Law:Title 7. Life Insurance And Annuities. Subtitle B. Group Life Insurance (Texas)

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Subtitle B. Group Life Insurance

Contents

Chapter 1131. Group Life Insurance And Wholesale, Franchise, Or Employee Life Insurance

Subchapter A. General Provisions

Section  1131.001.  Definition.

In this chapter, "wholesale, franchise, or employee life insurance" means a term life insurance plan under which a number of individual term life insurance policies are issued to a selected group at a rate that is lower than the rate shown in the issuing insurer's manual for an individually issued policy of the same type issued to an insured of the same class.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.002.  Certain Group Life Insurance Authorized.

A group life insurance policy may be delivered in this state only if the policy:

(1)  covers a group described by Subchapter B; and

(2)  complies with this chapter.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.003.  Certain Wholesale, Franchise, Or Employee Life Insurance Authorized.

A wholesale, franchise, or employee life insurance policy may be issued or delivered in this state only if the policy:

(1)  covers a group described by Section 1131.065; and

(2)  complies with Subchapter P.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.004.  Forfeiture Of Certificate Of Authority For Unauthorized Group Life Insurance Contract.

The certificate of authority to engage in the business of insurance in this state of an insurer that enters into a group life insurance contract other than as authorized by this chapter may be forfeited by an action brought for that purpose by the attorney general at the department's request.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.005.  Guaranteeing Issuance Of Life Insurance Policy Without Evidence Of Insurability.

(a) In this section, "qualified pension or profit-sharing plan" means a plan that meets the requirements of:

(1)  Section 401 or 403, Internal Revenue Code of 1986, and their subsequent amendments; or

(2)  any corresponding provisions of prior or subsequent United States revenue laws.

(b)  This code does not prohibit a life insurance company authorized to engage in the business of insurance in this state from guaranteeing to issue individual life insurance policies insuring participants in a qualified pension or profit-sharing plan on other than the term plan without evidence of insurability.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.006.  Assignment Of Benefits.

(a) Subject to the terms of a group life insurance policy, an insured under the policy may make to any individual, firm, corporation, association, trust, or other legal entity, other than the insured's employer, an absolute or collateral assignment of all rights and benefits conferred on the insured by the policy or by Subchapter C.

(b)  Subsection (a) applies without regard to the date a policy is issued.

(c)  Subject to the terms of the policy, an assignment by an insured before September 1, 1969, is valid for the purpose of vesting in the assignee all assigned rights and privileges but without prejudice to the insurer because of any payment the insurer makes or individual policy the insurer issues before receiving notice of the assignment.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section 1131.007.  Policy Form.

A policy of group life insurance is subject to Chapter 1701.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.

Amended by:

Acts 2007, 80th Leg., R.S., Ch. 730, Sec. 2F.007, eff. April 1, 2009.



Subchapter B. Group And Wholesale, Franchise, Or Employee Life Insurance: Eligible Policyholders

Section  1131.051.  Employers.

(a) A group life insurance policy may be issued to an employer or to trustees of a fund established by an employer to insure the employer's employees for the benefit of persons other than the employer.

(b)  A policy to which this section applies may provide that "employee" includes:

(1)  an individual proprietor or partner, if the employer is an individual proprietorship or partnership;

(2)  an employee of a subsidiary corporation of the employer;

(3)  an employee, individual proprietor, or partner of an affiliated corporation, proprietorship, or partnership, if the business of the employer and the affiliated corporation, proprietorship, or partnership is under common control through stock ownership, contract, or otherwise; or

(4)  a retired employee.

(c)  The employer or the trustees of a fund established by an employer are the policyholder under a policy to which this section applies.

(d)  A policy to which this section applies is subject to Subchapter E.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.052.  Labor Unions.

(a) A group life insurance policy may be issued to a labor union to insure the union's members who are actively engaged in the same occupation.

(b)  For purposes of this chapter:

(1)  a labor union is considered to be an employer; and

(2)  a member of a labor union is considered to be an employee of the union.

(c)  The labor union is the policyholder under a policy to which this section applies.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.053.  Funds Established By Employers Or Labor Unions.

(a) A group life insurance policy that insures the employers' employees or the unions' members for the benefit of persons other than the employers or unions may be issued to the trustees of a fund established or adopted by two or more employers in the same industry or by one or more labor unions, by one or more employers in the same industry and one or more labor unions, or by one or more employers and one or more labor unions whose members are in the same or related occupations or trades.

(b)  A policy to which this section applies may provide that "employee" includes:

(1)  an individual proprietor or partner, if the employer is an individual proprietorship or partnership;

(2)  a trustee, an employee of the trustee, or both, if the person's duties are principally connected with the trusteeship; or

(3)  a retired employee.

(c)  The trustees are the policyholder under a policy to which this section applies.

(d)  A policy may not be issued under this section to insure employees of:

(1)  an employer whose eligibility to participate in the fund as an employer arises out of considerations directly related to the employer being a commercial correspondent or business client or patron of another employer, without regard to whether the other employer participates in the fund;  or

(2)  an employer that is not located in this state, unless:

(A)  the majority of the employers whose employees are to be insured are located in this state; or

(B)  the policy is issued to the trustees of a fund established or adopted by one or more labor unions.

(e)  A policy to which this section applies is subject to Subchapter F.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.

