Texas Statutes
Subtitle D - Other Professionals
Chapter 4151 - Third-Party Administrators

Section 4151.004. Applicability to Certain Insurers and Health Maintenance Organizations - Sec. 4151.004. APPLICABILITY TO CERTAIN INSURERS AND HEALTH MAINTENANCE ORGANIZATIONS....

Section 4151.005. Administrator Not Insurance Agent - Sec. 4151.005. ADMINISTRATOR NOT INSURANCE AGENT. (a) An administrator licensed...

Section 4151.0051. Referral to Adjuster by Administrator - Sec. 4151.0051. REFERRAL TO ADJUSTER BY ADMINISTRATOR. (a) An administrator...

Section 4151.006. Rules - Sec. 4151.006. RULES. The commissioner may adopt, in the manner...

Subchapter B. Certificate of Authority

Section 4151.051. Certificate of Authority Required - Sec. 4151.051. CERTIFICATE OF AUTHORITY REQUIRED. (a) An individual, corporation,...

Section 4151.052. Application - Sec. 4151.052. APPLICATION. (a) An application for a certificate of...

Section 4151.053. Approval of Application - Sec. 4151.053. APPROVAL OF APPLICATION. The commissioner shall approve an...

Section 4151.054. Denial of Application - Sec. 4151.054. DENIAL OF APPLICATION. (a) If the commissioner is...

Section 4151.055. Fidelity Bond Required - Sec. 4151.055. FIDELITY BOND REQUIRED. (a) If the commissioner approves...

Section 4151.056. Duration of Certificate of Authority - Sec. 4151.056. DURATION OF CERTIFICATE OF AUTHORITY. A certificate of...

Subchapter C. Powers and Duties of Administrators and Insurers

Section 4151.101. Written Agreement With Insurer or Plan Sponsor Required - Sec. 4151.101. WRITTEN AGREEMENT WITH INSURER OR PLAN SPONSOR REQUIRED....

Section 4151.102. Contents of Written Agreement - Sec. 4151.102. CONTENTS OF WRITTEN AGREEMENT. (a) The written agreement...

Section 4151.103. Retention of Written Agreement; Inspection by Commissioner - Sec. 4151.103. RETENTION OF WRITTEN AGREEMENT; INSPECTION BY COMMISSIONER. (a)...

Section 4151.104. Notice of Use of Administrator's Services - Sec. 4151.104. NOTICE OF USE OF ADMINISTRATOR'S SERVICES. (a) If...

Section 4151.1041. Referral by Insurer - Sec. 4151.1041. REFERRAL BY INSURER. (a) An insurer may not...

Section 4151.1042. Responsibilities of Insurer; Semiannual Audit - Sec. 4151.1042. RESPONSIBILITIES OF INSURER; SEMIANNUAL AUDIT. (a) If an...

Section 4151.105. Payments to Administrator - Sec. 4151.105. PAYMENTS TO ADMINISTRATOR. (a) If an insurer, plan,...

Section 4151.106. Certain Funds Collected or Received by Administrator - Sec. 4151.106. CERTAIN FUNDS COLLECTED OR RECEIVED BY ADMINISTRATOR. (a)...

Section 4151.107. Delivery or Deposit of Certain Funds Received by Administrator - Sec. 4151.107. DELIVERY OR DEPOSIT OF CERTAIN FUNDS RECEIVED BY...

Section 4151.108. Withdrawals From Fiduciary Account - Sec. 4151.108. WITHDRAWALS FROM FIDUCIARY ACCOUNT. A withdrawal from a...

Section 4151.109. Payment of Claims From Fiduciary Account Prohibited - Sec. 4151.109. PAYMENT OF CLAIMS FROM FIDUCIARY ACCOUNT PROHIBITED. An...

Section 4151.110. Underwriting Standards - Sec. 4151.110. UNDERWRITING STANDARDS. If an administrator has the authority...

Section 4151.111. Adjudication of Claims - Sec. 4151.111. ADJUDICATION OF CLAIMS. (a) An administrator shall adjudicate...

Section 4151.112. Maintenance of Books and Records - Sec. 4151.112. MAINTENANCE OF BOOKS AND RECORDS. (a) An administrator...

Section 4151.113. Access to Books and Records - Sec. 4151.113. ACCESS TO BOOKS AND RECORDS. (a) For the...

Section 4151.114. Disposition of Books and Records on Termination of Written Agreement - Sec. 4151.114. DISPOSITION OF BOOKS AND RECORDS ON TERMINATION OF...

Section 4151.115. Confidentiality of Personal Information - Sec. 4151.115. CONFIDENTIALITY OF PERSONAL INFORMATION. (a) Information that identifies...

Section 4151.116. Advertising - Sec. 4151.116. ADVERTISING. Before an administrator uses advertising relating to...

Section 4151.117. Compensation of Administrator - Sec. 4151.117. COMPENSATION OF ADMINISTRATOR. (a) An administrator's compensation may...

