Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Subtitle G - Health Coverage Availability

Section 1501.003. Applicability: Small Employer Health Benefit Plans - Sec. 1501.003. APPLICABILITY: SMALL EMPLOYER HEALTH BENEFIT PLANS. An individual...

Section 1501.004. Applicability: Large Employer Health Benefit Plans - Sec. 1501.004. APPLICABILITY: LARGE EMPLOYER HEALTH BENEFIT PLANS. An individual...

Section 1501.005. Exception: Certain Individually Underwritten Policies - Sec. 1501.005. EXCEPTION: CERTAIN INDIVIDUALLY UNDERWRITTEN POLICIES. Except as provided...

Section 1501.006. Certification - Sec. 1501.006. CERTIFICATION. (a) In accordance with rules adopted by...

Section 1501.007. Affiliates - Sec. 1501.007. AFFILIATES. (a) In this section, "affiliate" has the...

Section 1501.008. Late Enrollees - Sec. 1501.008. LATE ENROLLEES. (a) For purposes of this chapter,...

Section 1501.009. School District Election - Sec. 1501.009. SCHOOL DISTRICT ELECTION. (a) An independent school district...

Section 1501.0095. School District Employee Election - Sec. 1501.0095. SCHOOL DISTRICT EMPLOYEE ELECTION. (a) Notwithstanding any other...

Section 1501.010. General Rules - Sec. 1501.010. GENERAL RULES. The commissioner shall adopt rules necessary...

Section 1501.011. Determination of Employer Status for Certain Employers - Sec. 1501.011. DETERMINATION OF EMPLOYER STATUS FOR CERTAIN EMPLOYERS. (a)...

Subchapter B. Coalitions and Cooperatives

Section 1501.051. Definitions - Sec. 1501.051. DEFINITIONS. In this subchapter: (1) "Board of directors"...

Section 1501.052. Texas Health Benefits Purchasing Cooperative; Board of Trustees - Sec. 1501.052. TEXAS HEALTH BENEFITS PURCHASING COOPERATIVE; BOARD OF TRUSTEES....

Section 1501.053. Texas Health Benefits Purchasing Cooperative: Executive Director and Other Employees - Sec. 1501.053. TEXAS HEALTH BENEFITS PURCHASING COOPERATIVE: EXECUTIVE DIRECTOR AND...

Section 1501.054. Regional Subdivisions of Texas Health Benefits Purchasing Cooperative - Sec. 1501.054. REGIONAL SUBDIVISIONS OF TEXAS HEALTH BENEFITS PURCHASING COOPERATIVE....

Section 1501.055. Applicability of Public Information Law to Texas Health Benefits Purchasing Cooperative - Sec. 1501.055. APPLICABILITY OF PUBLIC INFORMATION LAW TO TEXAS HEALTH...

Section 1501.056. Private Purchasing Cooperatives and Health Group Cooperatives - Sec. 1501.056. PRIVATE PURCHASING COOPERATIVES AND HEALTH GROUP COOPERATIVES. (a)...

Section 1501.057. Immunity - Sec. 1501.057. IMMUNITY. (a) The Texas cooperative or a member...

Section 1501.0575. Voluntary Participation by Issuer in Cooperative - Sec. 1501.0575. VOLUNTARY PARTICIPATION BY ISSUER IN COOPERATIVE. A health...

Section 1501.058. Powers and Duties of Cooperatives - Sec. 1501.058. POWERS AND DUTIES OF COOPERATIVES. (a) A cooperative...

Section 1501.0581. Special Provisions Relating to Health Group Cooperatives - Sec. 1501.0581. SPECIAL PROVISIONS RELATING TO HEALTH GROUP COOPERATIVES. (a)...

Section 1501.0582. Health Group Cooperative: Expedited Approval Process - Sec. 1501.0582. HEALTH GROUP COOPERATIVE: EXPEDITED APPROVAL PROCESS. The department...

Section 1501.059. Self-Insured or Self-Funded Plan Prohibited - Sec. 1501.059. SELF-INSURED OR SELF-FUNDED PLAN PROHIBITED. A cooperative may...

Section 1501.060. Scope of Group Coverage - Sec. 1501.060. SCOPE OF GROUP COVERAGE. Subchapter B, Chapter 1251,...

Section 1501.061. Requirements Applicable to Health Benefit Plan Issuers With Which Cooperative May Contract - Sec. 1501.061. REQUIREMENTS APPLICABLE TO HEALTH BENEFIT PLAN ISSUERS WITH...

Section 1501.062. Cooperative Not Insurer; Agents and Administrators - Sec. 1501.062. COOPERATIVE NOT INSURER; AGENTS AND ADMINISTRATORS. (a) A...

