By: Shapleigh S.B. No. 389
2001S0217/3
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the establishment and funding of a statewide group
1-3 insurance program for employees and retirees of certain public
1-4 schools.
1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-6 SECTION 1. Title 1, Insurance Code, is amended by adding
1-7 Chapter 3A to read as follows:
1-8 CHAPTER 3A. TEXAS SCHOOL EMPLOYEES UNIFORM GROUP
1-9 INSURANCE BENEFITS ACT
1-10 SUBCHAPTER A. GENERAL PROVISIONS
1-11 Art. 3A.001. SHORT TITLE. This chapter may be cited as the
1-12 Texas School Employees Uniform Group Insurance Benefits Act.
1-13 Art. 3A.002. DEFINITIONS. In this chapter:
1-14 (1) "Administering firm" means any firm designated by
1-15 the board of trustees to administer any coverage, service, benefit,
1-16 or requirement under this chapter and the board of trustees' rules
1-17 adopted under this chapter.
1-18 (2) "Board of trustees" means the board of trustees of
1-19 the Teacher Retirement System of Texas.
1-20 (3) "Cafeteria plan" means a plan as defined and
1-21 authorized by Section 125, Internal Revenue Code of 1986 (26 U.S.C.
1-22 Section 125), as amended.
1-23 (4) "Employee" means an individual who:
1-24 (A) is a member of the system;
1-25 (B) is employed by a school district or another
2-1 entity that receives allotments under the foundation school program
2-2 and:
2-3 (i) the school district or other entity
2-4 participates in the program; or
2-5 (ii) the individual pays premiums to
2-6 participate in the group program in accordance with Article 3A.102
2-7 of this code; and
2-8 (C) is not a direct participant in a group
2-9 insurance program under the Texas Employees Uniform Group Insurance
2-10 Benefits Act (Article 3.50-2, Vernon's Texas Insurance Code) or the
2-11 Texas State College and University Employees Uniform Insurance
2-12 Benefits Act (Article 3.50-3, Vernon's Texas Insurance Code).
2-13 (5) "Employer" means a school district or an
2-14 institution of higher education as defined by Section 61.003,
2-15 Education Code, that employs one or more employees as defined by
2-16 Subdivision (4) of this article.
2-17 (6) "Group program" means the Texas school employees
2-18 group insurance program authorized by this chapter.
2-19 (7) "Health benefits plan" means a group insurance
2-20 policy or contract, medical, dental, or hospital service agreement,
2-21 membership or subscription contract, salary continuation plan,
2-22 health maintenance organization agreement, preferred provider
2-23 arrangement, or any similar group arrangement or any combination of
2-24 those policies, plans, contracts, agreements, or arrangements to
2-25 provide, pay for, or reimburse expenses for health care services,
2-26 including comparable health care services for employees and
3-1 retirees who rely solely on spiritual means through prayer for
3-2 healing in accordance with the teaching of a recognized church or
3-3 denomination.
3-4 (8) "Optional insurance fund" means the school
3-5 employees optional insurance fund created under Article 3A.202 of
3-6 this chapter.
3-7 (9) "Plan provider" means an insurance company, group
3-8 hospital service corporation, health maintenance organization, or
3-9 other entity authorized by the department under this code to
3-10 provide any insurance coverage, benefit, or service provided by
3-11 this chapter.
3-12 (10) "Primary health plan" means the health benefits
3-13 plan determined by the board of trustees in which each full-time
3-14 employee and each retiree participates automatically unless
3-15 participation is specifically waived.
3-16 (11) "Primary health fund" means the school employees
3-17 primary health coverage fund described under Article 3A.201 of this
3-18 chapter.
3-19 (12) "Program participant" means an employee or a
3-20 retiree who participates in the group program.
3-21 (13) "School district" means a political subdivision
3-22 organized to provide general elementary or secondary public
3-23 education, including an open-enrollment charter school that has
3-24 been granted a charter under Subchapter D, Chapter 12, Education
3-25 Code. The term does not include any state agency, a junior college
3-26 district, a special-purpose school district established under
4-1 Section 11.351, Education Code, or the Windham School District
4-2 established under Section 19.002, Education Code.
4-3 (14) "System" means the Teacher Retirement System of
4-4 Texas.
