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SUBCHAPTER R. Withdrawal Plan Requirements and Procedures

28 TAC §§7.1801 - 7.1808

The Texas Department of Insurance proposes to amend §§7.1801 - 7.1802 -7.18037.1808 concerning withdrawal plan requirements and procedures. The proposed amendments implement H.B. 3020, 76 th Legislature, 1999 which amended Insurance Code article 20A.26 to require health maintenance organizations (HMOs) to comply with the requirements of Insurance Code article 21.49-2C which requires authorized insurers to file withdrawal plans with the Department when an insurer intends to totally withdraw from a line of insurance or reduce total annual premium volume in a line of insurance by 75 percent. The purpose of Insurance Code article 21.49-2C is to help stabilize the market for insurance in Texas. The proposed amendments are necessary to provide orderly and uniform procedures for an HMO to file a withdrawal plan that provides the Commissioner with the information necessary to determine that the plan is constructed to protect the interests of the people of the State and to monitor the effect of the withdrawal on the market for health care plans. In addition the department proposes amendments to the subchapter to conform the terminology of the subchapter to that used in various applicable provisions of the Insurance Code, including Chapter 26, the Health Insurance Portability and Availability Act. Also the proposed amendments will add disclosures to a withdrawal plan requiring insurers to identify the provisions of the Insurance Code and the Texas Administrative Code which require notice to a policyholder when a policy is not renewed or cancelled, to identify the policy forms to be withdrawn, to address the needs of policyholders or certificateholders with special circumstances and to identify those insurance products, if any, a withdrawing insurer will continue to offer. In summary, the proposed amendments add definitions, delete references to the former State Board of Insurance, revise the enumeration of lines of insurance, add disclosures to be included in a withdrawal plan, clarify the relationship between Insurance Code article 21.49-2C and other statutes regulating the nonrenewal or cancellation of insurance coverage, describe the information an HMO must include in a withdrawal plan and redefine what constitutes a "line of insurance" for the purpose of HMO withdrawal plans.

Ms. Betty Patterson, CPA, CFE, Senior Associate Commissioner-Financial Program, has determined that, for the first five years the amended sections are in effect, there will be no fiscal implications for state or local government as a result of these amendments, and there will be no effect on local employment or the local economy.

Ms. Patterson has also determined that, for each year of the first five years the amended sections are in effect, the public benefit will be that the sections will be consistent with recent changes in state law, provide for the efficient regulation of insurance and HMO coverage, provide for timely notice of significant withdrawals initiated by insurers and HMOs, and provide for greater protection of the interests of persons in this state affected by HMOs withdrawing from the state. The economic cost to any HMO complying with the proposed sections, is the result of the legislative enactment of H.B. 3020 and not the result of the adoption, enforcement or administration of the proposed amendments. The cost to comply with the proposed sections will vary from company to company. The total cost to HMOs and insurers is not directly dependent on the size of the company, but is rather primarily dependant on the number of enrollees or policyholders affected by the proposed withdrawal. Therefore, it is the department's position that the adoption of these proposed sections will have no adverse economic effect on small or micro businesses. Regardless of the fiscal effect, the requirements of this rule are mandated by the underlying state statutes, and considering the statute's purposes, it is neither legal nor feasible to waive or modify the requirements of these sections for small and micro businesses, as doing so would result in a disparate effect on enrollees, policyholders, and other persons affected by these rules.

To be considered, written comments on the proposal must be submitted no later than 5:00 p.m. on November 26, 2001 to Lynda H. Nesenholtz, General Counsel and Chief Clerk, Mail Code 113-2A, Texas Department of Insurance, P. O. Box 149104, Austin, Texas 78714-9104. An additional copy of the comments should be submitted simultaneously to Betty Patterson, Senior Associate Commissioner - Financial Program, Mail Code 305-2A, P. O. Box 149104, Austin, Texas 78714-9104. Any requests for a public hearing should be submitted separately to the Office of Chief Clerk.

