28 Tex. Admin. Code § 26.534 - Participation Through Direct Purchase of Health Benefit Plan

A regional or local health care program may apply to participate through purchase of an available Healthy Texas health benefit plan pursuant to the Health and Safety Code § 75.102(a)(3), so long as the eligibility criteria in paragraphs (1) and (2) of this section are met.

(1) Employers of employees for whom the regional or local health care program is purchasing or facilitating the purchase of health benefit plan coverage through Healthy Texas must:

(A) comply with the provisions of § 26.521(a) - (e) and (g) - (k) of this subchapter (relating to Small Employer Participation); and

(B) contribute an amount of premium costs for employees which, when combined with any amount obtained from any other eligible source as provided in the Health and Safety Code § 75.055, amounts to at least 50 percent of the premium for each employee covered under the Healthy Texas benefit plan.

(2) Employees of small employers associated with the regional or local health care program must:

(A) meet the definition of "eligible employee" as defined in the Insurance Code § 1508.002(2);

(B) meet the annual wage criteria of the Insurance Code § 1508.051(a)(2) or § 1508.052(b);

(C) elect to participate in the Healthy Texas Program at a rate equal to or greater than 60 percent of eligible employees; and

(D) comply with § 26.521(e)(3) of this subchapter.

Notes

28 Tex. Admin. Code § 26.534

The provisions of this §26.534 adopted to be effective March 16, 2010, 35 TexReg 2174