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Texas Statutes (Last Updated: January 4, 2014) |
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HEALTH AND SAFETY CODE |
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Title 2. HEALTH |
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Subtitle C. PROGRAMS PROVIDING HEALTH CARE BENEFITS AND SERVICES |
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Chapter 62. CHILD HEALTH PLAN FOR CERTAIN LOW-INCOME CHILDREN |
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Subchapter B. ADMINISTRATION OF CHILD HEALTH PLAN PROGRAM |
Sec. 62.059. HEALTH INSURANCE PREMIUM ASSISTANCE PROGRAM FOR CHILDREN ELIGIBLE FOR CHILD HEALTH PLAN
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(a) In this section, "group health benefit plan" means a plan described by Section 1207.001, Insurance Code.
(b) The commission shall identify children, otherwise eligible to enroll in the state child health plan under this chapter, who are eligible to enroll in a group health benefit plan.
(c) For a child identified under Subsection (b), the commission shall determine whether it is cost-effective to enroll the child in the group health benefit plan under this section. The commission may determine cost-effectiveness on an aggregate basis for the premium assistance program as a whole.
(d) If the commission determines that it is cost-effective to enroll the child in the group health benefit plan, the commission shall:
(1) inform the child and the child's parent or guardian of the availability of the premium assistance program under this section;
(2) offer, as an optional alternative to enrollment in the commission's state child health plan program, a premium assistance payment to assist with the employee's or member's share of the required premiums for the group health benefit plan that is available to the child; and
(3) provide written notice to the issuer of the group health benefit plan in accordance with Chapter 1207, Insurance Code.
(e) The commission shall determine the amount of the premium assistance payment. The premium assistance payment shall be paid only for the reimbursement of the employee's or member's share of required premiums for coverage of a child enrolled in the group health benefit plan.
(f) The premium assistance payment paid under Subsection (e) may provide assistance for the payment of a group health benefit plan premium that includes the child's parent or other individuals who are members of the child's family.
(g) The commission may not provide for the payment of any deductible, copayment, coinsurance, or other cost-sharing obligation for the child or another individual enrolled in a group health benefit plan under Subsection (f).
(h) Repealed by Acts 2003, 78th Leg., ch. 198, Sec. 2.07(b).
(i) Redesignated as subsec. (h) by Acts 2003, 78th Leg., ch. 11, Sec. 1.