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You are here: Home . rules . 2005 . 0111a-059

SUBCHAPTER D. Health Group Cooperatives – 28 TAC §26.412

1. INTRODUCTION. The Commissioner of Insurance adopts the repeal of §26.412, concerning the refusal of a health carrier to renew employer health benefit plans delivered or issued to a health group cooperative. The repeal of this section is adopted without changes to the proposal published in the November 18, 2005 issue of the Texas Register (30 TexReg 7690).

2. REASONED JUSTIFICATION. Section 26.412 regulated a health carrier's election to refuse to renew employer health benefit plans delivered or issued to a health group cooperative. Repeal of §26.412 is necessary because the enactment of SB 805, 79th Legislature, Regular Session, obviates the need for the section. Under SB 805, health carriers issuing employer health benefit plans to health group cooperatives are to treat such cooperatives as either large employers or small employers pursuant to the refusal-to-renew provisions of Insurance Code §1501.063.

3. HOW THE SECTION WILL FUNCTION. The adoption of the repeal will result in consistency between the Chapter 26 administrative rules regulating health care cooperatives with regard to refusal-to-renew provisions and the amendments to Insurance Code Chapter 1501 enacted in SB 805.

4. SUMMARY OF COMMENTS. The department did not receive any comments on the proposed repeal.

5. STATUTORY AUTHORITY. The repeal is adopted pursuant to the Insurance Code §§1501.010, 1501.058, 1501.0581, and 36.001, and SECTION 7 of SB 805 as enacted by the 79th Legislature, Regular Session. Section 1501.010 authorizes the Commissioner of Insurance to adopt rules as necessary to implement Chapter 1501. Section 1501.058 requires compliance with federal laws applicable to cooperatives and health benefit plans issued through cooperatives, to the extent required by state law or rules adopted by the Commissioner. Section 1501.0581 requires a carrier to make an informational filing with the Commissioner concerning intended offers of coverage to a cooperative and requires that the Commissioner by rule prescribe the form and the time of the filing. SECTION 7 of SB 805 directs the Commissioner, not later than January 1, 2006 , to adopt rules under §1501.010 as necessary to implement the change in law made by SB 805. Section 36.001 provides that the Commissioner of Insurance may adopt any rules necessary and appropriate to implement the powers and duties of the Texas Department of Insurance under the Insurance Code and other laws of this state.

6. TEXT.

§26.412. Refusal to Renew and Application to Reenter Health Group Cooperative Market.



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Last updated: 12/13/2016

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