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Commissioner’s Bulletin # B-0048-05

September 21, 2005

TO: ALL INSURERS LICENSED TO WRITE LIFE AND ACCIDENT AND HEALTH INSURANCE, ALL HEALTH MAINTENANCE ORGANIZATIONS, ALL LICENSED AGENTS, ALL THIRD PARTY ADMINISTRATORS, ALL UTILIZATION REVIEW AGENTS AND ALL MEWAS LICENSED IN TEXAS

RE: HURRICANE RITA - STATE OF EMERGENCY - NATURAL DISASTER - OUT-OF-NETWORK SERVICES

On September 20, 2005, Governor Rick Perry issued a proclamation declaring a disaster due to the effects of Hurricane Rita, certifying that Hurricane Rita poses a threat of imminent disaster along the Texas Coast beginning September 20, 2005, and directing that all necessary measures both public and private as authorized under Section 418.015 of the Texas Government Code be implemented to meet that threat. The proclamation also states that, as provided in Section 418.016 of the Texas Government Code, all rules and regulations that may inhibit or prevent prompt response to this threat are suspended for the duration of the incident.

Hurricane Rita is threatening the state, resulting in large scale evacuations. Because of the potential storm damage to local, regional and state-wide utilities and infrastructure, many insureds and enrollees will be forced to evacuate their residence locations and health care service areas. Restrictions on insureds and enrollees will result in many storm victims being without the health care or dental services necessary for their health. Insureds and enrollees should not be left without their necessary health care or dental services during a disaster or threat of imminent disaster. Under these circumstances, it is the opinion of the Texas Department of Insurance that all health insurance companies and health maintenance organizations should waive penalties and restrictions on insureds or enrollees when insureds or enrollees obtain necessary emergency and non-emergency health and dental services out-of-network as a result of the threat of imminent disaster during the pendency of this disaster.

Questions regarding this bulletin may be directed to the following:

Life/Health Division at 512-322-3409 or e-mail: life_health@tdi.state.tx.us

HMO/URA/QA Division at 512-322-4266 or e-mail: hmogrp@tdi.state.tx.us

Mike Geeslin

Commissioner of Insurance






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