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Texas Statutes (Last Updated: January 4, 2014) |
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INSURANCE CODE |
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Title 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES |
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Subtitle H. HEALTH BENEFITS AND OTHER COVERAGES FOR GOVERNMENTAL EMPLOYEES |
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Chapter 1575. TEXAS PUBLIC SCHOOL EMPLOYEES GROUP BENEFITS PROGRAM |
| Subchapter A. GENERAL PROVISIONS |
| § 1575.001. SHORT TITLE |
| § 1575.002. GENERAL DEFINITIONS |
| § 1575.003. DEFINITION OF DEPENDENT AND RELATED TERMS |
| § 1575.004. DEFINITION OF RETIREE |
| § 1575.005. ISSUANCE OF CERTIFICATE OF COVERAGE |
| § 1575.006. EXEMPTION FROM PROCESS |
| § 1575.007. EXEMPTION FROM STATE TAXES AND FEES |
| § 1575.008. COVERAGE EXEMPT FROM INSURANCE LAW |
| Subchapter B. ADMINISTRATION |
| § 1575.051. ADMINISTRATION OF GROUP PROGRAM |
| § 1575.052. AUTHORITY TO ADOPT RULES AND PROCEDURES; OTHER AUTHORITY |
| § 1575.053. PERSONNEL |
| § 1575.054. BUDGET |
| § 1575.055. DEPARTMENT ASSISTANCE |
| § 1575.056. TRANSFER OF RECORDS RELATING TO ACTIVE EMPLOYEE PROGRAM |
| Subchapter C. PROVISION OF BENEFITS |
| § 1575.101. SYSTEM AS GROUP PLAN HOLDER |
| § 1575.102. SELF-INSURED PLANS |
| § 1575.103. PLANS MAY VARY ACCORDING TO MEDICARE COVERAGE |
| § 1575.104. TERMS OF CONTRACT |
| § 1575.105. PLAN COVERAGE SECONDARY TO CERTAIN OTHER COVERAGE |
| § 1575.106. COMPETITIVE BIDDING REQUIREMENTS; RULE |
| § 1575.107. CONTRACT AWARD; CONSIDERATIONS |
| § 1575.108. USE OF PRIVATE ENTITIES |
| § 1575.109. USE OF HEALTH CARE PROVIDER |
| § 1575.110. PHARMACY BENEFIT MANAGER CONTRACTS |
| Subchapter D. COVERAGES AND PARTICIPATION |
| § 1575.151. TYPES OF COVERAGES |
| § 1575.152. BASIC PLAN MUST COVER PREEXISTING CONDITIONS |
| § 1575.153. BASIC COVERAGE |
| § 1575.155. COVERAGE FOR DEPENDENTS OF RETIREE |
| § 1575.156. COVERAGE FOR SURVIVING SPOUSE OR DEPENDENTS OF SURVIVING SPOUSE |
| § 1575.157. COVERAGE FOR SURVIVING DEPENDENT CHILD |
| § 1575.158. OPTIONAL GROUP HEALTH BENEFIT PLAN |
| § 1575.159. COVERAGE FOR PROSTATE-SPECIFIC ANTIGEN TEST |
| § 1575.160. GROUP LIFE OR ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE: PAYMENT OF CLAIM |
| § 1575.161. OPEN ENROLLMENT; ADDITIONAL ENROLLMENT PERIODS |
| § 1575.162. SPECIAL ENROLLMENTS |
| § 1575.163. LIMITATIONS |
| § 1575.164. DISEASE MANAGEMENT SERVICES. |
| § 1575.170. PRIOR AUTHORIZATION FOR CERTAIN DRUGS |
| Subchapter E. CONTRIBUTIONS |
| § 1575.201. ADDITIONAL STATE CONTRIBUTIONS; CERTAIN CONTRIBUTIONS |
| § 1575.202. STATE CONTRIBUTION BASED ON ACTIVE EMPLOYEE COMPENSATION |
| § 1575.203. ACTIVE EMPLOYEE CONTRIBUTION |
| § 1575.204. PUBLIC SCHOOL CONTRIBUTION |
| § 1575.205. PARTICIPATION CONTRIBUTION FOR OPTIONAL PLAN |
