28 Tex. Admin. Code § 7.1910 - Required Notice to Participants

(a) In addition to any other notices required by law, a multiple employer welfare arrangement (MEWA), in connection with an employee welfare benefit plan, must provide to each participating employee or former employee covered by the plan a written notice at the time the coverage of such participating employee or former employee becomes effective. The written notice must contain, at a minimum, the following:

(1) that individuals covered by the plan are only partially insured;

(2) that in the event the plan or the MEWA does not ultimately pay medical expenses that are eligible for payment under the plan for any reason, the participating employer or its participating employee covered by the plan may be liable for those expenses;

(3) that, if applicable, the plan does not participate in the guaranty fund; such disclosure must be provided in the same notice format required of insurers and health maintenance organizations in § 1.1001 of this title (relating to Disclosure of Guaranty Fund Nonparticipation);

(4) the toll-free telephone number and website for the department as required under Insurance Code § 521.005, concerning Notice to Accompany Policy; and

(5) that a copy of the summary plan description may be obtained from the plan administrator, employer, or trustee, as applicable.

(b) The notice must also briefly explain the types of information in the summary plan description.

Notes

28 Tex. Admin. Code § 7.1910

The provisions of this §7.1910 adopted to be effective May 27, 1994, 19 TexReg 3686; Amended by Texas Register, Volume 49, Number 44, November 1, 2024, TexReg 8730, eff. 11/6/2024