The amendments are proposed under the Insurance Code articles 3.70-3C, 20A.22, 20A.26, 21.49-2C, and §36.001. Article 3.70-3C addresses the regulation of preferred provider plans. Article 20A.26 makes any HMO authorized under Chapter 20A subject to, inter alia, article 21.49-2C. Article 21.49-2C requires that insurers file a withdrawal plan if the insurer proposes to withdraw from writing a line of insurance in this state or proposes to reduce its total annual premium volume in a line of insurance by 75 percent or more. Article 21.49-2C also authorizes the Commissioner to adopt rules necessary to enforce the provisions of the article. Article 20A.22 authorizes the Commissioner to promulgate reasonable rules as necessary and proper to carry out the provisions of the Texas Health Maintenance Organization Act (Insurance Code Chapter 20A). Section 36.001 authorizes the Commissioner to adopt rules for the conduct and execution of the powers and duties of the Department only as authorized by statute.

The following articles of the Insurance Code are affected by this proposal: Articles 3.70-3C, 20A.22, 20A.26, 21.49-1, and 21.49-2C.

§7.1801. Purpose. The purpose of this subchapter is to provide orderly and uniform procedures, as required by law and dictated by sound public policy, for any authorized insurer or HMO filing a plan of withdrawal with the Commissioner of Insurance pursuant to the Insurance Code, Article 21.49-2C. Nothing in this subchapter authorizes or allows an insurer or HMO to withdraw from any coverage if such withdrawal would violate any federal or state law or any provisions contained in a contract or evidence of coverage or a policy or certificate of insurance itself.

§7.1802. Definitions. The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise.

(1) Annual Statement - Annual statement most recently filed by the insurer or HMO with the Texas Department of Insurance.

(2) Association coverage - Coverage under a health benefit plan issued to an association or bona fide association as those terms are defined in §21.2702 of this title (relating to Association Plans) [ Board - State Board of Insurance.].

(3) Commissioner - Commissioner of Insurance.

(4) Department - Texas Department of Insurance.

(5) Individual coverage - Coverage issued by an HMO that provides an individual health care plan as defined in Insurance Code Article 20A.09(l).

(6) Large employer coverage - Coverage under a health benefit plan issued to a large employer as those terms are defined in §26.4 of this title (relating to Definitions).

(7) [ (5)] Line of insurance - Each line of business as specified in §7.1803 of this title (relating to What Constitutes a Line of Insurance).

(8) HMO - A health maintenance organization licensed under Insurance Code Chapter 20A.

(9) Medicaid - The Medicaid program under Title XIX of the Social Security Act of 1965.

(10) Medicare - Has the same meaning as specified in §3.3303 of this title (relating to Definitions)

(11) Medicare+Choice plan - Has the same meaning as specified in §3.3303 of this title.

(12) Small employer coverage - Coverage under a health benefit plan issued to a small employer as those terms are defined in §26.4 of this title.

(13) Enrollees of special circumstances - As provided for in Insurance Code articles 3.70-3C, §4 and 20A.18A(c).

(14) CHIP - The Texas Children's Health Insurance Program under Texas Health and Safety Code Chapter 62.

(15) [ (6)]Withdrawal -

(A) Substantial withdrawal occurs when an insurer or HMO on its own initiative reduces the company's total annual premium volume for a line of insurance, as defined in §7.1803 of this title [ (relating to What Constitutes a Line of Insurance),] by 75% or more, except when the insurer or HMO meets any exception specified in §7.1804(b) of this title (relating to When a Plan Is Required).

(B) Total withdrawal occurs when an insurer or HMO on its own initiative no longer engages in the writing of a line of insurance, as defined in §7.1803 of this title [ (relating to What Constitutes a Line of Insurance),] except when the insurer or HMO meets any exception specified in §7.1804(b) of this title [ (relating to When a Plan Is Required)].

§7.1803. What Constitutes a Line of Insurance.