| § 1575.206. CONTRIBUTIONS HELD IN TRUST FOR FUND |
| § 1575.207. INTEREST ASSESSED ON LATE PAYMENT OF DEPOSITS BY EMPLOYING PUBLIC SCHOOLS |
| § 1575.208. CERTIFICATION OF AMOUNT NECESSARY TO PAY STATE CONTRIBUTIONS |
| § 1575.209. CERTIFICATION OF AMOUNT OF STATE CONTRIBUTIONS |
| § 1575.210. PAYMENT OF STATE CONTRIBUTIONS; RECONCILIATION |
| § 1575.211. COST SHARING |
| § 1575.212. PAYMENT BY RETIREES; RANGES |
| § 1575.213. CERTAIN DISABILITY RETIREES |
| Subchapter F. FEDERAL OR PRIVATE SOURCE CONTRIBUTIONS |
| § 1575.251. DEFINITION |
| § 1575.252. APPLICATION BY EMPLOYER FOR MONEY TO PAY STATE CONTRIBUTIONS |
| § 1575.253. MONTHLY CERTIFICATION |
| § 1575.254. MONTHLY MAINTENANCE OF INFORMATION |
| § 1575.255. PROOF OF COMPLIANCE |
| § 1575.256. CRIMINAL OFFENSE: FAILURE OF ADMINISTRATOR TO COMPLY |
| § 1575.257. CIVIL SANCTIONS FOR FAILURE OF EMPLOYER TO COMPLY |
| Subchapter G. RETIRED SCHOOL EMPLOYEES GROUP INSURANCE FUND |
| § 1575.301. FUND; ADMINISTRATION |
| § 1575.302. PAYMENTS INTO FUND |
| § 1575.303. PAYMENTS FROM FUND |
| § 1575.304. TRANSFER OF CERTAIN CONTRIBUTIONS |
| § 1575.305. INVESTMENT OF FUND |
| § 1575.306. EMPLOYEE CONTRIBUTIONS PROPERTY OF FUND ON RECEIPT; NO REFUND |
| Subchapter H. COORDINATED CARE NETWORK |
| § 1575.351. DEFINITIONS |
| § 1575.352. IMPLEMENTATION AND ADMINISTRATION |
| § 1575.353. CONTRACTS WITH HEALTH CARE PROVIDERS AND OTHERS |
| § 1575.354. CREDENTIALING COMMITTEES |
| § 1575.355. IMMUNITY FROM LIABILITY ARISING FROM ACTS OR OMISSIONS OF HEALTH CARE PROVIDER |
| § 1575.356. IMMUNITY FROM LIABILITY ARISING FROM EVALUATION OF QUALIFICATIONS OR CARE |
| § 1575.357. IMMUNITY FROM LIABILITY ARISING FROM ACTS RELATING TO CREDENTIALING COMMITTEE |
| § 1575.358. OPEN MEETINGS LAW NOT APPLICABLE TO CREDENTIALING COMMITTEE |
| § 1575.359. RECORDS AND PROCEEDINGS OF CREDENTIALING COMMITTEE NOT SUBJECT TO SUBPOENA |
| § 1575.360. CONFIDENTIALITY |
| § 1575.361. DISCLOSURE TO HEALTH CARE PROVIDER |
| § 1575.362. DISCLOSURE TO CERTAIN ENTITIES |
| § 1575.363. DISCLOSURE TO DEFENDANTS IN CIVIL ACTIONS |
| Subchapter I. RETIREES ADVISORY COMMITTEE |
| § 1575.401. DEFINITION |
| § 1575.402. APPOINTMENT OF COMMITTEE MEMBERS |
| § 1575.403. TERMS |
| § 1575.404. VACANCY |
| § 1575.405. MEETINGS |
| § 1575.406. DUTIES |
| § 1575.407. PROCEDURAL RULES |
| § 1575.408. REIMBURSEMENT FOR ACTUAL AND REASONABLE EXPENSES |
| Subchapter J. ACCOUNTING, REPORTS, AND RECORDS |
| § 1575.451. ANNUAL ACCOUNTING |
| § 1575.452. ANNUAL REPORT |
| § 1575.453. STUDY AND REPORT BY TRUSTEE |
| § 1575.454. REPORTS BY AND EXAMINATION OF CARRIER |
| § 1575.455. PUBLIC INSPECTION |
| § 1575.456. CONFIDENTIALITY OF RECORDS |
| Subchapter K. EXPULSION FOR FRAUD |
| § 1575.501. EXPULSION FOR FRAUD |
| § 1575.502. HEARING |
| § 1575.503. CONTESTED CASE |
| § 1575.504. EXPULSION AT CONCLUSION OF HEARING |
| § 1575.505. EFFECT OF EXPULSION |
| § 1575.506. APPEAL |