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0 chapters · 390 sections in this title.
La. Rev. Stat. § 42:801 Administration
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§801. Administration A. The Office of Group Benefits is hereby created within the office of the governor, division of administration. B. As used in this Chapter, "office" means the Office of Group Benefits created in this Section. C. The general administration of all aspects of p…
La. Rev. Stat. § 42:802 Powers and duties; Office of Group Benefits
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§802. Powers and duties; Office of Group Benefits A.(1) The Office of Group Benefits shall have the powers and privileges of a corporation and shall exercise all powers, duties, functions, and responsibilities provided or authorized for it by law. It shall directly exercise all p…
La. Rev. Stat. § 42:802.1 Benefit plans for provision of coverage through a fully insured product provided by a health maintenance organization domiciled in Louisiana
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§802.1. Benefit plans for provision of coverage through a fully insured product provided by a health maintenance organization domiciled in Louisiana A. In the development of contracts for health insurance plans intended to be offered in each of the office's regions, the office sh…
La. Rev. Stat. § 42:803 Chief executive officer; chief operating officer; powers and duties
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§803. Chief executive officer; chief operating officer; powers and duties A. The commissioner of administration shall appoint a chief executive officer who shall be an unclassified employee and serve at the pleasure of the commissioner of administration and shall be subject to Se…
La. Rev. Stat. § 42:805 Collection and deposit of contributions
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§805. Collection and deposit of contributions A. The office shall be responsible for preparing and transmitting to each employer agency a monthly invoice premium statement delineating the participating employees of that agency, the class of coverage, total amount of employer and …
La. Rev. Stat. § 42:806 Claims
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§806. Claims The office shall be responsible for the processing of all claims under policies for group benefits for state employees contracted for under the provisions of this Chapter. The office shall be responsible for the disbursement of all payments of such claims to program …
La. Rev. Stat. § 42:807 Retroactive cancellation of coverage
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§807. Retroactive cancellation of coverage A. The office is authorized to retroactively cancel coverage in programs offered through the office in the following instances: (1) To the extent the cancellation of coverage is attributable to a failure of the enrollee to timely pay req…
La. Rev. Stat. § 42:808 Eligibility in group programs
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§808. Eligibility in group programs A. For the purposes of participating in life, health, or other programs sponsored by the Office of Group Benefits, an employee is defined as: (1) A classified or unclassified state civil service employee. (2) A retiree as defined by the rules a…
La. Rev. Stat. § 42:809 Payroll deductions for payment of premiums, surcharges, and other voluntary
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§809. Payroll deductions for payment of premiums, surcharges, and other voluntary contributions State boards, commissions, municipalities, and other public bodies may deduct from the employee's pay, salary, or compensation, such parts of the premiums, surcharges, and other volunt…
La. Rev. Stat. § 42:81 Demand for possession
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§81. Demand for possession If the judgment is against the defendant, and rendered upon the right and in favor of the person alleged to be entitled to the office, he shall have the right, after taking the oath of office, and otherwise complying with the requirements of law, to tak…
La. Rev. Stat. § 42:810 Audit of program accounts
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§810. Audit of program accounts The office shall have the accounts of the program audited annually by the legislative auditor or a certified public accountant as described by R.S. 24:513 and shall furnish, as of the end of each fiscal year, a report showing a statement of revenue…
La. Rev. Stat. § 42:811 Termination provisions
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§811. Termination provisions A. No state agency, local school board, political subdivision, or other entity participating in programs offered through the Office of Group Benefits shall terminate participation in those programs, unless each of the following conditions is met: (1) …
La. Rev. Stat. § 42:812 Transparency in prior authorizations
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§812. Transparency in prior authorizations A. Beginning January 1, 2023: (1) The office shall require every health plan offered through the office to furnish in writing or provide electronically, within one business day of a written or oral request by a healthcare provider, the m…
La. Rev. Stat. § 42:813 Definitions
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§813. Definitions For the purposes of this Subpart, the following terms shall have the following meanings: (1) "Administrative fee" means the sole compensation that the administrator or pharmacy benefit manager receives under the contract. The administrative fee includes all serv…
La. Rev. Stat. § 42:814 Revenue reports
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§814. Revenue reports A.(1) Annually on or before April first, each administrator and pharmacy benefit manager that had a contract with the office in the preceding calendar year shall file a report with the office detailing any known revenues outside of the administrative fee rel…
