Tex.
Ins. Code Section 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 (Continuation of Group Coverage). 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 (Continuation of Group Coverage), Chapter 1251 (Group and Blanket Health Insurance), 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 (Continuation of Group Coverage), Chapter 1251 (Group and Blanket Health Insurance), 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.
Source:
Section 1551.064 — Certain Group Health and Accident Policies or Contracts, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1551.htm#1551.064 (accessed Jun. 5, 2024).
