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TITLE 28INSURANCE
PART 1TEXAS DEPARTMENT OF INSURANCE
CHAPTER 21TRADE PRACTICES
SUBCHAPTER SSCONTINUATION AND CONVERSION PROVISIONS
DIVISION 2GROUP CONTINUATION PROVISIONS
RULE §21.5313Continuation Premium

(a) Under Insurance Code §1251.254 and §1271.303, the premium for state continuation coverage elected under §21.5310 of this title must be the same premium charged for active employees, members, dependents, or enrollees, including any amount contributed by the employer or group policy or contract holder, plus 2 percent.

(b) The employee, member, dependent, or enrollee electing state continuation coverage under §21.5312 of this title must pay the initial premium not later than the 45th day after the date of the initial election for coverage.

(c) After the first payment following the initial election for coverage under §21.5312 of this title, the employee, member, dependent, or enrollee must pay the premium on the due date of each payment. However, a payment under this subsection must be considered timely if made on or before the 30th day after the date on which the payment is due.

(d) The premium for state continuation coverage elected under Insurance Code Chapter 1251, Subchapter G, may not be more than the premium charged under the group policy or contract for the person had the family relationship not been severed, except as provided by Insurance Code §1551.064. Under Insurance Code §1251.306, the group policyholder or contract holder may require the person to pay a monthly fee of not more than $5 for administrative costs.

(e) A person covered under state continuation coverage elected under Insurance Code Chapter 1251, Subchapter G, must pay the premium for the coverage directly to the group policyholder or contract holder.


Source Note: The provisions of this §21.5313 adopted to be effective November 17, 2014, 39 TexReg 9036

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