CHAPTER 3. LIFE, HEALTH AND ACCIDENT INSURANCE
INSURANCE CODE - NOT CODIFIED
TITLE 1. THE INSURANCE CODE OF 1951
CHAPTER 3. LIFE, HEALTH AND ACCIDENT INSURANCE
SUBCHAPTER E. GROUP, INDUSTRIAL AND CREDIT INSURANCE
Art. 3.51. GROUP INSURANCE FOR EMPLOYEES OF STATE AND ITS
SUBDIVISIONS AND COLLEGE AND SCHOOL EMPLOYEES.
Sec. 1. (a) The State of Texas and each of its political,
governmental and administrative subdivisions, departments,
agencies, associations of public employees, and the governing
boards and authorities of each state university, colleges, common
and independent school districts or of any other agency or
subdivision of the public school system of the State of Texas are
authorized to procure contracts with any insurance company
authorized to do business in this state insuring their respective
employees, or if an association of public employees is the
policyholder, insuring its respective members, or any class or
classes thereof under a policy or policies of group health,
accident, accidental death and dismemberment, disability income
replacement and hospital, surgical and/or medical expense
insurance or a group contract providing for annuities. The
dependents of any such employees or association members, as the
case may be, may be insured under group policies which provide
hospital, surgical and/or medical expense insurance. The
insureds' contributions to the premiums for such insurance or
annuities issued to the employer or to an association of public
employees as the policyholder may be deducted by the employer
from the insureds' salaries when authorized in writing by the
respective employees so to do. The premium for the policy or
contract may be paid in whole or in part from funds contributed
by the employer or in whole or in part from funds contributed by
the insured employees. When an association of public employees is
the holder of such a policy of insurance or contract, the premium
for employees that are members of such association may be paid in
whole or in part by the State of Texas or other agency authorized
to procure contracts or policies of insurance under this section,
or in whole or in part from funds contributed by the insured
employees that are members of such association; provided,
however, that any monies or credits received by or allowed to the
policyholder or contract holder pursuant to any participation
agreement contained in or issued in connection with the policy or
contract shall be applied to the payment of future premiums and
to the pro rata abatement of the insured employee's contribution
therefor.
The term employees as used herein in addition to its usual
meaning shall include elective and appointive officials of the
state.
(b) Independent School Districts procuring policies insuring
their employees under this Section may pay all or any portion of
the premiums on such policies from the local funds of such
Independent School District, but in no event shall any part of
such premiums be paid from funds paid such districts by the State
of Texas.
Sec. 2. All group insurance contracts effected pursuant hereto
shall conform and be subject to all the provisions of any
existing or future laws concerning group insurance.
Sec. 3. (a) Notwithstanding any other provision of this article,
a common or independent school district or any other agency or
subdivision of the public school system of this state that is
participating in the uniform group coverage program established
under Article 3.50-7 of this code may not procure contracts under
this article for health insurance coverage and may not renew a
health insurance contract procured under this article after the
date on which the program of coverages provided under Article
3.50-7 of this code is implemented.
(b) This section does not preclude an entity described by
Subsection (a) of this section from procuring contracts under
this article for the provision of optional insurance coverages
for the employees of the entity.
Acts 1951, 52nd Leg., ch. 491. Amended by Acts 1961, 57th Leg.,
p. 840, ch. 376, Sec. 1; Acts 1967, 60th Leg., p. 239, ch. 126,
Sec. 1, eff. Aug. 28, 1967; Acts 1967, 60th Leg., p. 1007, ch.
437, Sec. 2, eff. Aug. 28, 1967; Acts 1969, 61st Leg., p. 1371,
ch. 414, Sec. 2, eff. Sept. 1, 1969.
Sec. 3 added by Acts 2001, 77th Leg., ch. 1187, Sec. 3.16, eff.
Sept. 1, 2001.
Art. 3.51-1. PAYMENT OF GROUP INSURANCE PREMIUMS BY CITIES, TOWNS
OR VILLAGES. Any incorporated city, town or village in the State
of Texas which is authorized by law to procure a contract
insuring its respective employees or any class or classes thereof
under a policy or policies of group insurance covering one or
more risks may pay all or any portion of the premiums on such
policy or policies from the local funds of such city, town or
village.
Added by Acts 1963, 58th Leg., p. 323, ch. 121, Sec. 1. Amended
by Acts 1981, 67th Leg., p. 1868, ch. 445, Sec. 1, eff. June 11,
1981.