Section 1501.063. Status as Employer - Sec. 1501.063. STATUS AS EMPLOYER. (a) A small employer health...

Section 1501.064. Certain Use of Appropriated Money Prohibited - Sec. 1501.064. CERTAIN USE OF APPROPRIATED MONEY PROHIBITED. The Texas...

Section 1501.065. Certain Actions Based on Risk Characteristics or Health Status Prohibited - Sec. 1501.065. CERTAIN ACTIONS BASED ON RISK CHARACTERISTICS OR HEALTH...

Section 1501.066. Election to Treat Participating Employers Separately for Rating Purposes - Sec. 1501.066. ELECTION TO TREAT PARTICIPATING EMPLOYERS SEPARATELY FOR RATING...

Section 1501.067. Eligible Single-Employee Business - Sec. 1501.067. ELIGIBLE SINGLE-EMPLOYEE BUSINESS. The commissioner shall adopt rules...

Subchapter C. Provision of Coverage

Section 1501.101. Geographic Service Areas - Sec. 1501.101. GEOGRAPHIC SERVICE AREAS. (a) Repealed by Acts 2015,...

Section 1501.102. Preexisting Condition Provision - Sec. 1501.102. PREEXISTING CONDITION PROVISION. (a) In this section, "creditable...

Section 1501.103. Treatment of Certain Conditions as Preexisting Prohibited - Sec. 1501.103. TREATMENT OF CERTAIN CONDITIONS AS PREEXISTING PROHIBITED. (a)...

Section 1501.104. Affiliation Period - Sec. 1501.104. AFFILIATION PERIOD. (a) In this section, "affiliation period"...

Section 1501.105. Waiting Period Permitted - Sec. 1501.105. WAITING PERIOD PERMITTED. Sections 1501.102-1501.104 do not preclude...

Section 1501.106. Certain Limitations or Exclusions of Coverage Prohibited - Sec. 1501.106. CERTAIN LIMITATIONS OR EXCLUSIONS OF COVERAGE PROHIBITED. (a)...

Section 1501.107. Discounts, Rebates, and Reductions - Sec. 1501.107. DISCOUNTS, REBATES, AND REDUCTIONS. (a) A small or...

Section 1501.108. Renewability of Coverage; Cancellation - Sec. 1501.108. RENEWABILITY OF COVERAGE; CANCELLATION. (a) Except as provided...

Section 1501.109. Refusal to Renew; Discontinuation of Coverage - Sec. 1501.109. REFUSAL TO RENEW; DISCONTINUATION OF COVERAGE. (a) A...

Section 1501.110. Notice to Covered Persons - Sec. 1501.110. NOTICE TO COVERED PERSONS. (a) A small or...

Section 1501.111. Written Statement of Denial, Cancellation, or Refusal to Renew Required - Sec. 1501.111. WRITTEN STATEMENT OF DENIAL, CANCELLATION, OR REFUSAL TO...

Subchapter D. Guaranteed Issue of Small Employer Health Benefit Plans; Continuation of Coverage

Section 1501.151. Guaranteed Issue - Sec. 1501.151. GUARANTEED ISSUE. (a) A small employer health benefit...

Section 1501.152. Exclusion of Eligible Employee or Dependent Prohibited - Sec. 1501.152. EXCLUSION OF ELIGIBLE EMPLOYEE OR DEPENDENT PROHIBITED. A...

Section 1501.153. Employer Contribution - Sec. 1501.153. EMPLOYER CONTRIBUTION. (a) This chapter does not require...

Section 1501.154. Minimum Participation Requirement - Sec. 1501.154. MINIMUM PARTICIPATION REQUIREMENT. (a) Except as provided by...

Section 1501.155. Exception to Minimum Participation Requirement - Sec. 1501.155. EXCEPTION TO MINIMUM PARTICIPATION REQUIREMENT. (a) A small...

Section 1501.156. Employee Enrollment; Waiting Period - Sec. 1501.156. EMPLOYEE ENROLLMENT; WAITING PERIOD. (a) The initial enrollment...

Section 1501.157. Coverage for Newborn Children - Sec. 1501.157. COVERAGE FOR NEWBORN CHILDREN. (a) A small employer...

Section 1501.158. Coverage for Adopted Children - Sec. 1501.158. COVERAGE FOR ADOPTED CHILDREN. (a) A small employer...

Section 1501.159. Continuation of Coverage for Certain Dependents - Sec. 1501.159. CONTINUATION OF COVERAGE FOR CERTAIN DEPENDENTS. An employee's...