4-5 Art. 3A.003. DEFINITION OF DEPENDENT AND RELATED TERMS. In
4-6 this chapter:
4-7 (1) "Dependent" means:
4-8 (A) the spouse of a program participant;
4-9 (B) an unmarried child of a program participant
4-10 or deceased employee if that child is under 25 years of age,
4-11 including:
4-12 (i) an adopted child;
4-13 (ii) a stepchild, foster child, or other
4-14 child who has a regular parent-child relationship with the program
4-15 participant; or
4-16 (iii) a recognized natural child;
4-17 (C) a person who is a program participant's
4-18 recognized natural child, adopted child, foster child, stepchild,
4-19 or other child who has a regular parent-child relationship with the
4-20 program participant, without regard to the age of the person, if
4-21 the person:
4-22 (i) lives with or has care provided by the
4-23 program participant or surviving spouse on a regular basis; and
4-24 (ii) is mentally retarded or physically
4-25 incapacitated to an extent that the person is dependent on the
4-26 program participant or surviving spouse for care or support, as
5-1 determined by the board of trustees; or
5-2 (D) a person who is a deceased employee's
5-3 recognized natural child, adopted child, foster child, stepchild,
5-4 or other child who had a regular parent-child relationship with the
5-5 deceased employee, without regard to the age of the person, if
5-6 while the employee was alive, the person:
5-7 (i) lived with or had care provided by the
5-8 deceased employee on a regular basis; and
5-9 (ii) was mentally retarded or physically
5-10 incapacitated to an extent that the person was dependent on the
5-11 deceased employee or surviving spouse for care or support, as
5-12 determined by the board of trustees.
5-13 (2) "Surviving dependent child" means:
5-14 (A) the dependent child of a deceased retiree
5-15 who has survived the deceased retiree and the deceased retiree's
5-16 spouse; or
5-17 (B) the dependent child of a deceased employee
5-18 who has survived the deceased employee and the deceased employee's
5-19 spouse if the deceased employee had 10 or more years of actual
5-20 service credit in the system.
5-21 (3) "Surviving spouse" means:
5-22 (A) the surviving spouse of a deceased retiree;
5-23 or
5-24 (B) the surviving spouse of a deceased employee
5-25 who had 10 or more years of actual service credit in the system.
5-26 Art. 3A.004. DEFINITION OF RETIREE. In this chapter,
6-1 "retiree" means an individual who:
6-2 (1) retired under the system with at least 10 years of
6-3 credit for actual service for an employer or has retired under the
6-4 system for disability and is entitled to receive an annuity from
6-5 the system under Section 824.304(b), Government Code; and
6-6 (2) is not eligible to directly participate in the
6-7 group insurance program provided under the Texas Employees Uniform
6-8 Group Insurance Benefits Act (Article 3.50-2, Vernon's Texas
6-9 Insurance Code) or the Texas State College and University Employees
6-10 Uniform Insurance Benefits Act (Article 3.50-3, Vernon's Texas
6-11 Insurance Code).
6-12 Art. 3A.005. EXEMPTION FROM PROCESS. (a) The following are
6-13 exempt from execution, attachment, garnishment, or any other
6-14 process:
6-15 (1) any contribution or benefit payment under this
6-16 chapter;
6-17 (2) any right, benefit, or payment accruing to any
6-18 person under this chapter; and
6-19 (3) any money in any fund administered under this
6-20 chapter.
6-21 (b) The items listed in Subsection (a) of this article may
6-22 not be assigned except for direct payment to benefit providers as
6-23 authorized by the board of trustees by contract or rule.
6-24 Art. 3A.006. EXEMPTION FROM STATE TAXES AND FEES. A premium
6-25 or contribution on a policy, insurance contract, or agreement
6-26 authorized by this chapter is not subject to any state tax,
7-1 regulatory fee, or surcharge, including a contribution or
7-2 maintenance tax or fee.
7-3 Art. 3A.007. APPLICABILITY OF OTHER LAW. This chapter does
7-4 not prohibit a school district from providing additional or
7-5 supplemental insurance coverage under Article 3.51 or 26.036 of
7-6 this code or Section 22.005, Education Code.
7-7 SUBCHAPTER B. POWERS AND DUTIES OF BOARD OF TRUSTEES
7-8 Art. 3A.051. ADMINISTRATION. (a) The board of trustees is
7-9 the trustee for the group program and shall administer the group
7-10 program.
7-11 (b) The board of trustees may adopt rules, plans,
7-12 procedures, and orders reasonably necessary to implement this
7-13 chapter, including:
7-14 (1) minimum benefit and financing standards for group
7-15 coverage for program participants, dependents, surviving spouses,
7-16 and surviving dependent children;
7-17 (2) primary health coverage and optional insurance
7-18 coverage for program participants, dependents, surviving spouses,
7-19 and surviving dependent children;
7-20 (3) procedures for contributions and deductions,
7-21 including annuity or payroll deductions;
7-22 (4) periods for enrollment and selection of optional
7-23 coverage and procedures for enrolling and exercising options under
7-24 the group program;
7-25 (5) adoption of a cafeteria plan;
7-26 (6) procedures for claims administration; and
8-1 (7) procedures to administer the fund.
8-2 Art. 3A.052. PERSONNEL. The board of trustees may employ
8-3 persons to assist the board of trustees in administering this
8-4 chapter.
8-5 Art. 3A.053. USE OF GENERIC AND MAIL-ORDER DRUGS. The board
8-6 of trustees shall adopt rules to maximize any available cost
8-7 savings from the use of generic or mail-order prescription drugs
8-8 unless the use of those drugs would cause an undue burden on or
8-9 adversely affect the health of any individual covered by a health
8-10 benefits plan adopted under this chapter.