Art. 3.51-4. PAYMENT OF PREMIUMS OF GROUP LIFE AND HEALTH
INSURANCE POLICIES FOR RETIREES OF THE CENTRAL EDUCATION AGENCY,
THE TEXAS REHABILITATION COMMISSION, THE COORDINATING BOARD,
TEXAS COLLEGE AND UNIVERSITY SYSTEM, RETIRED EMPLOYEES OF THE
TEXAS DEPARTMENT OF MENTAL HEALTH AND MENTAL RETARDATION WHO
ACCEPTED RETIREMENT UNDER THE TEACHER RETIREMENT SYSTEM OF TEXAS,
RETIRED EMPLOYEES OF THE TEXAS YOUTH COMMISSION WHO ACCEPTED
RETIREMENT UNDER THE TEACHER RETIREMENT SYSTEM OF TEXAS, AND
RETIRED EMPLOYEES OF THE TEACHER RETIREMENT SYSTEM OF TEXAS WHO
ACCEPTED RETIREMENT UNDER THE TEACHER RETIREMENT SYSTEM OF TEXAS.
The premium cost of group life, health, accident, hospital,
surgical and/or medical expense insurance for retirees of the
Central Education Agency, the Texas Rehabilitation Commission,
the Coordinating Board, Texas College and University System, for
retired employees of the Texas Department of Mental Health and
Mental Retardation, the Texas Youth Commission, and the Teacher
Retirement System of Texas who accepted retirement under the
Teacher Retirement System of Texas pursuant to Chapter 3, Texas
Education Code, shall be paid by the State of Texas, subject to
the following limitations and conditions:
(a) Payment shall be from the funds of the agency, commission,
board or department from which the officer or employee retired,
shall be limited to the same amount allowed active employees
under current group life and health insurance programs of the
agency, commission, board or department, and shall be made in
accordance with rules and regulations to be established no later
than September 1, 1973, by the Central Education Agency, the
Texas Rehabilitation Commission, and the Coordinating Board,
Texas College and University System for its respective retirees
and no later than September 1, 1975, by the Texas Department of
Mental Health and Mental Retardation, the Texas Youth Commission,
and the Teacher Retirement System of Texas for their retired
employees who accepted retirement under the Teacher Retirement
System of Texas pursuant to Chapter 3, Texas Education Code.
(b) The agency, commission, board and department shall certify to
the state comptroller of public accounts each month the amount
required each month to pay the insurance premiums of the said
retirees, and the State of Texas shall pay the amount so
ascertained each month, beginning September 1, 1973, to the
Central Education Agency, the Texas Rehabilitation Commission,
and the Coordinating Board, Texas College and University System,
and beginning September 1, 1975, to the Texas Department of
Mental Health and Mental Retardation and the Texas Youth
Commission.
Added by Acts 1973, 63rd Leg., p. 600, ch. 254, Sec. 1, eff. June
11, 1973. Amended by Acts 1975, 64th Leg., p. 1027, ch. 394, Sec.
1, eff. June 19, 1975.
Amended by Acts 1983, 68th Leg., p. 181, ch. 44, art. 3, Sec. 1,
eff. April 26, 1983; Acts 1997, 75th Leg., ch. 1423, Sec. 11.13,
eff. Sept. 1, 1997.
Art. 3.51-5. PAYMENTS OF GROUP LIFE AND HEALTH INSURANCE PREMIUMS
FOR RETIRED EMPLOYEES OF THE TEXAS CENTRAL EDUCATION AGENCY, THE
TEXAS REHABILITATION COMMISSION, THE TEXAS DEPARTMENT OF MENTAL
HEALTH AND MENTAL RETARDATION, THE TEXAS YOUTH COMMISSION, A
TEXAS SENIOR COLLEGE OR UNIVERSITY, AND THE COORDINATING BOARD,
TEXAS COLLEGE AND UNIVERSITY SYSTEM. (a) The costs of group life
and health insurance premiums to persons retired under the
Teacher Retirement Act, who at the time of their retirement were
employed by the Texas Central Education Agency, the Texas
Rehabilitation Commission, the Texas Department of Mental Health
and Mental Retardation, the Texas Youth Commission, a Texas
senior college or university, and the Coordinating Board, Texas
College and University System, shall be fully paid from the funds
of such agency, commission, institution, or board under the
following provisions and conditions: (1) The coverage of this Act
shall extend to all such retired persons within the limits of
eligibility under state contracts in force on the effective date
of this Act or as may be otherwise provided by law; (2) such
payment shall be in accordance with rules and regulations
established by such agency, commission, institution, or board;
(3) such agency, commission, institution, and board shall certify
to the Comptroller of Public Accounts each month the amount so
ascertained each month to such agency, commission, institution,
and board; (4) payments shall begin on the first day of the month
following the month in which this Act takes effect and shall
continue to be paid until otherwise provided by law.
