. PARTICIPATION BY CERTAIN EMPLOYEES WHOSE
POSITIONS ARE PRIVATIZED OR ELIMINATED. (a) An individual
described by Subsection (b) is entitled to receive state
contributions required to provide health benefit plan coverage
under the group benefits program for two months after the
effective date of the individual's separation from state service.
(b) This section applies only to an individual who separates
from state service and receives a cash payment under an incentive
program implemented by the Texas Department of Human Services or
the Texas Department of Health for certain employees whose
positions are eliminated as a result of privatization or other
reductions in services provided by those agencies.
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 3, eff. June 1,
2003.
Sec. 1551.114. PARTICIPATION BY COMMUNITY SUPERVISION AND
CORRECTIONS DEPARTMENTS. (a) In this section, "employee of a
community supervision and corrections department" means an
employee of a department established under Chapter 76, Government
Code.
(b) An employee or retired employee of a community supervision
and corrections department shall be treated as an employee or
annuitant, as applicable, for purposes of this chapter only as
provided by this section.
(c) A community supervision and corrections department of this
state participates in the group benefits program administered by
the board of trustees under this chapter. Participation under
this section is limited to:
(1) active employees of a community supervision and corrections
department;
(2) retired employees of a community supervision and corrections
department who retire on or after September 1, 2004, and who:
(A) have been employed by one or more community supervision and
corrections departments for a total of at least 10 years of
creditable service; and
(B) meet all the requirements for retirement benefits prescribed
by the Texas County and District Retirement System; and
(3) eligible dependents of the active employees and retired
employees described by Subdivisions (1) and (2).
(d) Each full-time active employee of a community supervision
and corrections department is automatically covered by the basic
coverage for employees unless the employee specifically waives
coverage or unless the employee is expelled from the program.
Each part-time active employee of a community supervision and
corrections department is eligible to participate in the group
benefits program on application in the manner provided by the
board of trustees, unless the employee has been expelled from the
program. Each community supervision and corrections department
shall notify each of its part-time employees of the employee's
eligibility for participation.
(e) An active employee described by Subsection (d) is not
eligible to receive a state contribution under Subchapter G for
premiums. The community justice assistance division of the Texas
Department of Criminal Justice is responsible for payment of the
contributions for each of a department's participating active
employees and the employees' dependents that the state would make
under Subchapter G if the employees were state employees. Each
covered active employee shall pay that portion of the cost of
group coverages selected by the employee that exceeds the amount
of division contributions.
(f) A retired employee is eligible to participate in the group
benefits program on application to the board of trustees. On
application, a retired employee is automatically covered by the
basic coverage for annuitants unless the retired employee
specifically waives coverage or unless the retired employee is
expelled from the program. A retired employee is not eligible to
receive a state contribution under Subchapter G for premiums. The
community justice assistance division of the Texas Department of
Criminal Justice is responsible for payment of the contributions
for each of a department's retired employees and the retired
employees' participating dependents that the state would make
under Subchapter G if the retired employees were retired state
employees. Each participating retired employee shall pay that
portion of the cost of group coverage selected by the retired
employee that exceeds the amount of division contributions. The
retired employee shall pay contributions required from the
retired employee in the manner prescribed by the board of
trustees. Each community supervision and corrections department
shall notify each of its retired employees of the eligibility for
participation and the costs associated with participation.
(g) All contributions received under this section from the
community justice assistance division of the Texas Department of
Criminal Justice, active employees of community supervision and
corrections departments, and retired employees of community
supervision and corrections departments for basic, optional, and
voluntary coverages under the group ben