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The Attorney General of Texas
March 24, 1980
MARKWHITE
Attorney General
Honorable Kenneth H. Ashworth Opinion No. MW-153
Coordinating Board
Texas College 6r University System Re: Whether a junior college may
Austin, Texas 78711 pay for employee enrollment in a
health maintenance organization in
lieu of the co&gets health
insurance program.
Dear Mr. Ashworth:
You have requested our opinion as to whether a junior college may pay
for employee enrollment In a health maintenance organization in lieu of the
college’s health insurance program.
Article 3.50-3 of the Texas Insurance Code establishes the Texas State
College and University Employees Uniform Insurance Benefits Program, the
purpose of which is, inter alla,
(a) to provide uniformity in the basic life, accident,
and health insurance coverages for all
employees of Texas state colleges and
universities; [and1
(b) to enable Texas state colleges and universities
to attract and retain competent and able
employees by providing them with basic life,
accident, and health insurance coverages at
least equal to those commonly provided in
private industry and those provided employees
of other agencies of the State of Texas under
the Texas Employees Uniform Group Insurance
Benefits Act;[article 3.50-21.
Article 3.50-3, section 2, Texas Insurance Code. The statute establishes an
administrative council, among whose duties it is to
(A) determine basic coverage standards which shall
be at least equal to those commonly provided in
private industry and those provided employees
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Honorable Kenneth II. Ashworth - Page Two (MW-153)
of other agencies of the State of Texas under the Texas
Employees Uniform Group Insurance Benefits Act, . . .
and
0) determine if existing institutional programs meet, equate to,
or exceed standards for such basic coverages. If so, such
programs may be continued in accordance with existing
contractual arrangements between those institutions and
their carrier or carriers, provided, however, that each
program so continued shall be submitted by the institution for
competitive bidding within standards established by the
administrative council at least once during each four-year
period following the effective date of coverage under this
Act. . . .
Section 4(a)(4). The particular institution is then required to select some type of coverage
from among carriers submitting bids. Section 4(a)(4)(D). The administrative council is
charged with continuing responsibility for review of an institution’s programs, section
4(a)(4)(E), and it is directed to
(G) adopt rules and regulations consistent with the provisions of
this Act and its purpose as it deems necessary to carry out
the statutory responsibilities.
end to
(I) publish such additional goals, guidelines, and surveys as are
necessary to assist covered institutions in providing their
employees with effective benefits programs.
Sections 4(a)(4)(G), 4(a)(4)(1).
The trustee of the Texas Employees Uniform Group Insurance Act, article 3.50-2, is
authorized to
. . . select and contract for services performed by health
maintenance organizations which are approved by the federal
government or the State of Texas to offer health care services to
eligible employees and annuitants in a specific area of the state.
Eligible employees and annuitants may participate in a selected
health maintenance organization in lieu of participation in the
health insurance benefits in the Employees Uniform Group
Insurance Program, and the employer contributions provided by
subsection (al, Section 15 of this Act for health care coverage shall
be paid to the selected health maintenance organizations on behalf
of the participants.
P. 492
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Honorable Kenneth II. Ashworth - Page Three (NW-1531
Section 5(e). Since, as we have indicated, the administrative council of the Texas State
College and University Employees Uniform Insurance Benefits Program is required to
“determine basic coverage standards which shall be at least equal to those . . . provided
. . . under the Texas Employees Uniform Group Insurance Benefits Act,” and since one
such kind of coverage may consist of %ervices performed by health maintenance
organizations . . . approved by the federal government,” we believe that the
administrative council may approve en insurance program in which a junior college offers
its employees membership in a federally approved health maintenance organization in lieu
of enrollment in the college’s regular health insurance program. If the administrative
council determines that such a program fulfills the statutory standards of article 3.50-3 of
the Insurance Code, it is our opinion that the junior college may pay for its employees’
enrollment in the program.
SUMMARY
If the administrative council of the Texas State College and
University Employees Uniform Insurance Benefits Program
approves an insurance program in which a junior college offers its
employees membership in a federally approved health maintenance
organization in lieu of enrollment in the college’s regular health
insurance program, the junior college may pay for its employees’
enrollment in the program.
MARK WHITE
Attorney General of Texas
JOHN W. FAINTER, JR.
First Assistant Attorney General
TED L. HARTLEY
Executive Assistant Attorney General
Prepared by Rick Gilpin
Assistant Attorney General
APPROVED:
OPINION COMMITTEE
C. Robert Heath, Chairmen
David B. Brooks
Susan Garrison
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Honorable Kenneth H. Ashworth - Page Four (m-153)
Rick Gilpin
Nancy Ricketts
Bruce Youngblood
Lonny Zwiener
P. 494