Subchapter E. Underwriting and Rating of Small Employer Health Benefit Plans

Section 1501.201. Definitions - Sec. 1501.201. DEFINITIONS. In this subchapter: (1) "Base premium rate"...

Section 1501.202. Establishment of Classes of Business - Sec. 1501.202. ESTABLISHMENT OF CLASSES OF BUSINESS. (a) Except as...

Section 1501.203. Establishment of Classes of Business on Certain Bases Prohibited - Sec. 1501.203. ESTABLISHMENT OF CLASSES OF BUSINESS ON CERTAIN BASES...

Section 1501.204. Index Rates - Sec. 1501.204. INDEX RATES. Under a small employer health benefit...

Section 1501.205. Premium Rates: Establishment - Sec. 1501.205. PREMIUM RATES: ESTABLISHMENT. (a) In this section: (1)...

Section 1501.206. Premium Rates: Adjustments - Sec. 1501.206. PREMIUM RATES: ADJUSTMENTS. (a) The percentage increase in...

Section 1501.207. Premium Rate Adjustment in Closed Plan - Sec. 1501.207. PREMIUM RATE ADJUSTMENT IN CLOSED PLAN. For a...

Section 1501.208. Premium Rates: Industry Classification - Sec. 1501.208. PREMIUM RATES: INDUSTRY CLASSIFICATION. A small employer health...

Section 1501.209. Premium Rates: Number of Employees - Sec. 1501.209. PREMIUM RATES: NUMBER OF EMPLOYEES. A small employer...

Section 1501.210. Premium Rates: Nondiscrimination - Sec. 1501.210. PREMIUM RATES: NONDISCRIMINATION. (a) A small employer health...

Section 1501.211. Rules Concerning Premium Rates - Sec. 1501.211. RULES CONCERNING PREMIUM RATES. Rules adopted under Section...

Section 1501.212. Restricted Provider Network - Sec. 1501.212. RESTRICTED PROVIDER NETWORK. (a) A small employer health...

Section 1501.213. Premium Rates: Health Maintenance Organization Health Benefit Plan - Sec. 1501.213. PREMIUM RATES: HEALTH MAINTENANCE ORGANIZATION HEALTH BENEFIT PLAN....

Section 1501.214. Enforcement - Sec. 1501.214. ENFORCEMENT. If the commissioner determines that a small...

Section 1501.215. Reporting Requirements - Sec. 1501.215. REPORTING REQUIREMENTS. (a) Annually, each small employer health...

Section 1501.216. Premium Rates: Notice of Increase - Sec. 1501.216. PREMIUM RATES: NOTICE OF INCREASE. (a) Not less...

Subchapter F. Coverage Under Small Employer Health Benefit Plans

Section 1501.251. Exception From Certain Mandated Benefit Requirements - Sec. 1501.251. EXCEPTION FROM CERTAIN MANDATED BENEFIT REQUIREMENTS. Except as...

Section 1501.252. Health Benefit Plans - Sec. 1501.252. HEALTH BENEFIT PLANS. (a) A small employer health...

Section 1501.254. Alcohol and Substance Abuse Benefits - Sec. 1501.254. ALCOHOL AND SUBSTANCE ABUSE BENEFITS. (a) This section...

Section 1501.255. Health Maintenance Organization Plans - Sec. 1501.255. HEALTH MAINTENANCE ORGANIZATION PLANS. (a) In this section,...

Section 1501.256. Coordination With Federal Law - Sec. 1501.256. COORDINATION WITH FEDERAL LAW. (a) To the extent...

Section 1501.2561. Waiver of Certain Federal Requirements - Sec. 1501.2561. WAIVER OF CERTAIN FEDERAL REQUIREMENTS. The commissioner may...

Section 1501.257. Cost Containment - Sec. 1501.257. COST CONTAINMENT. (a) A small employer health benefit...

Section 1501.258. Forms - Sec. 1501.258. FORMS. (a) A small employer health benefit plan...

Section 1501.259. Riders; Filing With Commissioner - Sec. 1501.259. RIDERS; FILING WITH COMMISSIONER. (a) A small employer...

Section 1501.260. Plain Language Required - Sec. 1501.260. PLAIN LANGUAGE REQUIRED. (a) A health benefit plan...

Subchapter G. Reinsurance for Small Employer Health Benefit Plans

Section 1501.301. Definitions - Sec. 1501.301. DEFINITIONS. In this subchapter: (1) "Board" means the...

Section 1501.302. Texas Health Reinsurance System - Sec. 1501.302. TEXAS HEALTH REINSURANCE SYSTEM. (a) The Texas Health...

