Section 218

A Section 218 Agreement is a voluntary agreement between the state and the Social Security Administration (SSA) to provide Social Security and Medicare Hospital Insurance (HI) or Medicare HI-only coverage for employees of the state and participating local governmental entities. These agreements are called "Section 218" Agreements because they are authorized by Section 218 of the Social Security Act.

Agreements between the State of Texas and local political subdivisions to add new positions to Social Security and Medicare coverages are actually modifications to the state’s single Section 218 Agreement with the federal government. Even though modifications are often referred to as 218’s (or 218 Agreements), each state has only one original Section 218 Agreement. The State of Texas Section 218 Agreement was signed back in 1951 and involved coverage for 20 counties and nine cities. Any entity subsequently covered after the effective date of the original agreement is covered by a uniquely numbered modification to that Agreement.

Most aspects of the Agreements/modifications are common, but there are details that are specific to the government entity identified.

Each state has a designated official, the State Social Security Administrator, who is responsible for administering the state's Section 218 Agreement and supervising the referendum process. The State Administrator provides public employers with information and advice about Social Security and Medicare coverage for state and local government employees, and maintains original copies of modifications to the state’s Section 218 Agreement. The State Administrator will provide a copy of these Agreement/modifications to covered local political divisions upon request.

Please reach out to State Social Security Administrator James E. Sawyer, MPA, CEBS at TXSSP@ers.texas.gov or 512-867-7373 to find out if your local governmental entity already has an agreement/modification with the State of Texas.

The State Administrator is responsible for conducting referenda elections for Social Security and Medicare coverage. Please reach out to State Social Security Administrator James E. Sawyer, MPA, CEBS at TXSSP@ers.texas.gov or 512-867-7373 to initiate this process.

No. Beginning April 20, 1983, Section 218 Agreements are permanent and cannot be terminated.  If a local political subdivision covered by a modification is dissolved, merged, or no longer has employees, its agreement under a modification with the State of Texas can be transitioned to inactive status, which suspends the annual $35 administrative fee billing cycle for the State of Texas. Please contact the State Social Security Administrator James E. Sawyer, MPA, CEBS at TXSSP@ers.texas.gov or 512-867-7373.

Yes. Desired changes to a current modification require a new modification. Changes can only increase coverage, never reduce coverage currently in effect, by potentially adding types/classes of employees, adding new groups of formerly excluded employees, or deleting/removing voluntary exceptions to coverage in the original/current modification.

Please email the change to State Social Security Administrator James E. Sawyer, MPA, CEBS at TXSSP@ers.texas.gov or 512-867-7373.
 

Please request copies of modifications from the State Social Security Administrator James E. Sawyer, MPA, CEBS at TXSSP@ers.texas.gov or 512-867-7373.

No. The employing local political divisions must have a Section 218 Agreement that covers the employee’s position or the employee’s position must otherwise be covered under mandatory coverage rules.