Amended by:

Acts 2009, 81st Leg., R.S., Ch. 689, Sec. 1, eff. September 1, 2009.



Section  1131.054.  Governmental Entities Or Associations Of Public Employees.

(a) In this section, "employee" includes an elected or appointed officer of the state.

(b)  A group life insurance policy may be issued to a governmental entity or an association of public employees listed in Subsection (c) to insure the governmental entity's employees or the association's members for the benefit of persons other than the governmental entity or association.

(c)  This section authorizes issuance of a group life insurance policy to:

(1)  a municipality, independent school district, or common school district;

(2)  a department of state government;

(3)  a state college or university; or

(4)  an association of public employees, including an association of:

(A)  employees of the United States government, if the majority of the members of the association reside in this state;

(B)  state employees; or

(C)  any combination of state, county, and municipal employees.

(d)  The governmental entity or association is the policyholder under a policy to which this section applies.

(e)  A policy to which this section applies is subject to Subchapter G.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.055.  Spouses And Children Of Employees Of United States Government.

(a) A group term life insurance policy may be extended, in the form of group term life insurance only, to insure the spouse and natural or adopted minor children of an insured employee of the United States government if:

(1)  the policy constitutes a part of the employee benefit program established for the benefit of employees of the United States government; and

(2)  the spouse or children of other employees covered by the same employee benefit program in other states are or may be covered by group term life insurance.

(b)  A policy to which this section applies is subject to Subchapter H.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.056.  Principals.

(a) In this section, "agent" includes a general agent, subagent, or salesperson.

(b)  A group life insurance policy may be issued to a principal, or if the principal is a life, life and accident, or life, accident, and health insurer, by or to the principal, to insure the principal's agents for the benefit of persons other than the principal.

(c)  A policy to which this section applies is subject to Subchapter I.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.057.  Creditors.

(a) A group life insurance policy may be issued to a creditor to insure the creditor's debtors.

(b)  The creditor is the policyholder under a policy to which this section applies.

(c)  A policy to which this section applies is subject to Subchapter J.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.058.  Veterans' Land Board.

(a) A group life insurance policy may be issued to the Veterans' Land Board to insure persons purchasing land under the Veterans' Land Program as provided by Subchapter I, Chapter 161, Natural Resources Code.

(b)  The Veterans' Land Board is the policyholder under a policy to which this section applies.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.059.  Associations Or Trusts For Payment Of Funeral Expenses.

A group life insurance policy may be issued to an association or trust for a group of individuals for the payment of future funeral expenses.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.060.  Nonprofit Organizations Or Associations.

(a) A group life insurance policy may be issued to a nonprofit service, civic, fraternal, or community organization or association to insure the organization's or association's members and employees for the benefit of persons other than the organization or association or an officer of the organization or association.

(b)  To be eligible to obtain a group life insurance policy under this section, an organization or association must:

(1)  have a constitution or bylaws;

(2)  have actively existed for at least two years; and

(3)  have been formed for purposes other than that of obtaining insurance.

(c)  The organization or association is the policyholder under a policy to which this section applies.

(d)  A policy to which this section applies is subject to Subchapter K.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.064.  Other Groups. (a) A

group life insurance policy may be issued to cover a group other than a group described by Sections 1131.051-1131.060 if the commissioner finds that:

(1)  the issuance of the policy is not contrary to the best interest of the public;

(2)  the issuance of the policy would result in economies of acquisition or administration; and

(3)  the benefits are reasonable in relation to the premiums charged.

(b)  Group life insurance coverage may not be offered under this section in this state by an insurer under a policy issued in another state unless this state or another state having requirements substantially similar to those prescribed by Subsections (a)(1)-(3) has determined that those requirements have been met.

(c)  A policy to which this section applies is subject to Subchapter O.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.065.  Wholesale, Franchise, Or Employee Life Insurance.

(a) Policies of wholesale, franchise, or employee life insurance may be issued to:

(1)  the employees of a common employer or employers;

(2)  the members of one or more labor unions; or

(3)  the members of one or more credit unions.

(b)  A policy to which this section applies is subject to Subchapter P.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Subchapter C. Group Life Insurance: Required Provisions

Section  1131.101.  Required Provisions.

(a) A group life insurance policy may not be delivered in this state unless the policy contains in substance the provisions prescribed by this subchapter or provisions in relation to provisions prescribed by this subchapter that, in the opinion of the commissioner, are:

(1)  more favorable to an insured under the policy; or

(2)  at least as favorable to an insured under the policy and more favorable to the policyholder.

(b)  The standard provisions required for individual life insurance policies do not apply to group life insurance policies.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.102.  Nonforfeiture.

(a) A group life insurance policy other than a group term life insurance policy must contain nonforfeiture provisions that, in the commissioner's opinion, are equitable to the insured and the policyholder.

(b)  This section does not require that a group life insurance policy contain the same nonforfeiture provisions as required for an individual life insurance policy.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.103.  Grace Period.

(a) A group life insurance policy must provide that the policyholder or premium payor is entitled to a grace period of 31 days for the payment of any premium, other than the first, due under the policy. During the grace period, the death benefit coverage continues in force unless the policyholder or premium payor gives the insurer written notice of discontinuance before the date of discontinuance and in accordance with the policy.