(a) For purposes of this subchapter, a line of insurance is defined as each line of business as specified in paragraphs (1)(A)-(P) [ and], (2)(A)- (PP) [ (QQ)] , and (3)(A)-(K) of this subsection, and including any line written in by the insurer or HMO on the annual statement pages specified in this section, for which financial data was reported by the individual withdrawing insurer or HMO filing any of the annual statement pages specified in this section, or any duly promulgated equivalent pages, of the annual statement forms specified in this section, or any duly promulgated equivalent forms, and including any line of business that is duly promulgated to be added to the annual statement pages specified in this section or to any duly promulgated equivalent page.

(1) For an insurer that is required to file the Life and Accident and Health Annual Statement [ Form 1 or Form 1A], Texas State Page 21 [ 19], Reporting Direct Business in the State of Texas During the Year, or the Health Statement, Exhibit of Premiums , Enrollment and Utilization, reporting direct business in the State of Texas (page 34 of the Health Statement), in addition to any line of insurance written in by the insurer, each of the following is a line of insurance:

(A) ordinary life;

(B)group and individual credit life;

(C)group life;

(D) industrial life;

(E) ordinary annuity;

(F) group annuity;

(G) ordinary annuity and other fund deposits;

(H) group annuity and other fund deposits;

(I) small employer coverage [ group accident and health];

(J) group and individual credit accident and health;

(K) individual accident and health coverage including collectively renewable accident and health , noncancellable accident and health, guaranteed renewable accident and health, non-renewable for stated reasons only accident and health, and other accident only;

(L) group accident and health other than association, large employer or small employer coverage [ noncancellable accident and health];

(M) Medicare+Choice plan [ guaranteed renewable accident and health];

(N) CHIP coverage [ nonrenewable for stated reasons only accident and health];

(O) association coverage [ other accident only accident and health]; or

(P) large employer coverage [ all other accident and health].

(2) For an insurer that is required to file the Property [ Fire] and Casualty Annual Statement [ Form 2, page 14 Texas Supplement], Exhibit of Premiums and Losses , page 15, (coded "Statutory Page 14") [ (coded "14 TS")], in addition to any line written in by the insurer, each of the following is a line of insurance:

(A) fire;

(B) allied lines;

(C) earthquake;

(D) flood;

(E) farmowners multiple peril;

(F) homeowners multiple peril;

(G) Texas commercial multiple peril (non-liability portion);

(H) growing crops (all other);

(I) multiple peril crop;

(J) inland marine;

(K) ocean marine;

(L) small employer coverage [ group accident and health];

(M) group and individual credit accident and health;

(N) [ other credit accident and health;]

[ (O)] individual accident and health coverage including collectively renewable accident and health, noncancellable accident and health, guaranteed renewable accident and health, non-renewable for stated reasons only accident and health, and other accident only;

(O) [ (P)] group accident and health other than association, large employer or small employer coverage [ noncancellable accident and health] ;

(P) [ (Q)] Medicare+Choice plans [ guaranteed renewable accident and health];

(Q) [ (R)] CHIP coverage [ nonrenewable for stated reasons only] ;

(R) [ (S)] association coverage[ other accidents only];

(S) [ (T)] large employer coverage [ all other accident and health ];

(T) [ (U)] workers compensation;

(U) [ (V)] Texas commercial multiple peril (liability portion);

(V) [ (W)] financial guaranty;

(W) [ (X)] medical malpractice liability (physicians - including surgeons and osteopaths);

(X) [ (Y)] medical malpractice liability (all other health care professionals);

(Y) [ (Z)] medical malpractice liability - hospitals;

(Z) [ (AA)] medical malpractice liability (all other health care facilities);

(AA) [ (BB)] product liability;

(BB) [ (CC)] other general liability;

(CC) [ (DD)] fidelity;

(DD) [ (EE)] surety;

(EE) [ (FF)] glass;

(FF) [ (GG)] burglary and theft;

(GG) [ (HH)] boiler and machinery;

(HH) [ (II)] credit guaranty;

(II) [( JJ)] mortgage guaranty;

(JJ) [ (KK)] aircraft (all perils);

(KK) [ (LL)] private passenger auto no-fault personal injury protection;

(LL) [ (MM)] other private passenger auto liability;

(MM) [ (NN)] commercial auto no-fault personal injury protection;

(NN) [ (OO)] other commercial auto liability;

(OO) [ (PP)] private passenger auto physical damage; or

(PP) [ (QQ)] commercial auto physical damage.

