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You are here: Home . bulletins . 2005 . b-0074-05
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COMMISSIONER'S BULLETIN # B-0074-05

December 21, 2005


To: WORKERS' COMPENSATION SYSTEM PARTICIPANTS


Re: Required Insurance Carrier Certification Under 28 TAC §10.20(2)

The purpose of this bulletin is to provide guidance and clarification with regards to the department´s rule at 28 TAC §10.20(2) relating to workers´ compensation health care network certification requirements.

The rule as adopted states that:

"A person, including an insurance carrier, who provides or arranges to provide workers´ compensation health care network services to injured employees within a service area by contracting with more than one person, must be certified as a workers´ compensation health care network under Insurance Code Chapter 1305 and this chapter."

As providing or arranging to provide services is essentially the primary activity of a workers´ compensation health care network as defined in Chapter 1305 and the rule, the phrase: "[a] person, including an insurance carrier, who provides or arranges to provide workers´ compensation health care network services to injured employees within a service area" is intended to refer to persons, including insurance carriers, who establish their own networks under Insurance Code Chapter 1305. As a whole §10.20 requires a person, including an insurance carrier, who establishes its own network to be certified.

It is the Department´s view that §10.20(2) does not require an insurance carrier that contracts with more than one certified workers´ compensation health care network in a service area to itself be certified as a network, provided that it does not establish or create its own network.

Questions regarding this bulletin may be submitted to the following TDI electronic mailbox: WCNet@tdi.state.tx.us or to Margaret Lazaretti, Deputy Commissioner, HMO Division, Texas Department of Insurance, at 512-322-4266.

Mike Geeslin Commissioner of Insurance



Last updated: 09/07/2014

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