"If children are eligible for coverage under the policy, any age limitation for an unmarried child may not be less than 25." This is a TEXAS state mandated provision. We have an ERISA self-funded plan and I am not aware of any mandates of this nature. If someone could point me to the section of the code that outlines dependent/spouse coverage, it would be greatly appreciated.

I'm confused by your question. Are you saying that you are not in Texas and want to know if any place else has similar mandates?

there is no general code or erisa section outlining spouse or dependent coverage requirements for ERISA self-funded plan from coverage prespective (note there are some mandated type coverage issues, e.g. QMCSO, COBRA and HIPAA portability)

Apologize for confusion. We are in Texas, but we are an ERISA self-funded plan not subject to Texas mandates. Fully insured plans in Texas have to follow the mandate noted--if they cover dependents, must cover to age 25 for unmarried children. Although our plan covers dependents to age 25, they are required to be full time students. I am looking for the code section that states that we can determine our dependent coverage--thus backing up our full time student provision.

First check Texas law (excuse me for not knowing what to refer to--in Ohio it is the Revised Code). Anyway, there should be a general statement that states to whom/what the Texas law applies. For example, policies issued under section *** of your revised code. It may even state that it does not apply to self-funded plans.

ERISA section 514(b) preempts state laws, including insurance laws, from applying to a self funded health plan subject to ERISA. Therefore Texas law determining who is a dependent for coverage purposes is preempted as it applies to a self funded plan.

Mbozek's answer is correct, as long as you are not part of a multiple employer self-funded plan. If you would like for me to locate the corresponding provision in the Texas Insurance Code, please e-mail me.
Don Levit

Thanks, this is exactly the information I needed.