8-11 Art. 3A.054. CONTRACTS. (a) The board of trustees may, on
8-12 a competitive bid basis, contract with:
8-13 (1) a qualified, experienced firm of group insurance
8-14 specialists; or
8-15 (2) an administering firm to act for the board of
8-16 trustees in the capacity of an independent administrator and
8-17 manager of a plan authorized under this chapter.
8-18 (b) The independent administrator selected by the board of
8-19 trustees shall assist the board of trustees to ensure the proper
8-20 administration of this chapter and the coverages, services, and
8-21 benefits provided for or authorized by this chapter.
8-22 (c) The board of trustees may enter into interagency
8-23 contracts with any state agency, including the Employees Retirement
8-24 System of Texas, for assistance in implementing or administering
8-25 the group program provided by this chapter.
8-26 Art. 3A.055. ADVISORY COMMITTEES. The board of trustees may
9-1 appoint advisory committees to advise the system in the
9-2 implementation or administration of the group program. The
9-3 advisory committees may include a credentialing advisory committee,
9-4 a medical advisory committee, and a retirement advisory committee.
9-5 SUBCHAPTER C. PROGRAM PARTICIPATION AND COVERAGE
9-6 Art. 3A.101. PARTICIPATION IN GROUP PROGRAM. (a) A school
9-7 district may participate in the group program provided by this
9-8 chapter if the district levies taxes authorized by the result of an
9-9 election under Section 45.003, Education Code, or if the district
9-10 pays a premium to participate in the group program under Article
9-11 3A.102 of this code.
9-12 (b) Each full-time employee or retiree is automatically
9-13 covered by the primary health plan for employees or retirees, as
9-14 applicable, unless the employee or retiree specifically waives
9-15 coverage or unless the employee or retiree is expelled from the
9-16 group program.
9-17 (c) Each part-time employee is eligible to participate in
9-18 the primary health plan provided by this chapter on application in
9-19 the manner provided by the board of trustees unless the employee
9-20 has been expelled from the group program. An employer shall notify
9-21 each of its part-time employees of their eligibility for
9-22 participation in the primary health plan.
9-23 Art. 3A.102. PARTICIPATION IN GROUP PROGRAM BY PAYMENT OF
9-24 PREMIUM. (a) A school district may participate in the group
9-25 program provided by this chapter by paying the appropriate premium
9-26 as determined by rules adopted by the board of trustees.
10-1 (b) A full-time or part-time employee of a school district
10-2 that does not participate in the group program may participate in
10-3 the group program by paying the appropriate premium as determined
10-4 by rules adopted by the board of trustees.
10-5 (c) The board of trustees shall adopt rules for the payment
10-6 of premiums by school districts and employees to participate in the
10-7 group program under this section.
10-8 Art. 3A.103. PRIMARY HEALTH COVERAGE. (a) The board of
10-9 trustees shall administer a primary health plan for program
10-10 participants and their dependents, surviving spouses, and surviving
10-11 children. The plan coverages shall be comparable in scope and, to
10-12 the greatest extent possible, in cost to the basic coverage for
10-13 health care that state employees automatically participate in under
10-14 the Texas Employees Uniform Group Insurance Benefits Act (Article
10-15 3.50-2, Vernon's Texas Insurance Code).
10-16 (b) The board of trustees must offer to program participants
10-17 plans of comparable primary health coverage except that the board
10-18 of trustees may offer enhanced primary health coverage to program
10-19 participants without Medicare coverage so that all program
10-20 participants receive comparable benefits under the primary health
10-21 plan.
10-22 (c) The board of trustees by rule shall define the primary
10-23 health coverage in which each full-time employee or retiree
10-24 participates unless specifically waived.
10-25 Art. 3A.104. COVERAGE FOR DEPENDENTS OF PRIMARY HEALTH PLAN
10-26 PARTICIPANT. A program participant who is covered by the primary
11-1 health plan is entitled to obtain dependent coverage in the primary
11-2 health plan as determined by the board of trustees. Additional
11-3 contribution payments for dependent coverage shall be made by the
11-4 program participant in the manner determined by the board of
11-5 trustees.
11-6 Art. 3A.105. COVERAGE FOR SURVIVING SPOUSE OR DEPENDENTS OF
11-7 SURVIVING SPOUSE. (a) A surviving spouse may elect to retain or
11-8 obtain coverage from the primary health plan for the surviving
11-9 spouse or dependents of the surviving spouse at the applicable rate
11-10 for a dependent.
11-11 (b) A surviving spouse must provide payment of applicable
11-12 contributions in the manner established by rules adopted by the
11-13 board of trustees.
11-14 Art. 3A.106. COVERAGE FOR SURVIVING DEPENDENT CHILD. (a) A
11-15 surviving dependent child, the guardian of the child's estate, or
11-16 the person having custody of the child may elect to retain or
11-17 obtain coverage from the primary health plan for the surviving
11-18 dependent child at the applicable rate for a dependent.
