34 Tex. Admin. Code § 67.91 - Form, Content, and Service of Orders
(a) All final Orders of the Board or its
designee shall be in writing and shall be signed by the chairman of the Board
or by the Board's designee. A final decision shall include, adopt or reference
findings of fact and conclusions of law separately stated. Findings of fact, if
set forth in statutory language, shall be accompanied by a concise and explicit
statement of the underlying facts supporting the findings.
(b) Acting in its capacity as fiduciary of
the employee benefit plans for which it serves as trustee, the Board or its
designee may, in their sole discretion, modify, refuse to accept, or delete any
adopted finding of fact or conclusion of law, or make alternative findings of
fact or conclusions of law, if it is determined by the Board or its designee
that all or part of the proposal for decision submitted by the Examiner, or a
adopted finding of fact or conclusion of law contained therein, is:
(1) clearly erroneous or illogical;
(2) against the weight of the
evidence;
(3) based on a
misapplication of the rules of evidence or an insufficient review of the
evidence;
(4) based on a medical
opinion that is not supported by objective medical evidence, or is not based on
reasonable medical probability;
(5)
inconsistent with the terms or intent, as determined by the Board or its
designee, of an applicable statute, benefit plan or insurance policy
provision;
(6) confusing,
incomplete or misleading;
(7)
immaterial or irrelevant to the issues; or
(8) not sufficient to protect the interests
of the plans and programs for which the Board is trustee, or the interests, as
a group, of the Members, retirees or participants covered by such plans and
programs. The Order shall contain or reference a written statement of the
reason and legal basis for each change made based on the foregoing policy
reasons. Correction of nonsubstantive typographical errors do not need to be
explained.
(c) A copy of
the Board's or its designee's decision or Order shall be served on each Party
or his Authorized Representative.
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.