(b)  The policy may provide that the policyholder or premium payor is liable to the insurer for payment of a pro rata premium for the time the policy was in force during a grace period.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.104.  Incontestability Of Policy.

A group life insurance policy must provide that:

(1)  the validity of the policy may not be contested, except for nonpayment of premiums, after the policy has been in force for two years after its date of issue; and

(2)  a statement made by any insured under the policy relating to the insured's insurability may not be used in contesting the validity of the insurance with respect to which the statement was made after the insurance has been in force before the contest for a period of two years from its date of issue during the insured's lifetime and unless the statement is contained in a written instrument signed by the insured making the statement.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.105.  Application For Policy; Statements Of Insured.

A group life insurance policy must provide that:

(1)  a copy of any application for the policy by the policyholder must be attached to the policy when issued;

(2)  a statement made by the policyholder or an insured is considered a representation and not a warranty; and

(3)  a statement made by an insured may not be used in any contest under the policy unless a copy of the instrument containing the statement is or has been furnished to the person or the person's beneficiary.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.106.  Evidence Of Insurability.

A group life insurance policy must state the conditions, if any, under which the insurer reserves the right to require an individual eligible for insurance to furnish evidence of individual insurability satisfactory to the insurer as a condition of obtaining part or all of the coverage.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.107.  Adjustment Of Premiums Or Benefits If Age Of Insured Is Misstated.

(a) A group life insurance policy must specify an equitable adjustment of premiums, benefits, or both, to be made if the age of an insured has been misstated.

(b)  The provision required by Subsection (a) must contain a clear statement of the method of adjustment to be used.

(c)  This section does not apply to a policy to which Section 1131.703 applies.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.108.  Insurance Certificate.

(a) A group life insurance policy must provide that the insurer will issue to the policyholder for delivery to each insured an individual certificate stating:

(1)  the insurance protection to which the insured is entitled;

(2)  to whom the insurance benefits are payable; and

(3)  the rights and conditions specified by Sections 1131.110-1131.112.

By agreement between the insurer and the policyholder, the certificate of insurance may be delivered electronically.

(b)  This section does not apply to:

(1)  a policy issued to a creditor to insure the creditor's debtors; or

(2)  a policy to which Section 1131.703 applies.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003. Amended by Acts 2003, 78th Leg., ch. 1075, Sec. 1, eff. Sept. 1, 2003.



Section  1131.109.  Person To Whom Benefits Are Payable.

(a) A group life insurance policy must provide that any amount due because of an insured's death must be paid to the beneficiary designated by the insured or the beneficiary's assignee, subject to:

(1)  the provisions of the policy, if the designated beneficiary as to all or any part of the amount is not living at the time the insured dies; and

(2)  any right reserved by the insurer in the policy and stated in the certificate to pay at the insurer's option a portion of the amount not to exceed $250 to any person the insurer determines is equitably entitled to the portion because of having incurred funeral or other expenses incident to the last illness or death of the insured.

(b)  This section does not apply to:

(1)  a policy issued to a creditor to insure the creditor's debtors; or

(2)  a policy to which Section 1131.703 applies.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.110.  Right To Individual Policy On Termination Of Employment Or Membership.

(a) A group life insurance policy must provide that if any portion of the insurance on an individual insured under the policy ceases because the individual's employment or membership in the class or classes eligible for coverage under the policy terminates, the individual is entitled to have the insurer issue to the individual an individual life insurance policy without disability or other supplementary benefits.

(b)  An individual must apply for an individual policy and pay the first premium to the insurer not later than the 31st day after the date the individual's employment or membership terminates.

(c)  An individual policy under this section must be issued without evidence of insurability.

(d)  The insured may select any individual policy, other than a term life insurance policy, customarily issued by the insurer for an individual of the insured's age and for the amount requested.

(e)  Except as provided by Subsection (f), the individual policy must be in an amount not to exceed the amount of life insurance that ceases because of the termination of employment or membership.

(f)  For purposes of Subsection (e), any amount of insurance that, on or before the date of the termination of employment or membership, has matured as an endowment payable to the insured is not included in the amount that is considered to cease because of the termination. This subsection applies without regard to whether the endowment is payable in full, in installments, or in the form of an annuity.

(g)  The premium on an individual policy must be at the insurer's then customary rate applicable to:

(1)  the form and amount of the individual policy;

(2)  the class of risk to which the insured then belongs; and

(3)  the insured's age on the effective date of the individual policy.

(h)  This section does not apply to:

(1)  a policy issued to a creditor to insure the creditor's debtors; or

(2)  a policy to which Section 1131.703 applies.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.111.  Right To Individual Policy On Termination Of Coverage Under Group Policy. (a)

A group life insurance policy must provide that if the policy terminates or is amended so as to terminate the insurance of a class of insured individuals, each individual insured under the policy on the date of the termination or amendment whose insurance terminates and who has been insured under the policy for at least five years before the date of the termination or amendment is entitled to have the insurer issue to the individual an individual life insurance policy, subject to the conditions and limitations provided by Section 1131.110.

(b)  Notwithstanding Section 1131.110(e), a group life insurance policy may provide that the amount of an individual policy issued under this section may not exceed the lesser of:

(1)  the amount of the individual's life insurance coverage that ceases because of the termination or amendment of the group policy, less the amount of any life insurance for which the individual is or becomes eligible under any group policy issued or reinstated by the same or another insurer not later than the 31st day after the date of the termination or amendment; or

(2)  $2,000.