11-19 (b) The applicable contributions must be provided in the
11-20 manner established by rules adopted by the board of trustees.
11-21 Art. 3A.107. OPTIONAL GROUP COVERAGE. (a) The board of
11-22 trustees shall contract with a qualified plan provider to offer
11-23 program participants:
11-24 (1) optional permanent life insurance coverage;
11-25 (2) long-term care insurance that provides coverage
11-26 for home, community, and institutional care; and
12-1 (3) insurance for short-term or long-term loss of
12-2 salary because of disability.
12-3 (b) The board of trustees may offer program participants
12-4 other optional group insurance coverages considered advisable by
12-5 the board of trustees.
12-6 (c) In contracting for any benefits under this article,
12-7 competitive bidding is required. The board of trustees by rule
12-8 shall prescribe the procedure for conducting the bidding. The
12-9 rules may provide criteria to determine qualified plan providers.
12-10 The board of trustees is not required to select the lowest bid and
12-11 shall consider ability to service contracts, past experiences,
12-12 financial stability, and other relevant criteria. If the board of
12-13 trustees awards a contract to an entity whose products deviate from
12-14 those for which bids were solicited, the deviation shall be
12-15 recorded and the reasons for the deviation shall be fully justified
12-16 in the minutes of the next meeting of the board of trustees.
12-17 (d) Insurance coverage provided under this article shall be
12-18 made available periodically during open-enrollment periods
12-19 determined by the board of trustees.
12-20 Art. 3A.108. AVAILABILITY OF OPTIONAL COVERAGE. (a) The
12-21 board of trustees shall offer the optional insurance coverage under
12-22 this chapter to:
12-23 (1) employees through their employers; and
12-24 (2) retirees through the system.
12-25 (b) The board of trustees shall offer long-term care
12-26 insurance to a program participant for that participant's:
13-1 (1) dependent;
13-2 (2) surviving spouse;
13-3 (3) parent or grandparent; and
13-4 (4) spouse's or surviving spouse's parent.
13-5 (c) Each program participant who participates in optional
13-6 insurance coverage provided under this chapter is responsible for
13-7 the full cost of that coverage.
13-8 (d) An employee who participates in optional insurance
13-9 coverage provided under this chapter shall pay contributions by
13-10 payroll deduction remitted by the employee's employer at the times
13-11 and in the manner provided by the trustee.
13-12 (e) A retiree who participates in optional insurance
13-13 coverage provided under this chapter shall pay contributions by
13-14 deduction from the retiree's monthly retirement annuity.
13-15 SUBCHAPTER D. CONTRIBUTIONS
13-16 Art. 3A.151. FUNDING OF PRIMARY HEALTH COVERAGE. (a) The
13-17 state shall contribute for each program participant who is covered
13-18 by the primary health plan the amount provided by the General
13-19 Appropriations Act.
13-20 (b) The board of trustees shall pay from the primary health
13-21 fund:
13-22 (1) 100 percent of the cost of primary health coverage
13-23 for employees and for retirees who retired with at least 10 years
13-24 of actual service credit with the system; and
13-25 (2) 50 percent of the cost of primary health coverage
13-26 for dependents of employees and retirees who retired with at least
14-1 10 years of actual service credit with the system.
14-2 (c) That portion of the cost of primary health coverage
14-3 selected by the program participant that exceeds the amount of
14-4 state contributions under Subsection (b)(2) of this article shall
14-5 be paid by the employee or retiree or the employee's school
14-6 district, according to the employee's employment contract.
14-7 Art. 3A.152. CERTIFICATION OF AMOUNT NECESSARY TO PAY STATE
14-8 CONTRIBUTION. Not later than October 31 preceding each regular
14-9 session of the legislature, the board of trustees shall certify the
14-10 amount necessary to pay the state contributions to the primary
14-11 health fund to:
14-12 (1) the Legislative Budget Board; and
14-13 (2) the budget division of the governor's office.
14-14 SUBCHAPTER E. FUNDS
14-15 Art. 3A.201. SCHOOL EMPLOYEES PRIMARY HEALTH COVERAGE FUND.
14-16 (a) The school employees primary health coverage fund is created
14-17 as a trust fund with the comptroller, who is custodian of the fund.
14-18 (b) The board of trustees shall administer the fund on
14-19 behalf of the participants in the plans of coverage provided under
14-20 this chapter.
