(a) A large employer health benefit plan issuer may require a large employer to meet a minimum contribution or participation requirement as a condition of issuance or renewal in accordance with the issuer’s usual and customary practices for all the issuer’s employer health benefit plans in this state.
(b) A participation requirement may determine the percentage of eligible employees who meet the participation criteria and who must be enrolled in the health benefit plan.

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Terms Used In Texas Insurance Code 1501.605

  • Contract: A legal written agreement that becomes binding when signed.

(c) A large employer health benefit plan issuer may apply a participation requirement to a large employer’s eligible employees, but may not apply the requirement to eligible dependents of those employees.
(d) A participation requirement must be stated in the health benefit plan contract and must be applied uniformly to each large employer offered or issued coverage by a large employer health benefit plan issuer in this state.