Texas Administrative Code
Title 34 - PUBLIC FINANCE
Part 3 - TEACHER RETIREMENT SYSTEM OF TEXAS
Chapter 41 - HEALTH CARE AND INSURANCE PROGRAMS
Subchapter C - TEXAS SCHOOL EMPLOYEES GROUP HEALTH (TRS-ACTIVECARE)
Section 41.31 - Eligible Bidders

Universal Citation: 34 TX Admin Code ยง 41.31

Current through Reg. 49, No. 38; September 20, 2024

(a) TRS-ActiveCare may include separate contracts for:

(1) health benefit plans ;

(2) prescription drug plans ;

(3) utilization review services ;

(4) administrative services ; and

(5) ancillary services.

(b) Except for health maintenance organizations, which must meet other requirements in this section, to be eligible to bid on any of the contracts in subsection (a) of this section, a bidder must comply with the minimum qualification standards contained in the applicable solicitation from TRS. , an HMO must satisfy all of the following conditions:

(1) The HMO must hold a valid certificate of authority issued by the Texas Department of Insurance to operate in the State of Texas.

(2) The HMO must demonstrate the capacity to provide adequate services, as determined by TRS, to the participants in TRS-ActiveCare.

(3) Once adopted by TRS, the rates and benefits submitted by an HMO may not be modified during a plan year without the prior written approval of TRS.

(4) A request for expansion of a service area shall require a separate responsive bid and approval by TRS.

(5) The HMO must comply with the other minimum qualification standards contained in the applicable solicitation from TRS.

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