(c)  This section does not apply to:

(1)  a policy issued to a creditor to insure the creditor's debtors; or

(2)  a policy to which Section 1131.703 applies.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.112.  Payment Of Benefits On Death Of Insured Before Individual Policy Becomes Effective.

(a) A group life insurance policy must provide that if an individual insured under the group policy dies during the period within which the individual would have been entitled to have an individual policy issued as provided by Section 1131.110 or 1131.111 and before such an individual policy takes effect, the amount of life insurance that the individual would have been entitled to have issued to the individual under the individual policy is payable as a claim under the group policy.

(b)  This section applies without regard to whether:

(1)  the application for the individual policy has been made; or

(2)  the first premium for the individual policy has been paid.

(c)  This section does not apply to:

(1)  a policy issued to a creditor to insure the creditor's debtors; or

(2)  a policy to which Section 1131.703 applies.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Subchapter D. Group Life Insurance: Optional Provisions

Section  1131.151.  Continuation Of Benefits For Family Members After Death Of Insured.

(a) A group life insurance policy that provides for the insurer to pay benefits for members of the family or dependents of an individual in the insured group may provide for a continuation of any part of those benefits after the death of the individual in the insured group.

(b)  Any amounts of insurance provided by benefits under Subsection (a) are not considered to be life insurance for the purpose of determining the maximum amount of term insurance that may be issued on any one life.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Subchapter E. Group Life Insurance Policies Issued To Employers: Additional Requirements

Section  1131.201.  App

LICABILITY OF

Subchapter

. This subchapter applies only to a group life insurance policy issued to a group described by Section 1131.051.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.202.  Eligible Employees.

All employees of the employer, or all of any class or classes of employees determined by conditions relating to their employment, are eligible for insurance under the policy.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.203.  Payment Of Premiums.

The policyholder must pay the premium for the policy:

(1)  wholly from the employer's fund or funds contributed by the employer;

(2)  partly from funds described by Subdivision (1) and partly from funds contributed by the insured employees; or

(3)  wholly from funds contributed by the insured employees.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.

Amended by:

Acts 2005, 79th Leg., Ch. 1073, Sec. 1, eff. June 18, 2005.

Acts 2005, 79th Leg., Ch. 1073, Sec. 2, eff. June 18, 2005.



Section  1131.204.  Minimum Enrollment.

(a) The policy must cover at least two employees on the date the policy is issued.

(b)  Repealed by Acts 2005, 79th Leg., Ch. 1073, Sec. 2, eff. June 18, 2005.

(c)  A policy as to which the insured employees do not pay any part of the premium must insure:

(1)  all eligible employees; or

(2)  all eligible employees except any employees as to whom evidence of individual insurability is not satisfactory to the insurer.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.

Amended by:

Acts 2005, 79th Leg., Ch. 2, Sec. 1, eff. September 1, 2005.

Acts 2005, 79th Leg., Ch. 1073, Sec. 2, eff. June 18, 2005.



Section  1131.205.  Amounts Of Insurance.

(a) The amounts of insurance under the policy must be based on a plan that precludes individual selection by the employees or by the employer or trustees.

(b)  Repealed by Acts 2005, 79th Leg., Ch. 496, Sec. 2(1), eff. June 17, 2005.

(c)  Repealed by Acts 2005, 79th Leg., Ch. 496, Sec. 2(1), eff. June 17, 2005.

(d)  Repealed by Acts 2005, 79th Leg., Ch. 496, Sec. 2(1), eff. June 17, 2005.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.

Amended by:

Acts 2005, 79th Leg., Ch. 496, Sec. 2(1), eff. June 17, 2005.



Subchapter F. Group Life Insurance Policies Issued To Funds Established By Employers Or Labor Unions: Additional Requirements

Section  1131.251.  App

LICABILITY OF

Subchapter

. This subchapter applies only to a group life insurance policy issued to a group described by Section 1131.053.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.252.  Eligible Employees Or Members.

(a) The individuals eligible for insurance under the policy are:

(1)  all employees of the employers and the employees of the trade association of those employers;

(2)  all members of the labor union; or

(3)  all of any class or classes of employees or members determined by conditions relating to their employment, to their membership in the unions, or both.

(b)  A director of a corporate employer is not eligible for insurance under the policy unless the person is otherwise eligible as a bona fide employee of the corporation by performing services other than the usual duties of a director.

(c)  An individual proprietor or partner is not eligible for insurance under the policy unless the person is actively engaged in and devotes a substantial part of the person's time to conducting the business of the proprietorship or partnership.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.253.  Payment Of Premiums.

(a) Subject to Subsection (b), the policyholder must pay the premium for the policy:

(1)  wholly from funds contributed by the employer or employers, the labor union or unions, or both; or

(2)  partly from funds described by Subdivision (1) and partly from funds contributed by the insureds.

(b)  An insured's contribution toward the cost of the insurance may not exceed 40 cents per month for each $1,000 of insurance coverage.

(c)  The policy may provide that a participating employer or labor union may pay the premium directly to the insurer for the policy issued to the trustee. If payment is made as provided by this subsection, the employer or labor union is the premium payor for the insured employees or union members for that employer unit.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.254.  Minimum Enrollment.