(3) For an HMO that is required to file the Health Statement, Exhibit of Premiums, Enrollment and Utilization, reporting direct business in the State of Texas (page 34 of the Health Statement), in addition to any line of insurance written in by the HMO, each of the following is a line of insurance for the purposes of this subchapter:

(A) small employer coverage;

(B) large employer coverage;

(C) health care services for Medicaid delivered under a contract with the Texas Health and Human Services Commission;

(D) health care services for Medicare or a Medicare+Choice plan delivered under a contract with the federal Centers for Medicare and Medicaid Service;

(E) CHIP coverage;

(F) individual coverage;

(G) association coverage;

(H)limited service group coverage;

(I) limited service individual coverage;

(J) single service group coverage; and

(K) single service individual coverage.

(b) Nothing in this section authorizes or allows an insurer or HMO to cancel or non-renew any coverage that would violate any law or provisions contained in a contract or evidence of coverage or a [ the] policy or certificate of insurance itself.

§7.1804. When a Plan Is Required.

(a) Any authorized insurer or HMO must file with the Commissioner of insurance a plan of orderly withdrawal before the insurer or HMO undertakes total or substantial withdrawal from a line of insurance.

(1) The insurer or HMO undertakes total withdrawal from a line of insurance when it takes any action on its own initiative that will result in the insurer's or HMO's ceasing to write a line of insurance, as defined in §7.1803 of this title (relating to What Constitutes a Line of Insurance). An insurer or HMO will not be held to have acted on its own initiative in effecting a total withdrawal from a line of insurance when it acts pursuant to a Commissioner [ or board] disciplinary or administrative directive or order, or when the insurer or HMO acts pursuant to a directive of a supervisor, conservator, or receiver. If any out-of-state directive or order is not provided to the Commissioner within 30 days of the issuance of any such directive or order, the insurer or HMO will be held to have acted on its own initiative.

(2) The insurer or HMO undertakes substantial withdrawal from a line of insurance when it takes any action on its own initiative that will result in reducing the insurer's or HMO's total annual premium volume in Texas for the current calendar year for a line of insurance, as defined in §7.1803 of this title, by 75% or more of the total annual premium volume in Texas for the immediately preceding calendar year for such line of insurance. An insurer or HMO will not be held to have acted on its own initiative in effecting a substantial withdrawal from a line of insurance when it acts pursuant to a Commissioner [ or board] disciplinary or administrative directive or order, or when the insurer or HMO acts pursuant to a directive of a supervisor, conservator, or receiver. If any out-of-state directive or order is not provided to the Commissioner within 30 days of the issuance of any such directive or order, the insurer or HMO will be held to have acted on its own initiative.

(b) Exceptions. An insurer or HMO is not required to file a plan of orderly withdrawal, but shall instead notify the Department, when:

(1) the insurer is transferring business from the insurer to a company within the same insurance holding company system, as defined in the Insurance Holding Company System Regulatory Act, the Insurance Code, Article 21.49-1, §2, and admitted to do business in this state; [ or]

(2) the line of business is written by a stipulated premium company unless such line is written pursuant to the Texas Insurance Code, Article 22.23(b) or Article 22.23A;

(3) the HMO is transferring business from the HMO to an affiliated HMO; or

(4) the line of insurance from which the HMO is withdrawing is Medicare, a Medicare+Choice plan or a Medicaid contract as provided in §7.1803(a) of this title.