14-21 (c) The following shall be paid into the primary health
14-22 fund:
14-23 (1) distributions from the permanent school fund as
14-24 authorized by any constitutional or statutory provision;
14-25 (2) local premium contributions provided by
14-26 participating school districts as authorized by an election held
15-1 under Section 45.003(f), Education Code;
15-2 (3) state appropriations for the premiums or other
15-3 contributions for primary health coverage for program participants;
15-4 (4) premiums or other contributions paid for primary
15-5 health coverage of the retirees, dependents, surviving spouses, and
15-6 surviving children of program participants;
15-7 (5) money recovered under contracts for the
15-8 implementation or administration of the primary health plan;
15-9 (6) appropriations for implementation and
15-10 administration of the primary health plan;
15-11 (7) investment and depository income of the primary
15-12 health fund; and
15-13 (8) other money required or authorized to be paid into
15-14 the primary health fund.
15-15 (d) Money in the primary health fund may be used only to pay
15-16 for primary health coverage provided under this chapter, including
15-17 the expenses of administering the program.
15-18 Art. 3A.202. PUBLIC SCHOOL EMPLOYEES OPTIONAL INSURANCE
15-19 FUND. (a) The school employees optional insurance fund is created
15-20 as a trust fund with the comptroller, who is custodian of the fund.
15-21 (b) The board of trustees shall administer the optional
15-22 insurance fund on behalf of the participants in the plans of
15-23 insurance coverage provided under this chapter.
15-24 (c) The following shall be credited to the optional
15-25 insurance fund:
15-26 (1) premiums and other contributions from participants
16-1 in plans of optional insurance;
16-2 (2) money recovered under contracts for providing
16-3 optional insurance coverage;
16-4 (3) investment and depository income of the optional
16-5 insurance fund; and
16-6 (4) other money required or authorized to be paid into
16-7 the optional insurance fund.
16-8 (d) Money in the optional insurance fund may be used only to
16-9 pay for optional insurance coverage, including the expenses of
16-10 administering the optional insurance program.
16-11 Art. 3A.203. INVESTMENT AUTHORITY. The board of trustees
16-12 may invest assets of any fund administered under this subchapter in
16-13 the manner provided by Subchapter D, Chapter 825, Government Code,
16-14 for assets of the system.
16-15 SUBCHAPTER F. RECORDS, PROCEEDINGS, AND ACCOUNTING
16-16 Art. 3A.251. CONFIDENTIALITY OF RECORDS. (a) Section
16-17 825.507, Government Code, applies to information in records
16-18 relating to a retiree, employee, annuitant, or beneficiary under
16-19 the group program.
16-20 (b) The system may disclose to a health or benefit provider
16-21 information in the records of an individual that the system
16-22 determines is necessary to administer the group program.
16-23 Art. 3A.252. CLAIM DENIAL OR EXPULSION. (a) A program
16-24 participant or a covered dependent, surviving spouse, or surviving
16-25 dependent child may appeal a claim denial or an expulsion from the
16-26 group program to the board of trustees.
17-1 (b) Adjudication of claims and expulsion from the group
17-2 program are subject to the contested case provisions under Chapter
17-3 2001, Government Code.
17-4 Art. 3A.253. HEARING EXAMINER. The board of trustees may
17-5 delegate its authority to adjudicate claims and expulsions to a
17-6 qualified hearing examiner.
17-7 Art. 3A.254. APPEAL. (a) A decision of the board of
17-8 trustees or a hearing examiner is subject to review by a district
17-9 court in Travis County or in the county in which the claimant
17-10 resides.
17-11 (b) An appeal of a determination under this section is under
17-12 the substantial evidence rule.
17-13 Art. 3A.255. ANNUAL ACCOUNTING. (a) In this article, "plan
17-14 year" means the period beginning on September 1 and ending on the
17-15 following August 31.
17-16 (b) Group coverage purchased under this chapter must provide
17-17 for an accounting to the board of trustees by each plan provider
17-18 providing the coverage.
17-19 (c) The accounting must be submitted:
17-20 (1) not later than the 90th day after the last day of
17-21 each plan year; and
17-22 (2) on a form approved by the board of trustees.
17-23 (d) Each plan provider shall prepare any other report
17-24 required by rule by the board of trustees.
17-25 (e) A plan provider may not assess an additional charge for
17-26 preparation of an accounting report.
