Sec. 1501.312. APPLICATION TO OPERATE AS RISK-ASSUMING HEALTH BENEFIT PLAN ISSUER. (a) A small employer health benefit plan issuer may apply to operate as a risk-assuming health benefit plan issuer by filing an application with the commissioner in a form and manner prescribed by the commissioner.
(b) In evaluating an application, the commissioner shall consider the small employer health benefit plan issuer's:
(1) financial condition;
(2) history of rating and underwriting small employer groups;
(3) commitment to market fairly to all small employers in the state or in the issuer's established geographic service area; and
(4) experience managing the risk of small employer groups.
(c) The commissioner shall provide public notice of an application and shall provide at least a 60-day period for public comment before making a decision on the application. If the commissioner does not act on the application before the 90th day after the date the commissioner receives the application, the issuer may request and the commissioner shall grant a hearing.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
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 G. Reinsurance for Small Employer Health Benefit Plans
Section 1501.302. Texas Health Reinsurance System
Section 1501.3021. Authorization of Operation
Section 1501.3022. Suspension of Operation
Section 1501.303. System Board of Directors
Section 1501.304. Open Meetings; Public Information
Section 1501.305. Board Member Immunity
Section 1501.306. System Plan of Operation
Section 1501.307. System Powers
Section 1501.308. System Notes as Legal Investment for Small Employer Health Benefit Plan Issuer
Section 1501.309. System Audit
Section 1501.310. Election of Status
Section 1501.311. Change in Status
Section 1501.312. Application to Operate as Risk-Assuming Health Benefit Plan Issuer
Section 1501.313. Rescission of Approval to Operate as Risk-Assuming Health Benefit Plan Issuer
Section 1501.315. Limits on Reinsurance
Section 1501.316. Termination of Reinsurance
Section 1501.317. Application of Managed Care Procedures
Section 1501.318. Premium Rates for Reinsurance
Section 1501.319. Determination of Net Loss
Section 1501.320. Assessments to Recover Net Losses
Section 1501.321. Limits on Assessments
Section 1501.322. Adjustment to Assessments on Federally Qualified Health Maintenance Organizations
Section 1501.323. Advance Interim Assessments
Section 1501.324. Limit on Total Assessments
Section 1501.325. Estimate of Assessments; Evaluation and Protection of System