Section 1501.3021. Authorization of Operation - Sec. 1501.3021. AUTHORIZATION OF OPERATION. (a) The commissioner shall hold...

Section 1501.3022. Suspension of Operation - Sec. 1501.3022. SUSPENSION OF OPERATION. (a) The commissioner shall hold...

Section 1501.303. System Board of Directors - Sec. 1501.303. SYSTEM BOARD OF DIRECTORS. (a) The board of...

Section 1501.304. Open Meetings; Public Information - Sec. 1501.304. OPEN MEETINGS; PUBLIC INFORMATION. The board is subject...

Section 1501.305. Board Member Immunity - Sec. 1501.305. BOARD MEMBER IMMUNITY. (a) A member of the...

Section 1501.306. System Plan of Operation - Sec. 1501.306. SYSTEM PLAN OF OPERATION. (a) The board shall...

Section 1501.307. System Powers - Sec. 1501.307. SYSTEM POWERS. (a) The system has the general...

Section 1501.308. System Notes as Legal Investment for Small Employer Health Benefit Plan Issuer - Sec. 1501.308. SYSTEM NOTES AS LEGAL INVESTMENT FOR SMALL EMPLOYER...

Section 1501.309. System Audit - Sec. 1501.309. SYSTEM AUDIT. (a) The transactions of the system...

Section 1501.310. Election of Status - Sec. 1501.310. ELECTION OF STATUS. (a) Each small employer health...

Section 1501.311. Change in Status - Sec. 1501.311. CHANGE IN STATUS. (a) The commissioner shall establish...

Section 1501.312. Application to Operate as Risk-Assuming Health Benefit Plan Issuer - Sec. 1501.312. APPLICATION TO OPERATE AS RISK-ASSUMING HEALTH BENEFIT PLAN...

Section 1501.313. Rescission of Approval to Operate as Risk-Assuming Health Benefit Plan Issuer - Sec. 1501.313. RESCISSION OF APPROVAL TO OPERATE AS RISK-ASSUMING HEALTH...

Section 1501.314. Reinsurance - Sec. 1501.314. REINSURANCE. (a) A small employer health benefit plan...

Section 1501.315. Limits on Reinsurance - Sec. 1501.315. LIMITS ON REINSURANCE. (a) The system may not...

Section 1501.316. Termination of Reinsurance - Sec. 1501.316. TERMINATION OF REINSURANCE. A small employer health benefit...

Section 1501.317. Application of Managed Care Procedures - Sec. 1501.317. APPLICATION OF MANAGED CARE PROCEDURES. Except as provided...

Section 1501.318. Premium Rates for Reinsurance - Sec. 1501.318. PREMIUM RATES FOR REINSURANCE. (a) As part of...

Section 1501.319. Determination of Net Loss - Sec. 1501.319. DETERMINATION OF NET LOSS. (a) Not later than...

Section 1501.320. Assessments to Recover Net Losses - Sec. 1501.320. ASSESSMENTS TO RECOVER NET LOSSES. (a) The board...

Section 1501.321. Limits on Assessments - Sec. 1501.321. LIMITS ON ASSESSMENTS. (a) The formula established under...

Section 1501.322. Adjustment to Assessments on Federally Qualified Health Maintenance Organizations - Sec. 1501.322. ADJUSTMENT TO ASSESSMENTS ON FEDERALLY QUALIFIED HEALTH MAINTENANCE...

Section 1501.323. Advance Interim Assessments - Sec. 1501.323. ADVANCE INTERIM ASSESSMENTS. (a) The system may make...

Section 1501.324. Limit on Total Assessments - Sec. 1501.324. LIMIT ON TOTAL ASSESSMENTS. The maximum assessment amount...

Section 1501.325. Estimate of Assessments; Evaluation and Protection of System - Sec. 1501.325. ESTIMATE OF ASSESSMENTS; EVALUATION AND PROTECTION OF SYSTEM....

Section 1501.326. Deferment of Assessment - Sec. 1501.326. DEFERMENT OF ASSESSMENT. (a) A reinsured health benefit...

Subchapter H. Marketing of Small Employer Health Benefit Plans

Section 1501.351. Marketing Requirements - Sec. 1501.351. MARKETING REQUIREMENTS. (a) Each small employer health benefit...

Section 1501.352. Health Status and Claims Experience; Prohibited Acts - Sec. 1501.352. HEALTH STATUS AND CLAIMS EXPERIENCE; PROHIBITED ACTS. (a)...

Section 1501.353. Agent Compensation - Sec. 1501.353. AGENT COMPENSATION. (a) A small employer health benefit...