(b) There are hereby authorized to be paid out of the funds of
each agency, commission, institution, or board named in the Act
the sums necessary to fund the payments of premiums provided in
this Act.
Added by Acts 1975, 64th Leg., p. 1062, ch. 408, Sec. 1, eff.
Sept. 1, 1975.
Amended by Acts 1983, 68th Leg., p. 182, ch. 44, art. 3, Sec. 2,
eff. April 26, 1983; Subsec.(a) amended by Acts 1997, 75th Leg.,
ch. 1423, Sec. 11.14, eff. Sept. 1, 1997.
Art. 3.51-7. PAYMENTS OF ADDITIONAL DEATH BENEFITS FOR RETIRED
APPOINTED OFFICERS AND EMPLOYEES OF THE TEACHER RETIREMENT SYSTEM
OF TEXAS, AND THE TEXAS CENTRAL EDUCATION AGENCY, AND THE TEXAS
SCHOOLS FOR THE BLIND AND VISUALLY IMPAIRED AND FOR THE DEAF.
(a) This article shall apply only to persons retired as
annuitants under the provisions of the Teacher Retirement System
of Texas who were immediately prior to retirement appointed
officers or employees of the Central Education Agency, the
Teacher Retirement System of Texas, the Texas School for the
Blind and Visually Impaired, or for the Texas School for the
Deaf.
(b) There shall be paid from the funds of the Central Education
Agency, the Teacher Retirement System of Texas, the Texas School
for the Blind and Visually Impaired, or for the Texas School for
the Deaf an additional lump-sum death benefit in such amount as,
when added to any lump-sum death benefit payable under the
provisions of the Teacher Retirement System of Texas, shall equal
$5,000 upon satisfactory proof of the death, occurring on or
after September 1, 1977, of any person defined in Part (a) of
this article. Each such additional lump-sum death benefit shall
be paid from the funds of the agency or school from which such
person retired.
(c) Such benefit shall be paid as provided by the laws of descent
and distribution unless the retiree has directed in writing that
it be paid otherwise.
(d) Such payment shall be made in accordance with rules and
regulations established by the Central Education Agency, the
Teacher Retirement System of Texas, the Texas School for the
Blind and Visually Impaired, or for the Texas School for the
Deaf, and each shall certify to the Comptroller of Public
Accounts of Texas each month the amounts of all such payments
made in the preceding month.
(e) There are hereby authorized to be paid out of the funds of
the Central Education Agency, the Teacher Retirement System of
Texas, the Texas School for the Blind and Visually Impaired, or
for the Texas School for the Deaf the sums necessary to pay such
additional lump-sum death benefits.
Added by Acts 1977, 65th Leg., p. 1272, ch. 494, Sec. 1, eff.
June 15, 1977.
Amended by Acts 1989, 71st Leg., ch. 247, Sec. 17, eff. June 14,
1989; Subsec. (d) amended by Acts 1997, 75th Leg., ch. 1423, Sec.
11.15, eff. Sept. 1, 1997.
SUBCHAPTER G. ACCIDENT AND SICKNESS INSURANCE
Art. 3.70-3D. CONSUMER ASSISTANCE PROGRAM FOR HEALTH MAINTENANCE
ORGANIZATIONS.
Text of article effective upon appropriation of funds
(a) The consumer assistance program for health maintenance
organizations is established. The commissioner may contract,
through a request for proposals, with a nonprofit organization to
operate the program.
(b) The program shall:
(1) assist individual consumers in complaints or appeals within
the operation of a health maintenance organization, and outside
of the operation of a health maintenance organization, including
appeals under Article 21.58A of this code or in Medicaid and
Medicare fair hearings; and
(2) refer consumers to other programs or agencies if appropriate.
(c) The program may:
(1) operate a statewide clearinghouse for objective consumer
information about health care coverage, including options for
obtaining health care coverage; and
(2) accept gifts, grants, or donations from any source for the
purpose of operating the program. The program may charge
reasonable fees to consumers to support the program.
(d) The commissioner or an entity contracting with the
commissioner to implement this article may establish an advisory
committee composed of consumers, health care providers, and
health care plan representatives.
(e) A nonprofit organization contracting with the commissioner
pursuant to Subsection (a) must not be involved in providing
health care or health care plans and must demonstrate that it has
expertise in providing direct assistance to consumers with
respect to their concerns and problems with health maintenance
organizations.
Added by Acts 1999, 76th Leg., ch. 1457, Sec. 5, eff. Sept. 1,
1999.