(c) If an insurer or HMO comes within an exception provided in subsection (b) of this section, such notification must be sent to the Department simultaneously with any notification required to be provided to any other state or federal agency. The notification will be accepted for information only and shall affirm that any appropriate state or federal agency has been notified of the company's intent to withdraw, and shall include the effective date of non-renewal, the names of the Texas counties affected, and the number of insureds or enrollees affected.

(d) This subchapter does not modify or supercede any requirement under the Insurance Code or any other state or federal law to notify policyholders or enrollees that an insurer or HMO will not renew any coverage; however, before any such notice is given a withdrawal plan must be filed with the Department and approved by the Department under §7.1806 of this title (relating to Plan Submission and Approval Procedures) when a plan is required by this section.

§7.1805. Contents of Withdrawal Plan.

(a) Except for withdrawing HMOs, which are addressed under subsection (b) of this section, a [ The] withdrawing insurer shall file a plan of orderly withdrawal with the Commissioner [ of Insurance] that is constructed to protect the interests of the people of this state. The plan must be signed by at least one officer of the insurer and, for each line of insurance being withdrawn or having total annual premium volume reduced by 75% or more, must contain the following:

(1) identification, in accordance with the line of insurance designations in §7.1803 of this title (relating to What Constitutes a Line of Insurance), of the line or lines of insurance being totally withdrawn or affected by having total annual premium volume reduced by 75% or more;

(2) identification of the policy forms by number and type affected by the withdrawal;

(3) [ (2)] the dates [ date] the insurer intends to begin and complete its withdrawal;

(4) [ (3)] an explanation of the reasons for the withdrawal;

(5) [ (4)] provisions for notifying all of the affected Texas policyholders and certificateholders of the dates of the beginning and completion of the total or substantial withdrawal and how the withdrawal will affect them, including, but not limited to:

(A) a copy of the notice and an explanation of the manner in which the notice will be provided to policyholders and certificateholders; and

(B) either affirmation that such notice will be provided within 30 days of the approval of the withdrawal plan or a request to provide the notice at some other specified date or time, and such request must be approved by the Commissioner;

(C) identification of any provision of the Insurance Code or Texas Administrative Code under which notice is mandated.

(6) [ (5)] provisions for meeting all of the insurer's contractual obligations, including, but not limited to:

(A) notification of all affected agents of the insurer of the date the insurer intends to begin and complete the withdrawal;

(B) for fire and casualty insurers, a statement affirming the insurer's compliance with the provisions of the Insurance Code, Article 21.11-1, relating to cancellation of agency contracts;

(C) for insurers writing liability coverage as specified in the Insurance Code, Article 21.49-2A, a statement affirming the insurer's compliance with the provisions of Article 21.49-2A, relating to cancellation and nonrenewal of certain liability insurance coverage; and

(D) for insurers writing property and casualty coverage as specified in the Insurance Code, Article 21.49-2B, a statement affirming the insurer's compliance with the provisions of Article 21.49-2B, relating to cancellation and nonrenewal of certain property and casualty policies;

(7) [ (6)] provisions for providing service to the insurer's Texas policyholders and claimants;

(8) [ (7)] information on Texas business, including:

(A) for insurers filing total withdrawal plans, the total annual premium volume and the number of policies and certificates and covered persons in Texas for each line to be withdrawn;

(B) for insurers filing substantial withdrawal plans, the total annual premium volume and number of policies and certificates and covered persons in Texas for each line in which the total annual premium volume in Texas is being reduced by 75% or more both before substantial withdrawal is effected and after substantial withdrawal is completed;

(C) estimate of what percentage of the Texas market the withdrawal constitutes;

(D) any information necessary to assist the Commissioner in determining whether a market availability problem is created by the total or substantial withdrawal, the extent of the problem, and what market assistance may be needed to alleviate the problem, including, but not limited to, the following:

(i) type of location and geographic area subject to the withdrawal if not statewide (identify type of area such as suburban, urban, rural, or list specific rating territories) and zip codes if entire state not included in withdrawal; and

(ii) if applicable, types of risks no longer being covered (for example, if no longer writing private passenger auto insurance coverage for single-car families or for persons without supporting business; or if no longer providing homeowner's insurance coverage for low-value homes, or in areas with high loss-ratios, or in areas with historically high exposure to natural disasters). The information listed in this clause is provided for purposes of example only and is not intended to be a comprehensive or exhaustive list.

