Sec. 1501.066. ELECTION TO TREAT PARTICIPATING EMPLOYERS SEPARATELY FOR RATING PURPOSES. (a) Notwithstanding Section 1501.063, a health group cooperative may file with the commissioner, on a form and in the manner prescribed by the commissioner, an election to treat each participating employer within the cooperative as a separate employer for purposes of rating small and large employer health benefit plans, subject to the rating requirements of this code applicable to such plans. An existing health group cooperative must file the election with the department not later than the 90th day before the date on which the election is to become effective.
(b) A health group cooperative must provide to all participating and prospective employers, in a manner prescribed by the commissioner, a written notice of the cooperative's election to treat participating employers within the cooperative as separate employers for purposes of rating small and large employer health benefit plans. Employers participating in the cooperative when such an election is made must be provided notice of the election not later than the 90th day before the date the election is to become effective. For a participating employer, the notice must contain the quote for the premium rate applicable to the employer as of the date the plan is renewed. Prospective employers must be provided notice of the election when the prospective employer applies to become a participating employer in the health group cooperative.
(c) An election under this section is effective on the earliest date after the election is made on which the plan to which the election applies is initially issued or renewed. The election remains in effect for not less than 12 months after the effective date.
Added by Acts 2011, 82nd Leg., R.S., Ch. 1067 (S.B. 859), Sec. 6, eff. June 17, 2011.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Subtitle G - Health Coverage Availability
Chapter 1501 - Health Insurance Portability and Availability Act
Subchapter B. Coalitions and Cooperatives
Section 1501.052. Texas Health Benefits Purchasing Cooperative; Board of Trustees
Section 1501.054. Regional Subdivisions of Texas Health Benefits Purchasing Cooperative
Section 1501.056. Private Purchasing Cooperatives and Health Group Cooperatives
Section 1501.0575. Voluntary Participation by Issuer in Cooperative
Section 1501.058. Powers and Duties of Cooperatives
Section 1501.0581. Special Provisions Relating to Health Group Cooperatives
Section 1501.0582. Health Group Cooperative: Expedited Approval Process
Section 1501.059. Self-Insured or Self-Funded Plan Prohibited
Section 1501.060. Scope of Group Coverage
Section 1501.062. Cooperative Not Insurer; Agents and Administrators
Section 1501.063. Status as Employer
Section 1501.064. Certain Use of Appropriated Money Prohibited
Section 1501.065. Certain Actions Based on Risk Characteristics or Health Status Prohibited
Section 1501.066. Election to Treat Participating Employers Separately for Rating Purposes