(a) The policy must cover at least 100 individuals on the date the policy is issued unless the policy is issued to the trustees of a fund established by:

(1)  employers that have assumed obligations through a collective bargaining agreement and are participating in the fund to:

(A)  comply with those obligations with regard to one or more classes of their employees who are covered by the collective bargaining agreement; or

(B)  provide insurance benefits for other classes of their employees; or

(2)  one or more labor unions.

(b)  A policy as to which the insureds are to pay part of the premium from funds contributed specifically for their insurance may take effect only if at least 75 percent of the individuals of each participating employer unit who are eligible on the date the policy takes effect, excluding any individuals as to whom evidence of insurability is not satisfactory to the insurer, elect to make the required contributions.

(c)  A policy as to which the insureds do not pay any part of the premium must insure:

(1)  all eligible individuals; or

(2)  all eligible individuals except any individuals as to whom evidence of individual insurability is not satisfactory to the insurer.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.255.  Amounts Of Insurance.

(a) The amounts of insurance under the policy must be based on a plan that precludes individual selection by the insureds or by the policyholder or employer.

(b)  Repealed by Acts 2005, 79th Leg., Ch. 496, Sec. 2(2), eff. June 17, 2005.

(c)  Repealed by Acts 2005, 79th Leg., Ch. 496, Sec. 2(2), eff. June 17, 2005.

(d)  Repealed by Acts 2005, 79th Leg., Ch. 496, Sec. 2(2), eff. June 17, 2005.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.

Amended by:

Acts 2005, 79th Leg., Ch. 496, Sec. 2(2), eff. June 17, 2005.



Subchapter G. Group Life Insurance Policies Issued To Governmental Entities Or Associations Of Public Employees: Additional Requirements

Section  1131.301.  App

LICABILITY OF

Subchapter

. This subchapter applies only to a group life insurance policy issued to a group described by Section 1131.054.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.302.  Eligible Employees Or Members.

All employees of the employer or all members of the association are eligible for insurance under the policy.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.303.  Payment Of Premiums.

(a) The premium for the policy may be paid wholly or partly from funds contributed by:

(1)  the employer;

(2)  the individuals insured under the policy; or

(3)  the insured employees who are members of the association of employees.

(b)  Any money or credits received by or allowed to the policyholder under any participation agreement contained in or issued in connection with the policy must be applied to the payment of future premiums and to the pro rata abatement of the insured employees' contribution for future premiums.

(c)  The employer may deduct from an employee's salary the employee's contribution for the premiums if authorized to do so in writing by that employee.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.304.  Minimum Enrollment.

(a) The policy must cover at least 10 employees or members on the date the policy is issued.

(b)  A policy as to which the insured employees or members pay part of the premium may take effect only if at least 75 percent of the employees or members eligible on the date the policy takes effect, excluding any employees or members as to whom evidence of individual insurability is not satisfactory to the insurer, elect to make the required contributions.

(c)  A group policy issued before September 1, 1969, to a group described by Section 1131.054 that was in existence on that date continues in force without regard to whether the number of the employees or members insured under the policy was less than 75 percent of the employees or members eligible on that date.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Subchapter H. Group Term Life Insurance Policies Extended To Spouses And Children Of Employees Of United States: Additional Requirements

Section  1131.351.  App

LICABILITY OF

Subchapter

. This subchapter applies only to a group term life insurance policy extended to a group described by Section 1131.055.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.352.  Payment Of Premiums.

The policyholder must pay the premium for the group term life insurance solely from funds contributed by the insured employees.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.353.  Amounts Of Insurance.

(a) The amounts of insurance under the policy must be based on a plan that precludes individual selection by the insured employees or by the policyholder.

(b)  Group term life insurance on the life of an employee's spouse may not exceed the lesser of:

(1)  $10,000; or

(2)  one-half of the amount of insurance on the life of the insured employee under the group policy.

(c)  Group term life insurance on the life of an employee's minor child may not exceed $2,000.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.354.  Conversion Rights.

On termination of group term life insurance coverage for a spouse insured under this subchapter because the insured employee's employment terminates or the employee dies, or because the group contract terminates, the spouse has the same conversion rights as to the group term life insurance on the spouse's life as the employee.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.355.  Certificate Of Insurance.

Only one certificate of insurance issued for delivery to an insured employee is required if the certificate includes a statement concerning any dependent's coverage.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Subchapter I. Group Life Insurance Policies Issued To Principals: Additional Requirements

Section  1131.401.  App

LICABILITY OF

Subchapter

. This subchapter applies only to a group life insurance policy issued to a group described by Section 1131.056.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.402.  Eligible Agents.

Agents who are under contract to provide personal services for the principal for a commission or other fixed or ascertainable compensation, or any class or classes of those agents determined by conditions relating to the services the agents provide to the principal, are eligible for insurance under the policy.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.403.  Payment Of Premiums.

The premium for the policy must be paid:

(1)  wholly by the principal; or

(2)  partly from funds contributed by the principal and partly from funds contributed by the insured agents.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.404.  Minimum Enrollment.

(a) The policy must cover at least 10 agents on the date the policy is issued.

