28 Tex. Admin. Code § 7.1804 - When a Withdrawal Plan is Required
(a) Any
authorized insurer or HMO must file with the Commissioner of Insurance a plan
of orderly withdrawal before the insurer or HMO undertakes a withdrawal.
(1) The insurer or HMO undertakes a
withdrawal when it takes any action on its own initiative that will result in
the insurer or HMO meeting the criteria under Insurance Code §
827.003.
(2) An insurer or HMO will not be held to
have acted on its own initiative in effecting a withdrawal when it acts under a
Commissioner disciplinary or administrative directive or order, or when the
insurer or HMO acts under a directive of a supervisor, conservator, or
receiver. If an out-of-state directive or order is not provided to the
Commissioner within 30 days of the issuance of such directive or order, the
insurer or HMO will be held to have acted on its own
initiative.
(b) An
insurer or HMO is not required to file a plan of orderly withdrawal, but must
instead notify the department, when:
(1) the
line of business is written by a stipulated premium company unless such line is
written under Insurance Code §
884.303 and §
884.307 or Chapter
884, Subchapter I; or
(2) the line
of insurance from which the HMO is withdrawing is Medicare, a Medicare+Choice
plan or a Medicaid contract as provided in §
7.1803(a) of
this title (relating to What Constitutes a Line of
Insurance).
(c) If an
insurer or HMO comes within an exception provided in subsection (b) of this
section, such notification must be sent to the department simultaneously with
any notification required to be provided to any other state or federal agency.
The notification will be accepted for information only and must affirm that any
appropriate state or federal agency has been notified of the company's intent
to withdraw, and must include the effective date of nonrenewal, the names of
the Texas counties affected, and the number of insureds or enrollees
affected.
(d) This subchapter does
not modify or supercede any requirement under the Insurance Code or any other
state or federal law to notify policyholders or enrollees that an insurer or
HMO will not renew any coverage; however, before any such notice is given a
withdrawal plan must be filed with the department and approved by the
department under §
7.1806 of this title (relating to
Withdrawal Plan Submission and Approval Procedures) when a plan is required by
this section.
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.