28 Tex. Admin. Code § 26.302 - Status of Health Carriers as Large Employer Carriers
(a) With the original filing to enter the
large employer market or when notifying TDI of a change in status, each health
carrier providing health benefit plans in this state must file with the
commissioner a statement indicating whether the health carrier will or will not
offer, renew, issue, or issue for delivery health benefit plans to large
employers in this state. The filing must include a certification, signed by an
officer of the company, that the carrier intends to operate in accordance with
the status certification unless or until changed in accordance with this
section, and provide a statement that:
(1)
the health carrier intends to offer, renew, issue, and issue for delivery
health benefit plans to large employers in Texas, and will operate in
accordance with Insurance Code Chapter 1501 (concerning Health Insurance
Portability and Availability Act) and this subchapter;
(2) the health carrier does not intend to
offer, issue, or issue for delivery health benefit plans to large employers in
Texas, but the health carrier intends to renew existing health benefit
plans;
(3) the health carrier does
not intend to offer, issue, or issue for delivery health benefit plans to large
employers in Texas; intends to nonrenew all health benefit plans issued to
large employers in Texas; and will provide notice to the commissioner and
employers in accordance with §
26.309 of this title (relating to
Refusal to Renew and Application to Reenter Large Employer Market) and
Insurance Code §
1501.110 (concerning
Notice to Covered Persons); or
(4)
the health carrier has no health benefit plans issued to large employers or to
employees of a large employer and does not intend to offer, issue, or issue for
delivery health benefit plans to large employers.
(b) If a health carrier chooses to change its
election or the date of implementing its election under subsection (a)(1), (2),
or (4) of this section, the health carrier must notify the commissioner of its
new election at least 30 days before the date the health carrier intends to
begin operations under the new election.
(c) A form fulfilling the requirements of
subsections (a) and (b) of this section is available online at
www.tdi.texas.gov/forms/form10smgroup.html through the link for Large Employer
Carrier Status Certification.
(d)
The large employer carrier must also comply with any other applicable legal
requirements, including those for withdrawal from the market under Chapter 7,
Subchapter R of this title (relating to Withdrawal Plan Requirements and
Procedures).
Notes
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