18-1 SECTION 2. Subsection (a), Section 22.004, Education Code,
18-2 is amended to read as follows:
18-3 (a) Each district that does not participate in the Texas
18-4 school employees group insurance program provided under Chapter 3A,
18-5 Insurance Code, shall make available to its employees group health
18-6 coverage provided by a risk pool established by one or more school
18-7 districts under Chapter 172, Local Government Code, or under a
18-8 policy of insurance or group contract issued by an insurer, a
18-9 company subject to Chapter 20, Insurance Code, or a health
18-10 maintenance organization under the Texas Health Maintenance
18-11 Organization Act (Chapter 20A, Vernon's Texas Insurance Code). The
18-12 coverage must meet the substantive coverage requirements of Article
18-13 3.51-6, Insurance Code, and any other law applicable to group
18-14 health insurance policies or contracts issued in this state. The
18-15 coverage must include major medical treatment but may exclude
18-16 experimental procedures. In this subsection, "major medical
18-17 treatment" means a medical, surgical, or diagnostic procedure for
18-18 illness or injury. The coverage may include managed care or
18-19 preventive care and must be comparable to the basic health coverage
18-20 provided under the Texas Employees Uniform Group Insurance Benefits
18-21 Act (Article 3.50-2, Vernon's Texas Insurance Code). The board of
18-22 trustees of the Teacher Retirement System of Texas shall adopt
18-23 rules to determine whether a school district's group health
18-24 coverage is comparable to the basic health coverage specified by
18-25 this subsection. The rules must provide for consideration of the
18-26 following factors concerning the district's coverage in determining
19-1 whether the district's coverage is comparable to the basic health
19-2 coverage specified by this subsection:
19-3 (1) the deductible amount for service provided inside
19-4 and outside of the network;
19-5 (2) the coinsurance percentages for service provided
19-6 inside and outside of the network;
19-7 (3) the maximum amount of coinsurance payments a
19-8 covered person is required to pay;
19-9 (4) the amount of the copayment for an office visit;
19-10 (5) the schedule of benefits and the scope of
19-11 coverage;
19-12 (6) the lifetime maximum benefit amount; and
19-13 (7) verification that the coverage is issued by a
19-14 provider licensed to do business in this state by the Texas
19-15 Department of Insurance or is provided by a risk pool authorized
19-16 under Chapter 172, Local Government Code, or that a district is
19-17 capable of covering the assumed liabilities in the case of coverage
19-18 provided through district self-insurance.
19-19 SECTION 3. Subchapter A, Chapter 22, Education Code, is
19-20 amended by adding Section 22.007 to read as follows:
19-21 Sec. 22.007. TEXAS SCHOOL EMPLOYEES GROUP INSURANCE PROGRAM.
19-22 A school district may participate in the Texas school employees
19-23 group insurance program provided under Chapter 3A, Insurance Code,
19-24 if the district imposes a tax as a result of an election under
19-25 Section 45.003(f) that complies with the requirements of Section
19-26 45.0031 or if the district pays a premium to participate in the
20-1 program under Article 3A.102, Insurance Code.
20-2 SECTION 4. Section 42.303, Education Code, is amended to
20-3 read as follows:
20-4 Sec. 42.303. LIMITATION ON ENRICHMENT TAX RATE. (a) Except
20-5 as provided by Subsection (b), the [The] district enrichment tax
20-6 rate ("DTR") under Section 42.302 may not exceed $0.64 per $100 of
20-7 valuation, or a greater amount for any year provided by
20-8 appropriation.
20-9 (b) The tax imposed as a result of an election under Section
20-10 45.003(f) for the purpose of participating in the Texas school
20-11 employees group insurance program under Chapter 3A, Insurance Code,
20-12 may not be included in the amount of the district enrichment tax
20-13 rate for the purposes of Subsection (a).
20-14 SECTION 5. The chapter heading to Chapter 43, Education
20-15 Code, is amended to read as follows:
20-16 CHAPTER 43. PERMANENT SCHOOL FUND, [AND] AVAILABLE
20-17 SCHOOL FUND, AND SCHOOL EMPLOYEES PRIMARY HEALTH COVERAGE FUND
20-18 SECTION 6. Section 43.001, Education Code, is amended to
20-19 read as follows:
20-20 Sec. 43.001. COMPOSITION OF PERMANENT SCHOOL FUND, [AND]
20-21 AVAILABLE SCHOOL FUND, AND SCHOOL EMPLOYEES PRIMARY HEALTH COVERAGE
20-22 FUND.
20-23 (a) Except as provided by Subsections (c)-(e), the [The]
20-24 permanent school fund, which is a perpetual endowment for the
20-25 public schools of this state, consists of:
20-26 (1) all land appropriated for the public schools by
21-1 the constitution and laws of this state;
21-2 (2) all of the unappropriated public domain remaining
21-3 in this state, including all land recovered by the state by suit or
21-4 otherwise except pine forest land as defined by Section 88.111;
21-5 (3) all proceeds from the authorized sale of permanent
21-6 school fund land;
21-7 (4) all proceeds from the lawful sale of any other
21-8 properties belonging to the permanent school fund;
21-9 (5) all investments authorized by Section 43.003 of
21-10 properties belonging to the permanent school fund; [and]
21-11 (6) all income from the mineral development of
21-12 permanent school fund land, including income from mineral
21-13 development of riverbeds and other submerged land;
21-14 (7) the interest and dividends arising from any
21-15 securities or funds belonging to the permanent school fund;
21-16 (8) all interest derivable from the proceeds of the
21-17 sale of land set apart for the permanent school fund; and
21-18 (9) all money derived from the lease of land belonging
21-19 to the permanent school fund.