(b)  Subject to Subsection (c), a policy as to which the insured agents pay part of the premium must cover, on the date the policy is issued, at least:

(1)  75 percent of the eligible agents; or

(2)  75 percent of any class or classes of eligible agents, determined by conditions relating to the services the agents provide to the principal.

(c)  Benefits may be extended to another class of agents if 75 percent of the class request coverage.

(d)  A policy as to which the insured agents do not pay any part of the premium must insure:

(1)  all eligible agents; or

(2)  all of any class or classes of eligible agents determined by conditions relating to the services the agents provide to the principal.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.405.  Amounts Of Insurance.

(a) The amounts of insurance under the policy must be based on a plan that precludes individual selection by the agents or by the principal.

(b)  Repealed by Acts 2005, 79th Leg., Ch. 496, Sec. 2(3), eff. June 17, 2005.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.

Amended by:

Acts 2005, 79th Leg., Ch. 496, Sec. 2(3), eff. June 17, 2005.



Subchapter J. Group Life Insurance Policies Issued To Creditors: Additional Requirements

Section  1131.451.  App

LICABILITY OF

Subchapter

. This subchapter applies only to a group life insurance policy issued to a group described by Section 1131.057.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.452.  Eligible Debtors.

All individuals who become borrowers, or purchasers of securities, merchandise, or other property, under an agreement to pay the borrowed amount or to pay the balance of the price of the securities, merchandise, or other property purchased, are eligible for insurance under the policy.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.453.  Payment Of Premiums.

The policyholder must pay the premium for the policy from:

(1)  the creditor's funds;

(2)  charges collected from the insured debtors; or

(3)  both the creditor's funds and charges collected from the insured debtors.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.454.  Minimum Enrollment.

The policy must cover at least 50 debtors at all times.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.455.  Amount Of Insurance.

(a) Except as otherwise provided by this section, the amount of insurance on a debtor's life under the policy may not exceed  the amount of the debtor's indebtedness.

(b)  Subject to Subsections (c) and (d), the face amount of any loan or loan commitment, totally or partially executed, made to a debtor for educational purposes or to a debtor with seasonal income by a creditor in good faith for general agricultural or horticultural purposes, secured or unsecured, under which the debtor becomes personally liable for the payment of the loan, may be insured in an initial amount of insurance not to exceed  the total amount payable under the contract of indebtedness.

(c)  If indebtedness described by Subsection (b) is payable in substantially equal installments, the amount of insurance may not at any time exceed the greater of the scheduled or actual amount of unpaid indebtedness.

(d)  Insurance on a loan commitment described by Subsection (b) that does not exceed one year in duration may be written up to the amount of the loan commitment on a nondecreasing or level term plan.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.

Amended by:

Acts 2005, 79th Leg., Ch. 496, Sec. 1, eff. June 17, 2005.



Section  1131.456.  Payment Of Proceeds.

(a) The proceeds of the insurance must be payable to the policyholder.

(b)  Payment to the policyholder reduces or extinguishes the debtor's unpaid indebtedness to the extent of the payment. In the case of a debtor under a loan or loan commitment described by Section 1131.455(b), any insurance proceeds in excess of the indebtedness to the creditor are payable:

(1)  to the debtor's estate; or

(2)  under a facility of payment clause.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.457.  Annuities And Endowment Insurance Prohibited.

The insurance issued may not include annuities or endowment insurance.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Subchapter K. Group Life Insurance Policies Issued To Nonprofit Organizations Or Associations: Additional Requirements

Section  1131.501.  App

LICABILITY OF

Subchapter

. This subchapter applies only to a group life insurance policy issued to a group described by Section 1131.060.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.502.  Eligible Members.

All members of the organization or association, or all of any class of members determined by conditions relating to their membership in the organization or association, are eligible for insurance under the policy.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.503.  Payment Of Premiums.

(a) The policyholder must pay the premium from:

(1)  the policyholder's funds;

(2)  funds contributed by the employees or members specifically for their insurance; or

(3)  both the policyholder's funds and funds contributed by the employees or members.

(b)  The policy may provide that the premium may be paid directly to the insurer by individual employees or members from their own funds. If the premium is paid as provided by this subsection, the respective employees or members become the premium payor for that particular certificate.

(c)  For purposes of Sections 222.002, 257.001, and 281.004, only the final retrospectively determined premium amount remitted to the issuer by the group policyholder is taxable as gross premiums, without regard to whether membership contributions, fees, assessments, dues, revenues, or other considerations in excess of that final amount are also collected from members.  This subsection applies only to a nonprofit membership association that:

(1)  qualifies under Section 501(c)(9), Internal Revenue Code of 1986;

(2)  has been in existence for at least 50 years;

(3)  limits association membership to:

(A)  members of the uniformed services of the United States serving on active duty;

(B)  members of the ready reserve forces of the United States, including the Army and Air National Guard;

(C)  retirees and separatees of:

(i)  the uniformed services of the United States; or

(ii)  the ready reserve forces of the United States, including the Army and Air National Guard;

(D)  cadets and midshipmen in the service academies of the United States and other officer candidates;

(E)  federal employees and contractors who are employed by the United States government or other related governmental entities or retired with pay from that employment;

(F)  employees or members of any state, county, municipal, or other local governmental body or other organized governmental entity who are involved in homeland defense and homeland security operations; and

(G)  any other category of membership established by the governing body of the association that falls within the scope of permissible membership authorized by Section 501(c)(9), Internal Revenue Code of 1986;

(4)  has no separate membership enrollment or application requirement;

(5)  collects member contributions, fees, or dues, including funds contributed specifically for insurance and remitted by the group policyholder to the issuer following a retrospective premium determination; and

(6)  provides insurance and noninsurance membership benefits.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.

