# Tex. Insurance Code § 846.004: LATE-PARTICIPATING EMPLOYEE OR DEPENDENT

> Texas · Statutes · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C846_S846.004

## Section

- **Citation:** Tex. Insurance Code § 846.004
- **Heading:** LATE-PARTICIPATING EMPLOYEE OR DEPENDENT
- **Jurisdiction:** Texas
- **Kind:** Statutes
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** TX Code / Code in / Chapter 846 / Section 846.004

## Text

(a) For purposes of this chapter, an employee or dependent eligible for enrollment in a participating employer's health benefit plan is a late-participating employee or dependent if the individual requests enrollment after the expiration of:

(1) the initial enrollment period established under the terms of the first health benefit plan for which that employee or dependent was eligible through the participating employer; or

(2) an open enrollment period under Section 846.257.

(b) An employee or dependent is not a late-participating employee or dependent if the individual:

(1) was covered under another health benefit plan or self-funded employer health benefit plan at the time the individual was eligible to enroll;

(2) declined enrollment in writing, at the time of the initial eligibility for enrollment, stating that coverage under another health benefit plan or self-funded employer health benefit plan was the reason for declining enrollment;

(3) has lost coverage under the other health benefit plan or self-funded employer health benefit plan as a result of:

(A) the termination of employment;

(B) a reduction in the number of hours of employment;

(C) the termination of the other plan's coverage;

(D) the termination of contributions toward the premium made by the employer; or

(E) the death of a spouse or divorce; and

(4) requests enrollment not later than the 31st day after the date coverage under the other health benefit plan or self-funded employer health benefit plan terminates.

(c) An employee or dependent is also not a late-participating employee or dependent if the individual is:

(1) employed by an employer that offers multiple health benefit plans and the individual elects a different health benefit plan during an open enrollment period under Section 846.257;

(2) a spouse for whom a court has ordered coverage under a covered employee's plan and the request for enrollment of the spouse is made not later than the 31st day after the date the court order is issued; or

(3) a child for whom a court has ordered coverage under a covered employee's plan and the request for enrollment is made not later than the 31st day after the date the employer receives the court order.

## Nearby sections

- [Tex. Insurance Code § 846.001 § 846.001. DEFINITIONS.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C846_S846.001.md)
- [Tex. Insurance Code § 846.002 § 846.002. APPLICABILITY OF CHAPTER.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C846_S846.002.md)
- [Tex. Insurance Code § 846.003 § 846.003. LIMITED EXEMPTION FROM INSURANCE LAWS; APPLICABILITY OF CERTAIN LAWS.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C846_S846.003.md)
- [Tex. Insurance Code § 846.004 § 846.004. LATE-PARTICIPATING EMPLOYEE OR DEPENDENT.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C846_S846.004.md)
- [Tex. Insurance Code § 846.005 § 846.005. RULES; ORDERS.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C846_S846.005.md)
- [Tex. Insurance Code § 846.006 § 846.006. APPEAL OF ORDERS.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C846_S846.006.md)
- [Tex. Insurance Code § 846.007 § 846.007. PREMIUM RATES; ADJUSTMENTS.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C846_S846.007.md)
- [Tex. Insurance Code § 846.0035 § 846.0035. APPLICABILITY OF CERTAIN LAWS TO ASSOCIATION PROVIDING HEALTH BENEFITS.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C846_S846.0035.md)
- [Tex. Insurance Code § 846.051 § 846.051. CERTIFICATE OF AUTHORITY REQUIRED.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C846_S846.051.md)
- [Tex. Insurance Code § 846.052 § 846.052. APPLICATION FOR INITIAL CERTIFICATE OF AUTHORITY.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C846_S846.052.md)
- [Tex. Insurance Code § 846.053 § 846.053. ELIGIBILITY REQUIREMENTS FOR INITIAL CERTIFICATE OF AUTHORITY.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C846_S846.053.md)
- [Tex. Insurance Code § 846.054 § 846.054. ISSUANCE OF INITIAL CERTIFICATE OF AUTHORITY.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C846_S846.054.md)
- [Tex. Insurance Code § 846.055 § 846.055. EXTENSION OF TERM OF INITIAL CERTIFICATE OF AUTHORITY.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C846_S846.055.md)
- [Tex. Insurance Code § 846.056 § 846.056. FINAL CERTIFICATE OF AUTHORITY.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C846_S846.056.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C846_S846.004. Check the current official text before relying on it. Not legal advice.