Chapter
1575
Texas Public School Employees Group Benefits Program
Sections
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
1575.009
Balance Billing Prohibition Notice
1575.010
Information Regarding Appeals
1575.0025
References to Basic Plan
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
1575.101
System as Group Plan Holder
1575.102
Self-insured Plans
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
1575.151
Types of Coverages
1575.152
Health Benefit Plan Must Cover Preexisting Conditions
1575.153
Health Benefit Plan Coverage for Retirees
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
Group Health Benefit Plans
1575.159
Coverage for Prostate-specific Antigen Test
1575.160
Group Life or Accidental Death and Dismemberment Insurance: Payment of Claim
1575.161
Enrollment Periods
1575.162
Special Enrollments
1575.163
Limitations
1575.164
Disease Management Services
1575.170
Prior Authorization for Certain Drugs
1575.171
Emergency Care Payments
1575.172
Out-of-network Facility-based Provider Payments
1575.173
Out-of-network Diagnostic Imaging Provider or Laboratory Service Provider Payments
1575.174
Out-of-network Emergency Medical Services Provider Payments
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
1575.206
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
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
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
1575.307
Contingency Reserve Account
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
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
1575.451
Annual Accounting
1575.453
Study and Report by Trustee
1575.454
Reports by and Examination of Carrier
1575.455
Public Inspection
1575.456
Confidentiality of Records
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
1575.1582
Eligibility for Group Health Benefit Plans
1575.1601
Group Benefits for Dental and Vision Care
1575.1701
Exemption from Preauthorization Requirements for Physicians and Health Care Providers Providing Certain Health Care Services