La. Rev. Stat. § 42:815 Administrators
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§815. Administrators A. Each administrator contract with the office shall clearly establish an administrative fee or a calculation for an administrative fee to be retained by the administrator for performance of its duties. The administrator is prohibited from retaining revenues …
La. Rev. Stat. § 42:816 Pharmacy benefit managers
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§816. Pharmacy benefit managers A. Each pharmacy benefit manager contract with the office shall clearly establish an administrative fee or a calculation for an administrative fee to be retained by the pharmacy benefit manager for performance of its duties. The pharmacy benefit ma…
La. Rev. Stat. § 42:817 Penalties
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§817. Penalties A. Each administrator and pharmacy benefit manager owes a duty of good faith and fair dealing to the office. Failure to file a report required by this Subpart or failure to accurately or completely disclose revenues on such report shall constitute a breach of the …
La. Rev. Stat. § 42:82 Damages
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§82. Damages If the judgment is in favor of the person alleged to be entitled to the office, he may recover the damages he sustained by reason of the usurpation by the defendant.
La. Rev. Stat. § 42:821 Authority for employee benefit programs; payment of premiums out of appropriated funds
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§821. Authority for employee benefit programs; payment of premiums out of appropriated funds A.(1)(a) The state of Louisiana, through the Office of Group Benefits, and each of its governmental and administrative subdivisions, departments, or agencies of the executive, legislative…
La. Rev. Stat. § 42:83 Joinder of claimants
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§83. Joinder of claimants Where several persons claim to be entitled to the same office or franchise one action may be brought against all of them in the same suit in order to try their rights to the office or franchise.
La. Rev. Stat. § 42:84 Defendant liable for costs and damages
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§84. Defendant liable for costs and damages When the defendant against whom such action is brought is adjudged guilty of usurping or intruding into, or unlawfully holding or exercising any office, franchise or privilege, judgment shall be rendered that the defendant be excluded f…
La. Rev. Stat. § 42:85 Appeal
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§85. Appeal Appeals to the supreme court may be taken from the action provided for in R.S. 42:76 through 42:84, the same as in other cases. But all these cases shall take preference when they come before the supreme court over all other cases in the order of trial, and shall be m…
La. Rev. Stat. § 42:851 Authority for employee benefit programs; payroll deduction for payment of premiums
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§851. Authority for employee benefit programs; payroll deduction for payment of premiums A. The state of Louisiana, through the Office of Group Benefits and each of its governmental and administrative subdivisions, departments, or agencies of the executive, legislative, or judici…
La. Rev. Stat. § 42:852 Coverage for optometric services
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§852. Coverage for optometric services Notwithstanding any provision of law or any rule or regulation to the contrary, the Office of Group Benefits shall provide its eligible benefits, as defined by the program, for visual services which are rendered within the lawful scope of pr…
La. Rev. Stat. § 42:853 Coverage for chiropractic services
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§853. Coverage for chiropractic services Notwithstanding any provision of law or any rule or regulation to the contrary, the Office of Group Benefits shall provide its eligible benefits as defined by the program for services which are rendered within the lawful scope of practice …
La. Rev. Stat. § 42:854 Office of Group Benefits; use of monies
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§854. Office of Group Benefits; use of monies A. Repealed by Acts 2018, No. 676, §2. B. Repealed by Acts 2018, No. 676, §2. C. Notwithstanding any other provision of law to the contrary, any money received by or under the control of the Office of Group Benefits shall not be used,…
La. Rev. Stat. § 42:856 Optional coverage for rehabilitative physical therapy, speech and language pathology therapy, and occupational therapy
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§856. Optional coverage for rehabilitative physical therapy, speech and language pathology therapy, and occupational therapy A. Notwithstanding any provision of law or any rule or regulation to the contrary, the Office of Group Benefits may, at the option of the chief executive o…
La. Rev. Stat. § 42:857 Authorization for surcharge
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§857. Authorization for surcharge A. Notwithstanding any other provision of law or rule or regulation to the contrary, the Office of Group Benefits may impose a surcharge, payable by the participant employer or an enrollee, regardless of the source of funding, upon any class of e…
La. Rev. Stat. § 42:858 Contracts to be subject to other laws concerning group insurance
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§858. Contracts to be subject to other laws concerning group insurance All group insurance contracts effected pursuant hereto shall conform and be subject to all the provisions of any existing or future laws concerning group insurance. Acts 2001, No. 1178, §5, eff. June 29, 2001.