Amended by:

Acts 2007, 80th Leg., R.S., Ch. 1252, Sec. 1, eff. June 15, 2007.



Section  1131.504.  Minimum Enrollment.

The policy must cover at least 25 individuals on the date the policy is issued.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.505.  Amounts Of Insurance.

The amounts of insurance under the policy must be based on a plan that precludes individual selection by the insured members or by the organization or association.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Subchapter O. Group Life Insurance Policies Issued To Other Groups: Additional Requirements

Section  1131.701.  App

LICABILITY OF

Subchapter

. This subchapter applies only to a group life insurance policy issued to a group described by Section 1131.064.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.702.  Payment Of Premiums.

The premium for the policy must be paid from:

(1)  the policyholder's funds;

(2)  funds contributed by the insureds; or

(3)  both the policyholder's funds and funds contributed by the insureds.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.703.  Insurance For Liabilities Related To Fringe Benefits.

(a) Notwithstanding any other law, an employer may insure the lives of the employer's officers, directors, employees, and retired employees under Section 1131.064 to and in an amount necessary to provide funds to offset liabilities related to fringe benefits.

(b)  An employer shall submit evidence of the purpose of the policy to the commissioner.

(c)  A policy issued for the purpose described by this section does not reduce any other life insurance benefits offered or provided by the employer.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Subchapter P. Wholesale, Franchise, Or Employee Life Insurance Policies: Additional Requirements

Section  1131.751.  App

LICABILITY OF

Subchapter

. This subchapter applies only to a wholesale, franchise, or employee life insurance policy issued as provided by Section 1131.065.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.752.  Payment Of Premiums.

(a) The premium for the policy must be paid:

(1)  wholly from funds contributed by the employer or employers of the insureds;

(2)  wholly from funds contributed by the labor or credit union or unions; or

(3)  partly from funds described by Subdivision (1) or (2) and partly from funds contributed by the insureds.

(b)  An insured's contribution toward the cost of the insurance may not exceed 40 cents per month for each $1,000 of insurance coverage.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.753.  Minimum Enrollment.

A policy of wholesale, franchise, or employee life insurance must cover at least five employees or members of a labor union or credit union on the date the policy is issued.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.755.  Individual Application Required.

(a) An insurer must take an individual application for each policy of wholesale, franchise, or employee life insurance.

(b)  Repealed by Acts 2005, 79th Leg., Ch. 496, Sec. 2(5), eff. June 17, 2005.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.

Amended by:

Acts 2005, 79th Leg., Ch. 496, Sec. 2(5), eff. June 17, 2005.



Section  1131.756.  Right To Individual Policy On Termination Of Employment Or Membership.

(a) A policy of wholesale, franchise, or employee life insurance must contain in substance the provisions prescribed by this section.

(b)  The policy must provide that, subject to Subsections (c) and (d), if the insurance on an individual insured under the policy ceases because the individual's employment or membership in the labor or credit union terminates, the individual is entitled to have the insurer issue to the individual an individual life insurance policy without disability or other supplementary benefits.

(c)  An individual policy under this section must be issued without evidence of insurability.

(d)  An individual must apply for an individual policy and pay the first premium to the insurer not later than the 31st day after the date the individual's employment or membership terminates.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.757.  Optional Policy Provisions.

A policy of wholesale, franchise, or employee life insurance may contain in substance provisions under which:

(1)  the policy is renewable at the option of the insurer only;

(2)  coverage by the insurer terminates on termination of employment or membership by the insured employee or member; or

(3)  an individual eligible for insurance must furnish evidence of individual insurability satisfactory to the insurer as a condition to coverage.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.758.  Certain Policies And Plans Unaffected.

This subchapter does not impair or otherwise affect:

(1)  a policy issued before August 28, 1961;

(2)  a plan of wholesale, franchise, or employee life insurance in effect before August 28, 1961, if the plan was legal on the date policies were issued under the plan; or

(3)  a policy issued on a salary savings franchise plan, bank deduction plan, pre-authorized check plan, or similar plan of premium collection.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Subchapter Q. Extension Of Group Life Insurance To Spouses And Children

Section  1131.801. 

 APPLICABILITY OF

Subchapter

. This subchapter applies to any group life insurance policy issued and delivered under the laws of this state other than a policy issued and delivered to a creditor as provided by Section 1131.057 or other law providing for credit life insurance.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section 1131.802.  Extension Of Group Life Insurance To Spouses And Children; Eligible Children.

Insurance under a group life insurance policy may be extended to cover:

(1)  the spouse of each individual eligible to be insured under the policy;

(2)  a natural or adopted child of each individual eligible to be insured under the policy if the child is:

(A)  unmarried and younger than 25 years of age;  or

(B)  physically or mentally disabled and under the parents' supervision; or

(3)  a natural or adopted grandchild of each individual eligible to be insured under the policy if the child is:

(A)  unmarried;

(B)  younger than 25 years of age; and

(C)  a dependent of the insured for federal income tax purposes at the time the application for coverage of the child is made.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.

