Section 85.19 - Termination of Coverage(a) Sanctions for Flexible Benefits Program violations. The plan administrator may expel any person from the Flexible Benefits Program or any part thereof, or impose any other sanction described by the Act, to any person who submits a fraudulent claim or otherwise submits a materially false claim or application for participation or change in status or defrauds or attempts to defraud any plan of benefits under the program or is determined by the executive director to have otherwise violated §1551.351 of the Act.(b) Indebtedness to the Flexible Benefits Program. The plan administrator may deny participation in the Flexible Benefits Program or any part thereof to any person who is indebted to the program from prior enrollments or who has otherwise failed to fulfill contractual agreements. Any person denied participation in the Flexible Benefits Program or any part thereof due to indebtedness to the Flexible Benefits Program or due to the failure to fulfill contractual obligations to the program must repay all outstanding indebtedness or otherwise fulfill contractual obligations to the program prior to being permitted once again to participate in the Flexible Benefits Program. A person who has repaid the indebtedness to the program may resume participation in the Flexible Benefits Program two full plan years from the date the indebtedness is repaid.(c) Any appeal of the executive director's determination will be conducted in accordance with §1551.351 of the Act.34 Tex. Admin. Code § 85.19
The provisions of this §85.19 adopted to be effective September 1, 1992, 17 TexReg 2874; amended to be effective July 17, 2003, 28 TexReg 5539