Powers and Duties of Cooperatives

Sec. 1501.058. POWERS AND DUTIES OF COOPERATIVES. (a) A cooperative shall: (1) arrange for small or large employer health benefit plan coverage for small employer groups, large employer groups, and, subject to Section 1501.0581, eligible single-employee businesses that participate in the cooperative by contracting with small or large employer health benefit plan issuers that meet the requirements established by Section 1501.061; (2) collect premiums to cover the cost of: (A) small or large employer health benefit plan coverage purchased through the cooperative; and (B) the cooperative's administrative expenses; (3) establish administrative and accounting procedures for the operation of the cooperative; (4) establish procedures under which an applicant for or participant in coverage issued through the cooperative may have a grievance reviewed by an impartial person; (5) contract with small or large employer health benefit plan issuers to provide services to small or large employers covered through the cooperative; and (6) develop and implement a plan to maintain public awareness of the cooperative and publicize the eligibility requirements for, and the procedures for enrollment in, coverage through the cooperative. (b) A cooperative may: (1) contract with agents to market coverage issued through the cooperative; (2) contract with a small or large employer health benefit plan issuer or third-party administrator to provide administrative services to the cooperative; (3) negotiate the premiums paid by its members; and (4) offer other ancillary products and services to its members that are customarily offered in conjunction with health benefit plans. (c) A cooperative shall comply with: (1) federal laws applicable to cooperatives and health benefit plans issued through cooperatives, to the extent required by state law or rules adopted by the commissioner; and (2) state laws applicable to cooperatives and health benefit plans issued through cooperatives. (d) To be eligible to exercise the authority granted under Subsection (a)(1), a health group cooperative must have at least 10 participating employers. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005. Amended by: Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.053(a), eff. September 1, 2005. Acts 2011, 82nd Leg., R.S., Ch. 1067 (S.B. 859), Sec. 2, eff. June 17, 2011.