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Health Care Collaboratives - Company Licensing and Registration

Health Care Collaboratives - Company Licensing and Registration
TDI Form Number Description File FormatLanguage
FIN321
Company Licensing Fee Transmittal Form
Company Licensing and Registration Fee Transmittal Form to be submitted with filings.
PDF English
FIN491
Health Care Collaborative (HCC) Acquisition Form
Department notification of an acquisition of a Health Care Collaborative
PDF English
FIN492
Application for Certificate of Authority to do the business of a Health Care Collaborative in the state of Texas
Health Care Collaborative application for initial or renewal of certificate of authority
PDF English
FIN493
Health Care Collaboratives Officers and Directors Page
Health Care Collaborative Officer and Director Information
PDF English
FIN494
Health Care Collaborative Payor Information Form
Form used to provide HCC market power information
PDF English
FIN495
Request to Convert to Renewal of Certificate of Authority (to do the business of a Health Care Collaborative)
Used to request that the Department convert an examination to an early renewal application
PDF English
FIN496
Transmittal Checklist for Health Care Collaborative (HCC) Filings
Health Care Collaborative Filing Transmittal Checklist
PDF English

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