28 Tex. Admin. Code § 26.410 - Expedited Approval for Plans Offered Through a Health Group Cooperative
(a) Unless a health carrier has identified a
previously approved health benefit plan in the filing required by §
26.407 of this title (relating to
Health Carrier Filing Before Issuance of Coverage to a Health Group
Cooperative), the health carrier must file each health benefit plan that will
be offered to a health group cooperative for approval and must clearly indicate
in the filing that the health benefit plan is to be offered to a health group
cooperative and is subject to review under this section.
(b) A health benefit plan subject to review
under this section may be filed as a file-and-use form consistent with
Insurance Code Chapter 1701, Subchapter B (concerning Filing Requirement) and
Subchapter C (concerning Sanctions; Applicability of Other Laws), and §
3.5(a)(2) of
this title (relating to Filing Authorities and Categories).
(c) An insurer that does not elect to file
for approval under subsection (b) of this section must file for approval
consistent with Insurance Code §
1701.051 (concerning
Filing Required), and §1701.054 (concerning Approval of Form), and §
3.5(a)(1) of
this title. TDI will approve or disapprove the filing within 40 calendar days
of receipt of the complete filing.
(d) An HMO must file for approval an HMO
evidence of coverage that is to be offered solely to a health group cooperative
and must indicate that review of the evidence of coverage is subject to the
expedited process available under this section. The HMO must file the evidence
of coverage as required by Chapter 11 of this title (relating to Health
Maintenance Organizations), and TDI will approve or disapprove the evidence of
coverage within 20 calendar days of receipt of a complete filing.
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.