Tex. Ins. Code Section 1579.101
Plans of Group Coverages

(a)

The trustee by rule shall establish plans of group coverages for employees participating in the program and their dependents.

(b)

The plans must include at least two tiers of group coverage, with coverage at different levels in each tier, ranging from the catastrophic care coverage plan to the primary care coverage plan. Each tier must contain a health coverage plan.

(c)

The trustee by rule shall define the requirements of each coverage plan and tier of coverage.

(d)

Comparable coverage plans of each tier of coverage established must be offered to employees of all participating entities.
Added by Acts 2003, 78th Leg., ch. 1276, Sec. 10A.471(a), eff. Sept. 1, 2003.

Source: Section 1579.101 — Plans of Group Coverages, https://statutes.­capitol.­texas.­gov/Docs/IN/htm/IN.­1579.­htm#1579.­101 (accessed Jun. 5, 2024).

1579.001
Short Title 1579.002
General Definitions 1579.003
Definition of Employee 1579.004
Definition of Dependent 1579.005
Confidentiality 1579.006
Exemption from Process 1579.007
Exemption from State Taxes and Fees 1579.008
Coverage Exempt from Insurance Law 1579.009
Balance Billing Prohibition Notice 1579.010
Information Regarding Appeals 1579.051
Administration of Group Program 1579.052
Authority to Adopt Rules 1579.053
Personnel 1579.054
Competitive Bidding Requirements 1579.055
Contract Award 1579.057
Pharmacy Benefit Manager Contracts 1579.101
Plans of Group Coverages 1579.102
Catastrophic Care Coverage Plan 1579.104
Optional Coverages 1579.105
Preexisting Condition Limitation 1579.106
Prior Authorization for Certain Drugs 1579.107
Disease Management Services 1579.108
Limitations 1579.109
Emergency Care Payments 1579.110
Out-of-network Facility-based Provider Payments 1579.111
Out-of-network Diagnostic Imaging Provider or Laboratory Service Provider Payments 1579.112
Out-of-network Emergency Medical Services Provider Payments 1579.152
Participation of Other School Districts 1579.153
Participation by Certain Risk Pools 1579.154
Participation by Charter Schools 1579.155
Program Participation: Election 1579.201
Definition 1579.202
Eligible Employees 1579.203
Selection of Coverage 1579.204
Certain Part-time Employees 1579.205
Payment by Participating Entity 1579.251
State Assistance 1579.252
Contribution by Participating Entities 1579.253
Contribution by Employee 1579.254
Contributions Held in Trust for Fund 1579.255
Interest Assessed on Late Payment of Contributions by Participating Entities 1579.301
Fund 1579.302
Composition of Fund 1579.303
Payments from Fund 1579.304
Investment of Fund 1579.1045
Alternative Group Health Coverage Prohibited 1579.1061
Exemption from Preauthorization Requirements for Physicians and Health Care Providers Providing Certain Health Care Services
Green check means up to date. Up to date

Accessed:
Jun. 5, 2024

§ 1579.101’s source at texas​.gov