The following words and terms, when used in this chapter, shall
have the following meanings, unless the context clearly indicates
(1) Administering Firm--Any firm designated by the
Board to administer any coverages, services, claims, benefits, or
requirements in accordance with Chapter 1551, Insurance Code and the
rules of the Board. The Administering Firm may be considered a Party
to any Proceeding in connection with such matters.
(2) Agency--Any state board, commission, department,
or officer having statewide jurisdiction (other than an agency wholly
financed by federal funds, the Legislature, the courts, or any publicly
funded institution of higher education) which makes rules or determines
(3) Appellant--Any Person with standing to pursue an
administrative appeal under this chapter who, by written Pleading,
including a notice of appeal, applies for or seeks an available administrative
remedy from the Board or its designee.
(4) Appellee--ERS and any other Party properly joined
in a contested case matter against whom the appeal is taken.
(5) Authorized Representative--An attorney or other
person legally authorized to represent a Party pursuant to §67.23
of this chapter (relating to representative appearances).
(6) Board--The Board of Trustees of the Employees Retirement
System of Texas.
(7) Examiner (hearings examiner)--Any person appointed
by the Executive Director to conduct hearings. This term also includes
an Administrative Law Judge ("ALJ") appointed by SOAH to preside at
the hearing of a contested case when the Executive Director requests
that SOAH conduct hearings.
(8) Executive Director--The Executive Director of the
Employees Retirement System of Texas or his/her designee.
(9) Good Cause--Good Cause means that a person's failure
to act was not because of a lack of due diligence the exercise of
which would have caused a reasonable person to take prompt and timely
action. A failure to act based on ignorance of the law or facts reasonably
discoverable through the exercise of due diligence does not constitute
(10) Insurer--Any insurance carrier who has contracted
with ERS to provide coverages authorized by the Texas Employees Group
Benefits Act, Chapter 1551, Insurance Code. The Insurer shall be considered
a Party to any Proceeding which involves a question of eligibility
or coverage under its contract with ERS.
(11) Intervenor--A Party other than an Appellant who
is permitted to become a Party to a Proceeding in accordance with §67.21
of this chapter (relating to Intervention).
(12) Member--A Person who is a member, retiree, or
beneficiary of any retirement system or program administered by the
(13) Order--The whole or a part of the final disposition,
whether affirmative, negative, injunctive, or declaratory in form,
of the Executive Director, Board or its designee in a matter other
(14) Participant--An eligible individual who participates
in the group benefits program pursuant to Chapter 1551 of the Texas
(15) Party--Each Appellant, Appellee, Administering
Firm, Insurer, Intervenor or Agency with standing who is named or
admitted as a party of record in a Proceeding.
(16) Person--Any natural person, partnership, company,
corporation, association, governmental subdivision, or public or private
organization of any character other than an Agency.
(17) Pleading--A written concise statement by a Party
of the issues on appeal arising from the Party's respective claims
or defenses in connection with a Proceeding. Pleadings may take the
form of applications, petitions, notices of appeals and requests for
hearing, complaints, briefs, exceptions, replies, motions, notices,
(18) Proceeding--Any hearing, investigation, inquiry,
determination or other fact-finding or decision-making procedure,
including, but not limited to a contested case under §2001.003(1)
of the APA.
(19) Trustee--One of the duly elected or appointed
members of the Board.
|Source Note: The provisions of this §67.3 adopted to be effective March 19, 1986, 11 TexReg 1149; amended to be effective January 10, 1999, 24 TexReg 165; amended to be effective September 14, 2006, 31 TexReg 7359; amended to be effective December 24, 2015, 40 TexReg 9302