28 Tex. Admin. Code § 26.309 - Refusal to Renew and Application to Reenter Large Employer Market
(a) A large employer carrier may elect to
refuse to renew all large employer health benefit plans delivered or issued for
delivery by the large employer carrier in this state or in a geographic service
area. The large employer carrier must notify the commissioner and each affected
covered large employer of the election as provided in Insurance Code §
1501.109 (concerning
Refusal to Renew; Discontinuation of Coverage).
(b) The large employer carrier may not write
a new large employer health benefit plan in this state or in the geographic
service area, as applicable, for five years after notice to the commissioner of
the election to refuse to renew. A large employer carrier that elects not to
renew all large employer health benefit plans under Insurance Code §
1501.109 and this
section may not resume offering health benefit plans to large employers in this
state or in the geographic area for which the election was made until it has
filed a petition with the commissioner to be reinstated as a large employer
carrier and the petition has been approved . In reviewing the petition, the
commissioner may ask for information and assurances as the commissioner finds
reasonable and appropriate.
(c) A
large employer carrier may elect to discontinue a particular type of large
employer coverage, only if the large employer carrier:
(1) before the 90th day preceding the date of
the discontinuation of the coverage:
(A)
provides notice of the discontinuation to each employer and TDI ; and
(B) offers to each employer the option to
purchase other large employer coverage offered by the large employer carrier at
the time of the discontinuation; and
(2) acts uniformly without regard to the
claims experience of the employer or any health-status-related factors of
employees or dependents who are or may become eligible for the
coverage.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.