Texas Insurance Code - INS § 1551.003. General Definitions

(1) “Administering firm” means a firm designated by the board of trustees to administer coverages, services, benefits, or requirements in accordance with this chapter and the rules adopted by the board of trustees under this chapter.

(2) “Annuitant” means an individual eligible to participate in the group benefits program under Section 1551.102.

(3) “Basic coverage” means the group coverage plans determined by the board of trustees in which each eligible full-time employee and annuitant participates automatically unless participation is specifically waived.

(4) “Board of trustees” means the board of trustees established under Chapter 815, Government Code, to administer the Employees Retirement System of Texas.

(5) “Cafeteria plan” means a plan defined and authorized by Section 125, Internal Revenue Code of 1986.

(6) “Employee” means an individual eligible to participate in the group benefits program under Section 1551.101.

(7) “Employer” means this state and its agencies.

(8) “Executive director” means the executive director of the Employees Retirement System of Texas.

(9) “Full-time employee” means an employee designated as a full-time employee under Section 1551.319(c) or (d) or an employee designated by the employer as working 30 or more hours a week.

(9-a) “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 good cause.

(10) “Group benefits program” means the state employees group benefits program provided by this chapter.

(10-a) “Participant” means an eligible individual who participates in the group benefits program.

(11) “Part-time employee” means an employee designated by the employer as working less than 30 hours a week.  For purposes of this chapter, an individual described by Section 1551.101(e)(2) is considered a part-time employee.

(12) “Serious mental illness” has the meaning assigned by Section 1355.001.

(13) “Service” means personal service to the state creditable in accordance with rules adopted by the board of trustees.

(14) “State agency” means a commission, board, department, division, institution of higher education, or other agency of this state created by the constitution or statutes of this state.  The term also includes the Texas Municipal Retirement System and the Texas County and District Retirement System.

(15) “Usual and customary rate” means the relevant allowable amount as described by the applicable master benefit plan document or policy.