21-20 (b) The available school fund, which shall be apportioned
21-21 annually to each county according to its scholastic population,
21-22 consists of:
21-23 (1) two-thirds of the distributions from the permanent
21-24 school fund under Subsection (d) each fiscal year;
21-25 (2) [the interest and dividends arising from any
21-26 securities or funds belonging to the permanent school fund;]
22-1 [(2) all interest derivable from the proceeds of the
22-2 sale of land set apart for the permanent school fund;]
22-3 [(3) all money derived from the lease of land
22-4 belonging to the permanent school fund;]
22-5 [(4)] one-fourth of all revenue derived from all state
22-6 occupation taxes, exclusive of delinquencies and cost of
22-7 collection;
22-8 (3) [(5)] one-fourth of revenue derived from state
22-9 gasoline and special fuels excise taxes as provided by law; and
22-10 (4) [(6)] all other appropriations to the available
22-11 school fund made by the legislature for public school purposes.
22-12 (c) The school employees primary health coverage fund, which
22-13 the Teacher Retirement System of Texas shall administer, consists
22-14 of appropriated funds and other funds as provided by law, local
22-15 premium contributions provided by participating school districts as
22-16 authorized by an election held under Section 45.003(f), and
22-17 one-third of the distributions from the permanent school fund under
22-18 Subsection (d) each fiscal year.
22-19 (d) The total amount to be distributed under this section
22-20 each fiscal year from the permanent school fund is equal to:
22-21 (1) at least three percent but not more than seven
22-22 percent of the average fair market value of the permanent school
22-23 fund at the end of each of the preceding 12 quarters, in accordance
22-24 with the rate adopted by a vote of two-thirds of the total
22-25 membership of the State Board of Education; or
22-26 (2) five percent of the market value of the permanent
23-1 school fund at the end of each of the preceding 12 quarters, if the
23-2 State Board of Education does not adopt a rate under Subdivision
23-3 (1).
23-4 (e) The term "scholastic population" in Subsection (b) or
23-5 any other law governing the apportionment, distribution, and
23-6 transfer of the available school fund means all students of school
23-7 age enrolled in average daily attendance the preceding school year
23-8 in the public elementary and high school grades of school districts
23-9 within or under the jurisdiction of a county of this state.
23-10 SECTION 7. Chapter 43, Education Code, is amended by adding
23-11 Section 43.0021 to read as follows:
23-12 Sec. 43.0021. TRANSFERS FROM PERMANENT SCHOOL FUND AND
23-13 GENERAL REVENUE FUND TO SCHOOL EMPLOYEES PRIMARY HEALTH COVERAGE
23-14 FUND. (a) On the first working day of each month in a state
23-15 fiscal year, the comptroller shall transfer from the permanent
23-16 school fund to the school employees primary health coverage fund an
23-17 amount equal to one-twelfth of the annual distribution from the
23-18 permanent school fund to the school employees primary health
23-19 coverage fund as determined by the State Board of Education under
23-20 Section 5, Article VII, Texas Constitution, for the fiscal year.
23-21 (b) Notwithstanding Subsection (a), for the fiscal year
23-22 beginning September 1, 2001, the comptroller shall transfer from
23-23 the permanent school fund to the school employees primary health
23-24 coverage fund:
23-25 (1) on January 2, 2002, an amount equal to
23-26 five-twelfths of the annual distribution from the permanent school
24-1 fund to the school employees primary health coverage fund as
24-2 provided by Section 5, Article VII, Texas Constitution, for that
24-3 fiscal year; and
24-4 (2) on the first working day of each month after
24-5 January 2002, an amount equal to one-twelfth of the annual
24-6 distribution from the permanent school fund to the school employees
24-7 primary health coverage fund as provided by Section 5, Article VII,
24-8 Texas Constitution, for that fiscal year.
24-9 (c) Subsection (b) and this subsection expire September 1,
24-10 2002.
24-11 SECTION 8. Section 45.003, Education Code, is amended by
24-12 amending Subsection (d) and adding Subsection (f) to read as
24-13 follows:
24-14 (d) Except as provided by Subsection (f), a [A] proposition
24-15 submitted to authorize the levy of maintenance taxes must include
24-16 the question of whether the governing board or commissioners court
24-17 may levy, assess, and collect annual ad valorem taxes for the
24-18 further maintenance of public schools, at a rate not to exceed the
24-19 rate, which may be not more than $1.50 on the $100 valuation of
24-20 taxable property in the district, stated in the proposition.
24-21 (f) In addition to a proposition submitted under Subsection
24-22 (d), a proposition may be submitted to authorize maintenance taxes
24-23 that includes the question of whether the governing board or
24-24 commissioners court may levy, assess, and collect ad valorem taxes
24-25 for the specific purpose of participating in the Texas school
24-26 employees group insurance program under Chapter 3A, Insurance Code,
25-1 at a rate not to exceed the rate stated in the proposition. The
25-2 tax imposed as a result of an election under this subsection may
25-3 not be used in the determination of the district enrichment tax
25-4 rate under Section 42.302, and the limitation on the tax rate of
25-5 $1.50 on the $100 valuation of taxable property in the district
25-6 under Subsection (d) shall not apply to the combined rate of taxes
25-7 imposed as a result of an election under Subsection (d) and an
25-8 election under this subsection.
