Tex. Ins. Code § 846.004 · Subchapter A. GENERAL PROVISIONS
LATE-PARTICIPATING EMPLOYEE OR DEPENDENT.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) For purposes of this chapter, an employee or dependent eligible for enrollment in a participating employer's health benefit plan is a late-participating employee or dependent if the individual requests enrollment after the expiration of:
(1) the initial enrollment period established under the terms of the first health benefit plan for which that employee or dependent was eligible through the participating employer; or
(2) an open enrollment period under Section 846.257.
(b) An employee or dependent is not a late-participating employee or dependent if the individual:
(1) was covered under another health benefit plan or self-funded employer health benefit plan at the time the individual was eligible to enroll;
(2) declined enrollment in writing, at the time of the initial eligibility for enrollment, stating that coverage under another health benefit plan or self-funded employer health benefit plan was the reason for declining enrollment;
(3) has lost coverage under the other health benefit plan or self-funded employer health benefit plan as a result of:
(A) the termination of employment;
(B) a reduction in the number of hours of employment;
(C) the termination of the other plan's coverage;
(D) the termination of contributions toward the premium made by the employer; or
(E) the death of a spouse or divorce; and
(4) requests enrollment not later than the 31st day after the date coverage under the other health benefit plan or self-funded employer health benefit plan terminates.
(c) An employee or dependent is also not a late-participating employee or dependent if the individual is:
(1) employed by an employer that offers multiple health benefit plans and the individual elects a different health benefit plan during an open enrollment period under Section 846.257;
(2) a spouse for whom a court has ordered coverage under a covered employee's plan and the request for enrollment of the spouse is made not later than the 31st day after the date the court order is issued; or
(3) a child for whom a court has ordered coverage under a covered employee's plan and the request for enrollment is made not later than the 31st day after the date the employer receives the court order.
Notes and commentary — not statutory text
History
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/IN/htm/IN.846.htm
- Text hash
- sha256 91c1433e66cef215e0927868ec74cd2e541d82fb1656dab761aaa1232a1e74ce
- Composed by
- compose_tx.py 2026-10-05: the Legislative Council's chapter files read in document order; verify_tx.py's independent reading (lxml DOM walk) agrees character for character
This section cites
Provisions in this library that the text above cites, as it prints each citation. A range cited as “ss. 61.13-61.16” links its first and last provisions.
Procedural information only. Not legal advice and not a substitute for the advice of an attorney. Confirm the current text with the official publisher before relying on it.