Section 1501.354. Required Disclosures - Sec. 1501.354. REQUIRED DISCLOSURES. (a) In connection with offering a...

Section 1501.355. Rules Concerning Marketing and Availability - Sec. 1501.355. RULES CONCERNING MARKETING AND AVAILABILITY. Rules adopted under...

Section 1501.356. Reporting Requirements - Sec. 1501.356. REPORTING REQUIREMENTS. (a) In this section, "case characteristics"...

Section 1501.357. Violations - Sec. 1501.357. VIOLATIONS. A violation of Section 1501.352 by a...

Section 1501.358. Applicability to Third-Party Administrator - Sec. 1501.358. APPLICABILITY TO THIRD-PARTY ADMINISTRATOR. If a small employer...

Subchapter M. Large Employer Health Benefit Plans

Section 1501.601. Participation Criteria - Sec. 1501.601. PARTICIPATION CRITERIA. (a) In this subchapter, "participation criteria"...

Section 1501.602. Coverage Requirements - Sec. 1501.602. COVERAGE REQUIREMENTS. (a) A large employer health benefit...

Section 1501.603. Exclusion of Eligible Employee or Dependent Prohibited - Sec. 1501.603. EXCLUSION OF ELIGIBLE EMPLOYEE OR DEPENDENT PROHIBITED. A...

Section 1501.604. Declining Coverage - Sec. 1501.604. DECLINING COVERAGE. (a) A large employer health benefit...

Section 1501.605. Minimum Contribution or Participation Requirements - Sec. 1501.605. MINIMUM CONTRIBUTION OR PARTICIPATION REQUIREMENTS. (a) A large...

Section 1501.606. Employee Enrollment; Waiting Period - Sec. 1501.606. EMPLOYEE ENROLLMENT; WAITING PERIOD. (a) The initial enrollment...

Section 1501.607. Coverage for Newborn Children - Sec. 1501.607. COVERAGE FOR NEWBORN CHILDREN. (a) A large employer...

Section 1501.608. Coverage for Adopted Children - Sec. 1501.608. COVERAGE FOR ADOPTED CHILDREN. (a) This section applies...

Section 1501.609. Coverage for Unmarried Children - Sec. 1501.609. COVERAGE FOR UNMARRIED CHILDREN. (a) This section applies...

Section 1501.610. Premium Rates; Adjustments - Sec. 1501.610. PREMIUM RATES; ADJUSTMENTS. (a) A large employer health...

Section 1501.611. Marketing Requirements - Sec. 1501.611. MARKETING REQUIREMENTS. On request, each large employer purchasing...

Section 1501.612. Encouraging Exclusion of Employee Prohibited - Sec. 1501.612. ENCOURAGING EXCLUSION OF EMPLOYEE PROHIBITED. A large employer...

Section 1501.613. Agents - Sec. 1501.613. AGENTS. A large employer health benefit plan issuer...

Section 1501.615. Additional Reporting Requirements - Sec. 1501.615. ADDITIONAL REPORTING REQUIREMENTS. The department may require periodic...

Section 1501.616. Applicability to Third-Party Administrator - Sec. 1501.616. APPLICABILITY TO THIRD-PARTY ADMINISTRATOR. If a large employer...

Chapter 1502 - Health Benefit Plans for Children

Subchapter A. General Provisions

Section 1502.001. Applicability of Chapter - Sec. 1502.001. APPLICABILITY OF CHAPTER. This chapter applies only to...

Section 1502.0011. Exception - Sec. 1502.0011. EXCEPTION. This chapter does not apply to a...

Section 1502.002. Rules - Sec. 1502.002. RULES. (a) The commissioner may adopt rules to...

Subchapter B. Children's Health Benefit Plan

Section 1502.051. Children's Health Benefit Plan - Sec. 1502.051. CHILDREN'S HEALTH BENEFIT PLAN. A health benefit plan...

Section 1502.052. Mandated Benefit Provisions Inapplicable - Sec. 1502.052. MANDATED BENEFIT PROVISIONS INAPPLICABLE. A children's health benefit...

Section 1502.053. Exemption From Certain Taxes - Sec. 1502.053. EXEMPTION FROM CERTAIN TAXES. (a) The issuer of...

Chapter 1503 - Coverage of Certain Students

Section 1503.001. Applicability of Chapter - Sec. 1503.001. APPLICABILITY OF CHAPTER. This chapter applies only to...

Section 1503.002. Exception - Sec. 1503.002. EXCEPTION. This chapter does not apply to: (1)...

