28 Tex. Admin. Code § 19.1026 - Small Employer Health Benefit Plan Specialty Certification Course

(a) An individual may advertise, in compliance with Chapter 21, Subchapter B of this title (relating to Insurance Advertising, Certain Trade Practices, and Solicitation), that the individual is specially trained to serve small employers in the health benefit plan market if the individual:

(1) holds a current life, accident, and health license issued by the department;

(2) agrees to market small employer health benefit plans to small employers that satisfy the requirements of the Insurance Code Chapter 1501 without regard to the number of employees to be covered under the plan;

(3) maintains on file with the department a current business address, phone number, and general description of the individual's service area;

(4) has completed a small employer health benefit plan specialty certification course meeting the requirements of this subchapter or qualifies for an exception from completion of the small employer health benefit plan specialty certification course in accordance with the Insurance Code § 4054.353(c); and

(5) has passed an examination testing the individual's knowledge and qualifications in compliance with the requirements of § 19.1011 of this subchapter (relating to Requirements for Successful Completion of Continuing Education Courses) or qualifies for an exception from completion of the small employer health benefit plan specialty certification course in accordance with the Insurance Code § 4054.353(c).

(b) This section establishes the standards for a small employer health benefit plan specialty certification course. The course shall:

(1) be submitted to the department for approval in compliance with § 19.1007 of this subchapter (relating to Course Certification Submission Applications, Course Expirations, and Resubmissions);

(2) be at least eight hours in length;

(3) cover each of the subjects described in subsection (e) of this section; and

(4) comply with the requirements of § 19.1011 of this subchapter.

(c) Licensees may count a small employer health benefit plan specialty certification course toward completion of the continuing education requirements prescribed in § 19.1003 of this subchapter (relating to Licensee Requirements). If a licensee chooses to use a small employer health benefit plan specialty certification course to satisfy a portion of the continuing education requirements prescribed in § 19.1003 of this subchapter, the licensee shall comply with § 19.1013 of this subchapter (relating to Licensee Record Maintenance).

(d) A licensee shall maintain proof of completion of a small employer health benefit plan specialty certification course for a period of four years from the date of completion of the course. Upon request, the licensee shall provide to the department the following:

(1) proof of completion of the small employer health benefit plan specialty certification course; or

(2) proof of exception from completion of the small employer health benefit plan specialty certification course in accordance with the Insurance Code § 4054.353(c).

(e) Course subjects for a small employer health benefit plan specialty certification course outline must include topics that address:

(1) topics related specifically to small employer health benefit plans;

(2) state and federal laws and rules related to employer health benefit plans;

(3) anti-rebating and prohibited sales practices regarding employer health benefit plans;

(4) federal programs and other alternatives related to small employer health benefit plans; and

(5) fraudulent and unfair trade practices regarding small employer health benefit plans.

Notes

28 Tex. Admin. Code § 19.1026

The provisions of this §19.1026 adopted to be effective February 21, 2010, 35 TexReg 1271