(E) if an insurer is unable to provide the exact number of policies and certificates and covered persons, the insurer shall provide estimates and explain how the estimates were determined;

(9) [ (8)] provisions for identifying policyholders or certificateholders of special circumstances;

(10)identification of any third party contracts which may provide for the continuity of care to enrollees of special circumstances;

(11) [(8)] number of and estimated amount of all losses outstanding in Texas, including claims incurred but not reported;

(12) [ (9)] a plan to handle the losses specified in paragraph (11) [ (8)] of this subsection, including, but not limited to:

(A) identification of what assets will be available for paying outstanding incurred but not reported claims, claims in the course of settlement, and associated loss adjustment expenses;

(B) identification of who specifically will administer the run-off of the business; and

(C) an actuarial opinion certifying that adequate reserves are available to pay outstanding claims.

(13) [ (10)] if Texas policyholders or certificateholders are to be reinsured, the filing of a reinsurance agreement pursuant to all statutory and regulatory requirements and, when applicable, the filing of an assumption certificate;

(14) [ (11)] provisions for meeting any applicable statutory obligations, including, but not limited to:

(A) payment of any guaranty fund assessments;

(B) participation in any assigned risk plan, pool, fund, facility, or joint underwriting arrangement; and

(C) payment of any taxes.

[ (12) if the insurer has any responsibility for small premium workers' compensation policies, provision of information on number of such policies assigned to the insurer by the department and number of such policies actually written; and]

(15) a list of any other products the insurer will continue to offer in Texas; and

(16) [ (13)] for insurers filing total withdrawal plans, affirmation that no new business will be solicited by the insurer in this state during or following the withdrawal period unless the insurer first complies with §7.1808 of this title (relating to Requirements To Resume Writing Insurance).

(b) A withdrawing HMO shall file a plan of orderly withdrawal with the Commissioner that is constructed to protect the interests of the people of this state. The plan must be signed by at least one officer of the HMO and, for each line of insurance being withdrawn or having total annual premium reduced by 75% or more, must contain the following:

(1) identification, in accordance with the line of insurance designations in §7.1803 of this title, of the line or lines of insurance being totally withdrawn or affected by having total annual premium volume reduced by 75% or more;

(2) identification by form number of the evidences of coverage affected by withdrawal;

(3) the dates the HMO intends to begin and complete its withdrawal;

(4) an explanation of the reasons for the withdrawal;

(5) provisions for notifying all of the affected Texas enrollees and contractholders of the dates of the beginning and completion of the total or substantial withdrawal and how the withdrawal will affect them, including, but not limited to:

(A) a copy of the notice and an explanation of the manner in which the notice will be provided to enrollees or contractholders;

(B) either an affirmation that such notice will be provided within 30 days of the approval of the withdrawal plan or a request to provide the notice at some other specified date or time, and such request must be approved by the Commissioner; and

(C)identification of any provisions of the Insurance Code or the Texas Administrative Code under which notice is mandated;

(6) provisions for meeting all of the HMO's contractual obligations, including, but not limited to, notification to all affected agents of the HMO of the dates the HMO intends to begin and complete the withdrawal;

(7) provisions for providing service to the HMO's Texas enrollees and providers;

(8)information on Texas business, including:

(A) for HMOs filing total withdrawal plans, the total annual premium volume and the number of affected contractholders and enrollees in Texas for each line to be withdrawn;

(B) for HMOs filing substantial withdrawal plans, the total annual premium volume and the number of affected enrollees and contractholders in Texas for each line of insurance in which the total annual premium volume in Texas is being reduced by 75% or more, both before the substantial withdrawal is effected and after the substantial withdrawal is completed;

(C) an estimate of what percentage of the Texas HMO market the withdrawal constitutes, as measured by enrollee;