Subchapter D. Pharmacy Benefit Plans

Section 4151.151. Definition - Sec. 4151.151. DEFINITION. In this subchapter, "pharmacy benefit manager" means...

Section 4151.152. Identification Cards - Sec. 4151.152. IDENTIFICATION CARDS. (a) Except as provided by rules...

Section 4151.153. Disclosure of Certain Patient Information Prohibited - Sec. 4151.153. DISCLOSURE OF CERTAIN PATIENT INFORMATION PROHIBITED. (a) A...

Section 4151.154. Discount Health Care Programs - Sec. 4151.154. DISCOUNT HEALTH CARE PROGRAMS. A pharmacy benefit manager...

Subchapter E. Department Regulation of Administrators

Section 4151.201. Examination of Administrator - Sec. 4151.201. EXAMINATION OF ADMINISTRATOR. (a) The commissioner may examine...

Section 4151.202. Contents of Examination; On-Site Evaluation - Sec. 4151.202. CONTENTS OF EXAMINATION; ON-SITE EVALUATION. (a) An examination...

Section 4151.203. Cost of Examination - Sec. 4151.203. COST OF EXAMINATION. The cost of an examination...

Section 4151.204. Examination Under Oath - Sec. 4151.204. EXAMINATION UNDER OATH. If necessary to make a...

Section 4151.205. Annual Report - Sec. 4151.205. ANNUAL REPORT. (a) An administrator shall annually, not...

Section 4151.206. Fees - Sec. 4151.206. FEES. (a) The commissioner shall collect and an...

Section 4151.210. Effect of Revocation of Other Certificates - Sec. 4151.210. EFFECT OF REVOCATION OF OTHER CERTIFICATES. An officer...

Section 4151.211. Restrictions on Acquisition of Ownership Interest - Sec. 4151.211. RESTRICTIONS ON ACQUISITION OF OWNERSHIP INTEREST. (a) A...

Section 4151.212. Maintenance of Qualifications Required - Sec. 4151.212. MAINTENANCE OF QUALIFICATIONS REQUIRED. The department may, in...

Subchapter F. Workers' Compensation Benefit Plans

Section 4151.251. Definition - Sec. 4151.251. DEFINITION. For purposes of this subchapter only, "insurance...

Section 4151.252. Application - Sec. 4151.252. APPLICATION. (a) This subchapter applies to the administration...

Section 4151.253. Agreements Between Administrators and Carriers - Sec. 4151.253. AGREEMENTS BETWEEN ADMINISTRATORS AND CARRIERS. (a) An administrator...

Section 4151.254. Agreements Between Administrators and Employers - Sec. 4151.254. AGREEMENTS BETWEEN ADMINISTRATORS AND EMPLOYERS. (a) In addition...

Section 4151.255. Administrator Compensation - Sec. 4151.255. ADMINISTRATOR COMPENSATION. Except as provided by Section 4151.117,...

Section 4151.256. Large Deductible Policies - Sec. 4151.256. LARGE DEDUCTIBLE POLICIES. An employer who enters into...

Section 4151.257. Rules - Sec. 4151.257. RULES. The commissioner shall adopt rules to implement...

Subchapter G. Disciplinary Actions; Penalties

Section 4151.301. Grounds for Denial, Suspension, or Revocation of Certificate of Authority - Sec. 4151.301. GROUNDS FOR DENIAL, SUSPENSION, OR REVOCATION OF CERTIFICATE...

Section 4151.302. Remedies for Violation of Insurance Laws or Commissioner Rules - Sec. 4151.302. REMEDIES FOR VIOLATION OF INSURANCE LAWS OR COMMISSIONER...

Section 4151.303. Probated Suspension - Sec. 4151.303. PROBATED SUSPENSION. If the suspension of a certificate...

Section 4151.304. Hearing - Sec. 4151.304. HEARING. If the department proposes to deny an...

Section 4151.305. Application for Certificate of Authority After Denial or Revocation - Sec. 4151.305. APPLICATION FOR CERTIFICATE OF AUTHORITY AFTER DENIAL OR...

Section 4151.306. Disciplinary Proceeding for Conduct Committed Before Surrender or Forfeiture of Certificate - Sec. 4151.306. DISCIPLINARY PROCEEDING FOR CONDUCT COMMITTED BEFORE SURRENDER OR...

Section 4151.307. Emergency Certificate Suspension - Sec. 4151.307. EMERGENCY CERTIFICATE SUSPENSION. (a) The commissioner may suspend...

Section 4151.308. General Administrative Sanctions - Sec. 4151.308. GENERAL ADMINISTRATIVE SANCTIONS. An administrator or other person...

Section 4151.309. Criminal Penalty - Sec. 4151.309. CRIMINAL PENALTY. (a) An administrator commits an offense...

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Texas Statutes Subtitle D - Other Professionals Chapter 4151 - Third-Party Administrators

Texas Statutes
Subtitle D - Other Professionals
Chapter 4151 - Third-Party Administrators