Section 1503.003. Coverage of Certain Students - Sec. 1503.003. COVERAGE OF CERTAIN STUDENTS. (a) A health benefit...

Chapter 1504 - Medical and Dental Child Support

Subchapter A. General Provisions

Section 1504.001. Definitions - Sec. 1504.001. DEFINITIONS. In this chapter: (1) "Child" has the...

Section 1504.002. Rules - Sec. 1504.002. RULES. (a) The commissioner shall adopt reasonable rules...

Section 1504.003. Violation of Chapter: Relief Available to Injured Person - Sec. 1504.003. VIOLATION OF CHAPTER: RELIEF AVAILABLE TO INJURED PERSON....

Subchapter B. Duties of Benefit Plan Issuer

Section 1504.051. Enrollment of Certain Children Required - Sec. 1504.051. ENROLLMENT OF CERTAIN CHILDREN REQUIRED. (a) A benefit...

Section 1504.052. Child Residing Outside Service Area; Comparable Health or Dental Coverage Required - Sec. 1504.052. CHILD RESIDING OUTSIDE SERVICE AREA; COMPARABLE HEALTH OR...

Section 1504.053. Cancellation or Nonrenewal of Coverage for Certain Children - Sec. 1504.053. CANCELLATION OR NONRENEWAL OF COVERAGE FOR CERTAIN CHILDREN....

Section 1504.054. Continuation or Conversion of Coverage - Sec. 1504.054. CONTINUATION OR CONVERSION OF COVERAGE. (a) If a...

Section 1504.055. Procedure for Claims - Sec. 1504.055. PROCEDURE FOR CLAIMS. (a) A benefit plan issuer...

Subchapter C. Prohibited Conduct

Section 1504.101. Denial of Enrollment on Certain Grounds Prohibited - Sec. 1504.101. DENIAL OF ENROLLMENT ON CERTAIN GROUNDS PROHIBITED. A...

Section 1504.102. Assignment of Medical or Dental Support Rights: Different Requirements Prohibited - Sec. 1504.102. ASSIGNMENT OF MEDICAL OR DENTAL SUPPORT RIGHTS: DIFFERENT...

Chapter 1505 - Group Health Insurance Plans for Persons 65 Years of Age or Older

Section 1505.001. Definition - Sec. 1505.001. DEFINITION. In this chapter, "health insurer" means an...

Section 1505.002. Plans for Certain Persons 65 Years of Age or Older - Sec. 1505.002. PLANS FOR CERTAIN PERSONS 65 YEARS OF AGE...

Section 1505.003. Application and Other Evidence of Insurance Forms - Sec. 1505.003. APPLICATION AND OTHER EVIDENCE OF INSURANCE FORMS. An...

Section 1505.004. Execution of Policy - Sec. 1505.004. EXECUTION OF POLICY. An authorized person may execute...

Section 1505.005. Use of Unincorporated Entity - Sec. 1505.005. USE OF UNINCORPORATED ENTITY. (a) The participating health...

Section 1505.006. Required Filings; Department Approval - Sec. 1505.006. REQUIRED FILINGS; DEPARTMENT APPROVAL. (a) The participating health...

Section 1505.007. Effect of Commissioner Disapproval - Sec. 1505.007. EFFECT OF COMMISSIONER DISAPPROVAL. If, after notice and...

Section 1505.008. Exemption From Premium Taxes - Sec. 1505.008. EXEMPTION FROM PREMIUM TAXES. Each premium received for...

Section 1505.009. Exemption From Certain Antitrust Requirements - Sec. 1505.009. EXEMPTION FROM CERTAIN ANTITRUST REQUIREMENTS. An association, trust,...

Chapter 1507 - Consumer Choice of Benefits Plans

Subchapter A. Consumer Choice of Benefits Health Insurance Plans

Section 1507.001. Purpose - Sec. 1507.001. PURPOSE. The legislature recognizes the need for individuals,...

Section 1507.002. Definitions - Sec. 1507.002. DEFINITIONS. In this subchapter: (1) "Health carrier" means...

Section 1507.003. State-Mandated Health Benefits - Sec. 1507.003. STATE-MANDATED HEALTH BENEFITS. (a) For purposes of this...

Section 1507.004. Standard Health Benefit Plans Authorized; Minimum Requirement - Sec. 1507.004. STANDARD HEALTH BENEFIT PLANS AUTHORIZED; MINIMUM REQUIREMENT. (a)...

Section 1507.005. Notice to Policyholder - Sec. 1507.005. NOTICE TO POLICYHOLDER. (a) Each written application for...

Section 1507.006. Disclosure Statement - Sec. 1507.006. DISCLOSURE STATEMENT. (a) A health carrier providing a...