La. Rev. Stat. § 42:859 Refund of expenditures ineligible for reimbursement
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§859. Refund of expenditures ineligible for reimbursement A. Notwithstanding any provision of law or any rule or regulation to the contrary, no refund shall be required from a plan member or health care provider on a paid claim determined by audit or review to be ineligible under…
La. Rev. Stat. § 42:86 Manner of trial
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§86. Manner of trial All the cases coming under the provisions of R.S. 42:76 through 42:84 may be tried before a judge of the district in chambers, or at a special term called by the judge on legal notice being given the parties interested; and, if required by either party, the j…
La. Rev. Stat. § 42:860 Severe obesity; legislative findings; coverage required
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§860. Severe obesity; legislative findings; coverage required A. The legislature hereby finds and declares that obesity is a significant health problem affecting hundreds of thousands of Louisiana residents. Severe obesity increases the mortality rate more than threefold, causes …
La. Rev. Stat. § 42:87 Discontinuance of contests
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§87. Discontinuance of contests Whenever there is pending in any court of this state, an untried suit wherein the title to or possession of any office is involved, regardless of the nature of the pleadings, it may be discontinued by the plaintiff upon payment of costs.
La. Rev. Stat. § 42:871 Group retirement plans
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§871. Group retirement plans Any agency or department of the state of Louisiana and each of its political, governmental, and administrative subdivisions are authorized to adopt group plans which allow the purchase of annuities, life insurance, or mutual funds which qualify for de…
La. Rev. Stat. § 42:881 Establishment of the Group Benefits Policy and Planning Board
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§881. Establishment of the Group Benefits Policy and Planning Board A. There is hereby established the Group Benefits Policy and Planning Board within the Office of Group Benefits. The board shall review and recommend life and health benefit programs offered to eligible employees…
La. Rev. Stat. § 42:882 Composition of board
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§882. Composition of board A. Membership and qualifications. The board shall be composed of eleven voting members, as follows: (1) Three members who shall be appointed by the speaker of the House of Representatives each of whom shall have a minimum of five years professional expe…
La. Rev. Stat. § 42:883 Officers; oath; meetings; quorum; minutes; reports; compensation
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§883. Officers; oath; meetings; quorum; minutes; reports; compensation A.(1) At the first meeting held in each fiscal year the board shall elect one of its members to serve as chairman until a new chairman is elected. At the same meeting, the board shall elect from its members a …
La. Rev. Stat. § 42:91 Purpose
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§91. Purpose The purpose of this Chapter is to prohibit a person who has his professional license or certificate suspended or revoked from serving as a member of a board or regulatory entity if membership on the board requires a valid professional license or certificate. Acts 199…
La. Rev. Stat. § 42:92 Automatic removal
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§92. Automatic removal A. Any person who is appointed, elected, or serves ex officio on any board which membership is conditioned on the possession of a current and valid occupational or professional license or certificate, whose occupational or professional license or certificat…
