28 Tex. Admin. Code § 26.407 - Health Carrier Filing Before Issuance of Coverage to a Health Group Cooperative

(a) A health carrier that intends to issue coverage to a health group cooperative must file with TDI information concerning the health carrier's offer of coverage no later than 30 days before the cooperative's initial enrollment period.

(b) A filing required by subsection (a) of this section must include:

(1) the name of the health carrier;

(2) the name, address, and telephone number or other contact information of the health group cooperative to which the health carrier intends to offer coverage;

(3) the county or expanded service area in which the health carrier intends to offer coverage to the health group cooperative;

(4) any limitations concerning the number of participating employers or employees in a health group cooperative that the health carrier is capable of administering; and

(5) the health benefit plan filed for use by the health carrier as a product available to health group cooperatives, or when appropriate under subsection (c) of this section, reference to a previously approved form, including the form number and date of approval.

(c) The form filing required by subsection (b)(5) of this section must comply, as appropriate, with all applicable filing requirements under Chapter 3 of this title (relating to Life, Accident and Health Insurance and Annuities) or Chapter 11 of this title (relating to Health Maintenance Organizations).

Notes

28 Tex. Admin. Code § 26.407

The provisions of this §26.407 adopted to be effective August 31, 2004, 29 TexReg 8360; amended to be effective January 31, 2006, 31 TexReg 512; Amended by Texas Register, Volume 42, Number 19, May 12, 2017, TexReg 2560, eff. 5/17/2017