Section 1507.007. Additional Policies - Sec. 1507.007. ADDITIONAL POLICIES. A health carrier that offers one...

Section 1507.008. Rates - Sec. 1507.008. RATES. A health carrier shall file for informational...

Section 1507.009. Rules - Sec. 1507.009. RULES. The commissioner shall adopt rules necessary to...

Subchapter B. Consumer Choice of Benefits Health Maintenance Organization Plans

Section 1507.051. Purpose - Sec. 1507.051. PURPOSE. The legislature recognizes the need for individuals...

Section 1507.052. Definitions - Sec. 1507.052. DEFINITIONS. (a) In this subchapter, "standard health benefit...

Section 1507.053. State-Mandated Health Benefits - Sec. 1507.053. STATE-MANDATED HEALTH BENEFITS. (a) For purposes of this...

Section 1507.054. Standard Health Benefit Plans Authorized - Sec. 1507.054. STANDARD HEALTH BENEFIT PLANS AUTHORIZED. A health maintenance...

Section 1507.055. Notice to Enrollees - Sec. 1507.055. NOTICE TO ENROLLEES. (a) Each written application for...

Section 1507.056. Disclosure Statement - Sec. 1507.056. DISCLOSURE STATEMENT. (a) A health maintenance organization providing...

Section 1507.057. Additional Evidences of Coverage - Sec. 1507.057. ADDITIONAL EVIDENCES OF COVERAGE. A health maintenance organization...

Section 1507.058. Rates - Sec. 1507.058. RATES. A health maintenance organization shall file for...

Section 1507.059. Rules - Sec. 1507.059. RULES. The commissioner shall adopt rules necessary to...

Chapter 1508 - Healthy Texas Program

Subchapter A. General Provisions

Section 1508.001. Purpose - Sec. 1508.001. PURPOSE. (a) The purposes of the Healthy Texas...

Section 1508.002. Definitions - Sec. 1508.002. DEFINITIONS. In this chapter: (1) "Dependent" has the...

Section 1508.003. Rules - Sec. 1508.003. RULES. The commissioner may adopt rules as necessary...

Subchapter B. Employer Eligibility; Contributions

Section 1508.051. Employer Eligibility to Participate - Sec. 1508.051. EMPLOYER ELIGIBILITY TO PARTICIPATE. (a) A small employer...

Section 1508.052. Commissioner Adjustments Authorized - Sec. 1508.052. COMMISSIONER ADJUSTMENTS AUTHORIZED. (a) The commissioner by rule...

Section 1508.053. Minimum Employer Participation Requirements - Sec. 1508.053. MINIMUM EMPLOYER PARTICIPATION REQUIREMENTS. A small employer that...

Section 1508.054. Employer Contribution Requirements - Sec. 1508.054. EMPLOYER CONTRIBUTION REQUIREMENTS. (a) A small employer that...

Subchapter C. Program Participation; Required Coverage and Benefits

Section 1508.101. Participating Plan Issuers - Sec. 1508.101. PARTICIPATING PLAN ISSUERS. (a) Subject to Subsection (b),...

Section 1508.102. Preexisting Condition Provision Required - Sec. 1508.102. PREEXISTING CONDITION PROVISION REQUIRED. A health benefit plan...

Section 1508.103. Exception From Mandated Benefit Requirements - Sec. 1508.103. EXCEPTION FROM MANDATED BENEFIT REQUIREMENTS. Except as expressly...

Section 1508.104. Certain Coverage Prohibited or Required - Sec. 1508.104. CERTAIN COVERAGE PROHIBITED OR REQUIRED. (a) A qualifying...

Subchapter D. Program Administration

Section 1508.151. Employer Certification - Sec. 1508.151. EMPLOYER CERTIFICATION. (a) At the time of initial...

Section 1508.152. Application Process - Sec. 1508.152. APPLICATION PROCESS. (a) Subject to Subsection (b), a...

Section 1508.153. Employee Enrollment; Waiting Period - Sec. 1508.153. EMPLOYEE ENROLLMENT; WAITING PERIOD. (a) A qualifying health...

Section 1508.154. Reports - Sec. 1508.154. REPORTS. A health benefit plan issuer that participates...

Subchapter E. Rating of Qualified Health Benefit Plans

Section 1508.201. Rating; Premium Practices in General - Sec. 1508.201. RATING; PREMIUM PRACTICES IN GENERAL. (a) A health...

Section 1508.202. Premium Rate Development and Calculation - Sec. 1508.202. PREMIUM RATE DEVELOPMENT AND CALCULATION. (a) Rating factors...

