SECTION 67.3. Definitions

The following words and terms, when used in this chapter, shall have the following meanings, unless the context clearly indicates otherwise.

(1) Administering Firm--Any firm designated by the Board to administer any coverages, services, claims, benefits, or requirements in accordance with Chapter 1551, Insurance Code and the rules of the Board. The Administering Firm may be considered a Party to any Proceeding in connection with such matters.

(2) Agency--Any state board, commission, department, or officer having statewide jurisdiction (other than an agency wholly financed by federal funds, the Legislature, the courts, or any publicly funded institution of higher education) which makes rules or determines contested cases.

(3) Appellant--Any Person with standing to pursue an administrative appeal under this chapter who, by written Pleading, including a notice of appeal, applies for or seeks an available administrative remedy from the Board or its designee.

(4) Appellee--ERS and any other Party properly joined in a contested case matter against whom the appeal is taken.

(5) Authorized Representative--An attorney or other person legally authorized to represent a Party pursuant to §67.23 of this chapter (relating to representative appearances).

(6) Board--The Board of Trustees of the Employees Retirement System of Texas.

(7) Examiner (hearings examiner)--Any person appointed by the Executive Director to conduct hearings. This term also includes an Administrative Law Judge ("ALJ") appointed by SOAH to preside at the hearing of a contested case when the Executive Director requests that SOAH conduct hearings.

(8) Executive Director--The Executive Director of the Employees Retirement System of Texas or his/her designee.

(9) Good Cause--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) Insurer--Any insurance carrier who has contracted with ERS to provide coverages authorized by the Texas Employees Group Benefits Act, Chapter 1551, Insurance Code. The Insurer shall be considered a Party to any Proceeding which involves a question of eligibility or coverage under its contract with ERS.

(11) Intervenor--A Party other than an Appellant who is permitted to become a Party to a Proceeding in accordance with §67.21 of this chapter (relating to Intervention).

(12) Member--A Person who is a member, retiree, or beneficiary of any retirement system or program administered by the Board.

(13) Order--The whole or a part of the final disposition, whether affirmative, negative, injunctive, or declaratory in form, of the Executive Director, Board or its designee in a matter other than rulemaking.

(14) Participant--An eligible individual who participates in the group benefits program pursuant to Chapter 1551 of the Texas Insurance Code.

(15) Party--Each Appellant, Appellee, Administering Firm, Insurer, Intervenor or Agency with standing who is named or admitted as a party of record in a Proceeding.

(16) Person--Any natural person, partnership, company, corporation, association, governmental subdivision, or public or private organization of any character other than an Agency.

(17) Pleading--A written concise statement by a Party of the issues on appeal arising from the Party's respective claims or defenses in connection with a Proceeding. Pleadings may take the form of applications, petitions, notices of appeals and requests for hearing, complaints, briefs, exceptions, replies, motions, notices, or answers.

(18) Proceeding--Any hearing, investigation, inquiry, determination or other fact-finding or decision-making procedure, including, but not limited to a contested case under §2001.003(1) of the APA.

(19) Trustee--One of the duly elected or appointed members of the Board.

Source Note: The provisions of this §67.3 adopted to be effective March 19, 1986, 11 TexReg 1149; amended to be effective January 10, 1999, 24 TexReg 165; amended to be effective September 14, 2006, 31 TexReg 7359; amended to be effective December 24, 2015, 40 TexReg 9302