25-9 SECTION 9. Subchapter A, Chapter 45, Education Code, is
25-10 amended by adding Sections 45.0031 and 45.0032 to read as follows:
25-11 Sec. 45.0031. TAX RATE FOR SUPPORT OF HEALTH PLANS. The
25-12 legislature in the General Appropriations Act shall set a threshold
25-13 tax rate for a district to impose by virtue of an election under
25-14 Section 45.003(f) in order for the district to participate in the
25-15 Texas school employees group insurance program under Chapter 3A,
25-16 Insurance Code.
25-17 Sec. 45.0032. REMITTANCE OF TAX RECEIPTS FOR TAXES FOR
25-18 SUPPORT OF HEALTH PLANS. (a) Each year, the commissioner, with
25-19 the assistance of the comptroller, shall determine the amount of
25-20 tax receipts of a school district from the tax levied by the
25-21 district as authorized by an election under Section 45.003(f) for
25-22 the purpose of participating in the Texas school employees group
25-23 insurance program under Chapter 3A, Insurance Code.
25-24 (b) The school district shall remit the amount determined by
25-25 the commissioner under Subsection (a) to the comptroller for
25-26 deposit in the school employees primary health coverage fund in the
26-1 manner prescribed by the comptroller by rule.
26-2 SECTION 10. The following are repealed:
26-3 (1) Article 3.50-4, Insurance Code;
26-4 (2) Article 3.50-4A, Insurance Code, as added by
26-5 Chapter 1540, Acts of the 76th Legislature, Regular Session, 1999;
26-6 and
26-7 (3) Article 3.50-4A, Insurance Code, as added by
26-8 Chapter 372, Acts of the 76th Legislature, Regular Session, 1999.
26-9 SECTION 11. Section 43.008, Education Code, is repealed.
26-10 SECTION 12. (a) The Teacher Retirement System of Texas
26-11 shall transfer all assets and liabilities of the programs provided
26-12 under Article 3.50-4A, Insurance Code, as added by Chapter 1540,
26-13 Acts of the 76th Legislature, Regular Session, 1999, and Article
26-14 3.50-4A, Insurance Code, as added by Chapter 372, Acts of the 76th
26-15 Legislature, Regular Session, 1999, all coverages provided under
26-16 those programs, and all records pertaining to those programs to the
26-17 optional group insurance program provided under Chapter 3A,
26-18 Insurance Code, as added by this Act, not later than the date that
26-19 optional program is implemented.
26-20 (b) The Teacher Retirement System of Texas shall transfer
26-21 all assets and liabilities of the program provided under Article
26-22 3.50-4, Insurance Code, all coverages provided under that program,
26-23 and all records pertaining to that program to the primary health
26-24 plan provided under Chapter 3A, Insurance Code, as added by this
26-25 Act, not later than the date the primary health plan provided under
26-26 Chapter 3A is implemented.
27-1 SECTION 13. (a) The Teacher Retirement System of Texas
27-2 shall use money appropriated by the 77th Legislature for initial
27-3 costs for the establishment of a primary health plan in a manner
27-4 necessary to ensure that enrollment in that plan provided under
27-5 Chapter 3A, Insurance Code, as added by this Act, begins not later
27-6 than the 2002-2003 school year.
27-7 (b) In 2001, the Teacher Retirement System of Texas shall
27-8 deliver with the certification required under Article 3A.152,
27-9 Insurance Code, as added by this Act, a comprehensive report on its
27-10 proposal for the primary health plan under that article and the
27-11 status of planned implementation of the primary health plan.
27-12 SECTION 14. Except as provided by Sections 15 and 16 of this
27-13 Act, this Act takes effect immediately if it receives a vote of
27-14 two-thirds of all the members elected to each house, as provided by
27-15 Section 39, Article III, Texas Constitution. If this Act does not
27-16 receive the vote necessary for immediate effect, this Act takes
27-17 effect on the 91st day after the last day of the legislative
27-18 session.
27-19 SECTION 15. Section 10 of this Act takes effect September 1,
27-20 2002.
27-21 SECTION 16. (a) Sections 5, 6, 7, and 11 of this Act take
27-22 effect January 1, 2002, but only if the constitutional amendment
27-23 proposed by the 77th Legislature, Regular Session, 2001, relating
27-24 to distributions from the permanent school fund to the available
27-25 school fund and to the school employees primary health coverage
27-26 fund, is approved by the voters. If the proposed constitutional
28-1 amendment is not approved by the voters, Sections 5, 6, 7, and 11
28-2 of this Act have no effect.
28-3 (b) Section 43.001, Education Code, as amended by Section 6
28-4 of this Act, and Section 43.0021, Education Code, as added by
28-5 Section 7 of this Act, apply beginning with the state fiscal year
28-6 beginning September 1, 2001.