Section 1508.203. Filing; Approval - Sec. 1508.203. FILING; APPROVAL. (a) A health benefit plan issuer...

Subchapter F. Healthy Texas Small Employer Premium Stabilization Fund

Section 1508.251. Establishment of Fund - Sec. 1508.251. ESTABLISHMENT OF FUND. (a) To the extent that...

Section 1508.252. Operation of Fund; Claim Eligibility - Sec. 1508.252. OPERATION OF FUND; CLAIM ELIGIBILITY. (a) A health...

Section 1508.253. Reimbursement Request Submission - Sec. 1508.253. REIMBURSEMENT REQUEST SUBMISSION. (a) A health benefit plan...

Section 1508.254. Fund Availability - Sec. 1508.254. FUND AVAILABILITY. (a) The commissioner shall compute the...

Section 1508.255. Program Reporting - Sec. 1508.255. PROGRAM REPORTING. (a) Each health benefit plan issuer...

Section 1508.256. Claims Experience Data - Sec. 1508.256. CLAIMS EXPERIENCE DATA. (a) Based on available data...

Section 1508.257. Total Eligible Enrollment Determination - Sec. 1508.257. TOTAL ELIGIBLE ENROLLMENT DETERMINATION. (a) The commissioner shall...

Section 1508.258. Evaluation and Protection of Fund; Employer Enrollment Suspension - Sec. 1508.258. EVALUATION AND PROTECTION OF FUND; EMPLOYER ENROLLMENT SUSPENSION....

Section 1508.259. Employer Enrollment Reactivation - Sec. 1508.259. EMPLOYER ENROLLMENT REACTIVATION. If, at any point during...

Section 1508.260. Fund Administrator - Sec. 1508.260. FUND ADMINISTRATOR. (a) The commissioner may obtain the...

Section 1508.261. Stop-Loss Insurance; Reinsurance - Sec. 1508.261. STOP-LOSS INSURANCE; REINSURANCE. (a) The administrator of the...

Section 1508.262. Public Education and Outreach - Sec. 1508.262. PUBLIC EDUCATION AND OUTREACH. (a) The commissioner may...

Chapter 1509 - Short-Term Limited-Duration Insurance

Section 1509.001. Definition - Sec. 1509.001. DEFINITION. In this chapter, "short-term limited-duration insurance" has...

Section 1509.002. Policy Disclosure Form - Sec. 1509.002. POLICY DISCLOSURE FORM. (a) The commissioner by rule...

Chapter 1510 - Temporary Health Insurance Risk Pool

Section 1510.001. Definition - Sec. 1510.001. DEFINITION. In this chapter, "pool" means a temporary...

Section 1510.002. Establishment of Temporary Health Insurance Risk Pool - Sec. 1510.002. ESTABLISHMENT OF TEMPORARY HEALTH INSURANCE RISK POOL. To...

Section 1510.003. Purpose of Pool - Sec. 1510.003. PURPOSE OF POOL. (a) The exclusive purpose of...

Section 1510.004. Provision of Guaranteed Issue Health Coverage - Sec. 1510.004. PROVISION OF GUARANTEED ISSUE HEALTH COVERAGE. (a) Subject...

Section 1510.005. Contracts and Agreements - Sec. 1510.005. CONTRACTS AND AGREEMENTS. (a) The commissioner may enter...

Section 1510.006. Funding - Sec. 1510.006. FUNDING. (a) The commissioner may use funds appropriated...

Section 1510.007. Public Education and Outreach - Sec. 1510.007. PUBLIC EDUCATION AND OUTREACH. (a) The commissioner may...

Section 1510.008. Waiver - Sec. 1510.008. WAIVER. (a) The commissioner may apply to the...

Section 1510.009. Additional Authority - Sec. 1510.009. ADDITIONAL AUTHORITY. In addition to the powers granted...

Section 1510.010. Rules - Sec. 1510.010. RULES. The commissioner may adopt rules necessary to...

Section 1510.011. Exemption From State Taxes and Fees - Sec. 1510.011. EXEMPTION FROM STATE TAXES AND FEES. Notwithstanding any...

Section 1510.012. Annual Report of Pool Activities - Sec. 1510.012. ANNUAL REPORT OF POOL ACTIVITIES. (a) Beginning June...

Section 1510.013. Expiration of Chapter - Sec. 1510.013. EXPIRATION OF CHAPTER. This chapter expires August 31,...

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Texas Statutes Title 8 - Health Insurance and Other Health Coverages Subtitle G - Health Coverage Availability

Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Subtitle G - Health Coverage Availability