Amended by:

Acts 2007, 80th Leg., R.S., Ch. 1243, Sec. 1, eff. September 1, 2007.



Section  1131.803.  Payment Of Premiums.

The premium for group life insurance extended to cover a spouse or child may be paid by:

(1)  the group policyholder;

(2)  the insured under the policy; or

(3)  the group policyholder and the insured jointly.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.804.  Amounts Of Insurance.

(a) The amounts of insurance under the policy must be based on a plan that precludes individual selection by the insured or the policyholder.

(b)  The amount of insurance on the life of the spouse or a child may not exceed the amount of insurance for which the insured is eligible under the policy.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.805.  Conversion Rights.

On termination of group life insurance coverage for a spouse insured under this subchapter because the insured's employment terminates, the insured's eligibility for insurance terminates, or the insured dies, or because the group life insurance policy terminates, the spouse has the same conversion rights as to the group life insurance on the spouse's life as the insured.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.806.  Certificate Of Insurance.

Only one certificate of insurance issued for delivery to an insured is required if the certificate includes a statement concerning any spouse's or child's coverage.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Subchapter R. Continuation Of Certain Group Life Insurance During Labor Dispute

Section  1131.851. 

 APPLICABILITY OF

Subchapter

. This subchapter applies only to a group life insurance policy that is delivered or issued for delivery in this state and as to which any part of the premium is paid or is to be paid by an employer under the terms of a collective bargaining agreement.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.852.  Continuation Of Group Life Insurance During Labor Dispute Required For Certain Policies.

An insurer may not deliver or issue for delivery a policy subject to this subchapter unless the policy provides that if the employees covered by the policy stop work because of a labor dispute, coverage continues under the policy, on timely payment of the premium, for each employee who:

(1)  is covered under the policy on the date the work stoppage begins;

(2)  continues to pay the employee's individual contribution, subject to the conditions provided by this subchapter; and

(3)  assumes and pays during the work stoppage the contribution due from the employer, subject to the conditions provided by this subchapter.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.853.  Contributions If Policyholder Is Trustee.

(a) An employee's contribution for purposes of a policy as to which the policyholder is a trustee or the trustees of a fund established or maintained wholly or partly by the employer is the amount the employee and employer would have been required to contribute to the fund for the employee if:

(1)  the work stoppage had not occurred; and

(2)  the agreement requiring the employer to make contributions to the fund were in effect.

(b)  The policy may provide that continuation of coverage is contingent on the collection of individual contributions by the policyholder or the policyholder's agent.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.854.  Contributions If Policyholder Is Not Trustee.

(a) A policy as to which the policyholder is not a trustee or the trustees of a fund established or maintained in whole or in part by the employer must provide that the employee's individual contribution:

(1)  is the policy rate applicable:

(A)  on the date the work stoppage begins; and

(B)  to an individual in the class to which the employee belongs as provided by the policy; or

(2)  if the policy does not provide for a rate applicable to an individual, is an amount equal to the amount determined by dividing:

(A)  the total monthly premium in effect under the policy on the date the work stoppage begins; by

(B)  the total number of insureds under the policy on that date.

(b)  The policy may provide that continuation of coverage under this subchapter is contingent on the collection of individual contributions by the union or unions representing the employees.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.855.  Payment Of Contribution And Premium.

A policy may provide that continuation of coverage for an employee under the policy is contingent on timely payment of:

(1)  contributions by the employee; and

(2)  the premium by the entity responsible for collecting the individual employee contributions.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.856.  Past Due Premium.

(a) A policy may provide that the continuation of coverage is contingent on payment of any premium that:

(1)  is unpaid on the date the work stoppage begins; and

(2)  became due before the date the work stoppage begins.

(b)  A premium described by Subsection (a) must be paid before the date the next premium becomes due under the policy.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.857.  Individual Premium Rate Increase.

(a) A policy may provide that, during the period of a work stoppage, an individual premium rate may be increased by an amount not to exceed 20 percent of the amount shown in the policy, or a greater percentage as approved by the commissioner, to provide sufficient compensation to the insurer to cover increased:

(1)  administrative costs; and

(2)  mortality and morbidity.

(b)  If a policy provides for a premium rate increase in accordance with this section, the amount of an employee's contribution must be increased by the same percentage.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.858.  Premium Rate Change Not Limited.

(a) This subchapter does not limit any right of the insurer under a policy to increase or decrease a premium rate before, during, or after a work stoppage if the insurer would be entitled to increase the premium rate had a work stoppage not occurred.

(b)  A change in a premium rate made in accordance with this section takes effect on a date that is determined by the insurer in accordance with the terms of the policy.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.859.  Limitations On Continuation Of Coverage.

This subchapter does not require the continuation of coverage under a policy for a period:

(1)  longer than six months after a work stoppage occurs;

(2)  beyond the time that 75 percent of the covered employees continue the coverage; or

(3)  as to an individual covered employee, beyond the time that the employee takes a full-time job with another employer.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.



Section  1131.860.  Other Provisions; Commissioner Approval Required.

A policy may contain any other provision relating to continuation of policy coverage during a work stoppage that the commissioner approves.

Added by Acts 2001, 77th Leg., ch. 1419, Sec. 2, eff. June 1, 2003.


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