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You are here: Home . wc . wcnet . impmntSB822

Registration of Provider Network Contracting Entities

Texas Insurance Code Section 1458.051 requires each person operating as a Provider Network Contracting Entity (PNCE) to register with TDI.  A person begins acting as a PNCE when:

  • the person enters into or offers to enter into a direct contract(s) with one or more providers for the delivery of health care services to covered individuals that serve to create a provider network or networks; and
  • the PNCE's network or networks are accessed by another party or by an affiliate of the PNCE.

To register, the PNCE must submit a fully completed PNCE Registration and Exemption of Affiliates Form with the required fee to TDI.

PNCE Exemption of Affiliates Form

The following entities are not required to register as a PNCE with TDI:

  • A health maintenance organization operating under Insurance Code Chapter 843;
  • An entity holding a certificate of authority issued by TDI to engage in the business of insurance in Texas; or
  • An affiliate named on the PNCE Exemption of Affiliates Form submitted to TDI and granted an exemption by the commissioner in writing.

Each PNCE that is a health maintenance organization or other entity holding a certificate of authority issued by TDI to engage in the business of insurance in this state is required to submit to TDI a fully completed PNCE Registration and Exemption of Affiliates Form with the required fee, unless the commissioner has granted an affiliate exemption to the PNCE.

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Last updated: 07/15/2016

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