(D) an estimate of what percentage of the HMO's service area or service areas the withdrawal constitutes and the counties affected by the withdrawal; and

(E) any information necessary to assist the Commissioner in determining whether a market availability problem is created by the total or substantial withdrawal, the extent of the problem, and what market assistance may be needed to alleviate the problem;

(9) provisions for identifying enrollees of special circumstance;

(10) identification of any third party contracts which may provide for the continuity of care to enrollees of special circumstance;

(11) number of and estimated amount of all losses outstanding in Texas, including claims incurred but not reported;

(12) a plan to handle the losses specified in paragraph (11) of this subsection, including, but not limited to:

(A) identification of what assets will be available for paying outstanding incurred but not reported claims, claims in the course of settlement, and associated loss adjustment expenses;

(B) identification of who specifically will administer the run-off of the business, if any; and

(C)an actuarial opinion certifying that adequate reserves are available to pay outstanding claims;

(13) provisions for meeting any applicable statutory obligations;

(14) for HMOs filing total withdrawal plans, an affirmation that no new business will be solicited by the HMO in this state during or following the withdrawal period unless the HMO first complies with §7.1808 of this title;

(15) a list of any other products the HMO will continue to sell in Texas in each service area; and

(16) for HMOs filing total withdrawal plans, quarterly financial projections from the beginning of the withdrawal to the completion of the withdrawal. The quarterly financial projections shall include:

(A) a balance sheet;

(B) an income statement;

(C) a statement of cash flows; and

(D) members.

(c) [(B)] The filing of a single consolidated withdrawal plan for all withdrawing insurance companies or HMOs in the same holding company system, as defined in the Insurance Holding Company System Regulatory Act, the Texas Insurance Code Article 21.49-1, §2, does not meet the requirements of this subchapter. A separate withdrawal plan must be filed for each insurance company or HMO intending to totally or substantially withdraw from a line or lines of insurance.

§7.1806. Plan Submission and Approval Procedures.

(a) Any insurer or HMO filing a plan of orderly withdrawal should submit the plan to the Texas Department of Insurance, Company Licensing and Registration [ License Section], Mail Code 305 - 2C [ 305-5B], P.O. Box 149104, Austin, Texas 78714-9104 or 333 Guadalupe Street, Austin, TX 78701.

(b) The withdrawal plan shall be deemed approved if the Commissioner has not held a hearing within 30 days after the complete plan is filed or has not been denied approval within 30 days after the hearing.

(c) No plan shall be considered "filed" until such date as the withdrawing insurer or HMO has provided to the Commissioner all information and material necessary to constitute a completed plan of orderly withdrawal, as required under this subchapter.

(d) Within 10 business days of the Commissioner's receipt of the withdrawal plan, the insurer or HMO will be notified by letter either that the plan is sufficient to constitute a completed plan of orderly withdrawal that meets all of the requirements of this subchapter or that the plan is insufficient to constitute a completed plan of orderly withdrawal that meets all of the requirements of this subchapter and what information and material must be provided in order for the insurer or HMO to have filed a completed plan of orderly withdrawal, as required under this subchapter.

§7.1807. Filing of Annual Financial Statement and Other Required Data and Information. Any insurer or HMO filing a total withdrawal plan or a substantial withdrawal plan shall continue to file all annual financial statement data, other required statistical and data filings, other reporting, and any other department-requested information applicable to any withdrawn line until all policyholder obligations for such line in this state are fulfilled. This section does not exempt an insurer or HMO from any filings or information requests required by the department.

§7.1808. Requirements To Resume Writing Insurance. Any insurer or HMO totally or substantially withdrawing from writing any line of insurance in this state and required to file a plan of orderly withdrawal pursuant to the Insurance Code, Article 21.49-2C, may not resume writing the withdrawn line in this state without complying with all applicable statutory and regulatory provisions governing authorization to write such line of insurance in this state and receiving the written approval of the Commissioner to resume such writing



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