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Notice

If you are submitting an RFP (request for proposal) for the Texas Health and Human Services Commission Medicaid Service, the TDI Form FIN361 is not needed. For more information see Service Area Expansion.

Health Maintenance Organizations

Transactions

Resources

New HMO

Organizational documents must be filed with the Texas Secretary of State's Office prior to submitting the application. Please read Licensure of HMOs in Texas which includes detailed information about filing requirements.

  • FIN357 (HMO Certificate of Authority Application Checklist)
  • FIN302 (Application for Certificate of Authority)
  • FIN358 (HMO DBA Filing Checklist)

DBAs, Trade Marks or Service Marks

Documents must be filed with the Texas Secretary of State's Office prior to submitting to this department.

Officers and Directors

Biographical Affidavits are required for ALL Officers: Chief Executive Officer, President, Executive Director, Secretary, Treasurer, Chief Financial Officer/Controller, Chief Operating Officer and Medical Director (if applicable). We DO NOT require biographical affidavits for Vice Presidents or Assistant-officers. Documentation must be submitted with Admissions application, and when changes occur. When submitting an amended Officers and Directors Page a $50 filing fee is required.

Statutory Deposits

Depending on the type of HMO, the product it offers and the level of uncovered expenses, some operations will be required to place funds on deposit. See TIC Chapter 843 or 28 TAC, Chapter 11.

Placing initial securities on deposit with the department

  • FIN435 (Initial Statutory Deposit Checklist). Checklist for an insurance company to initially place security funds on deposit.

Withdrawing securities on deposit with the department

  • FIN438 (Withdrawal of Statutory Deposit Checklist). Instructions outlining documents required for an insurance company to withdraw securities on deposit, due to a reduction, dissolution, merger, or cancellation of company's Certificate of Authority

Substituting securities on deposit with the department

  • FIN437 (Substitution of Securities on Deposit Checklist). Checklist outlining documents required for an insurance company to substitute securities held on deposit.

Name Change

Amended Articles of Incorporation must be filed with the Texas Secretary of State's Office prior to submitting transaction with this department.

Home Office Change

Amended Articles of Incorporation must be filed with the Texas Secretary of State's Office prior to submitting transaction with this department.

  • FIN359 (HMO Home Office Change Checklist)

Administrative Office Change

Submit administrative office changes to clrfilings@tdi.texas.gov 

Mailing Address Changes

By-Laws and Amended By-Laws

All HMOs must file a copy of any amendments to its By-Laws with a notarized certification, bearing the original signature of the corporate secretary, that is a true, accurate and complete copy of the original. A $50 filing fee is required when submitting Amended By-Laws.

Service Area Expansion

An email with a bookmarked .pdf of the application is required.

  • FIN361 (HMO Service Area Expansion Checklist)
  • UCAA Form 11 (Biographical Affidavit), if applicable

Note, if you are submitting a RFP (request for proposals) for the Texas Health and Human Services Commission Medicaid Service, the FIN361 is not needed. Please email the following items to clrfilings@tdi.texas.gov:

  • A request letter for the RFP service area expansion
  • A detailed business plan 
  • Identify all of the counties you are expanding into

When we receive the RFP request, TDI will issue an Order outlining required documents and financial standards that the Company will need to provide and maintain, respectively, if they are awarded a contract.

Total and Partial Assumption Agreements

  • FIN345 (Total and Partial Assumption Reinsurance Agreements Involving a Domestic Company)
  • UCAA Form 15 (Affidavit of Lost Certificate of Authority). TDI will not issue a "replacement" Certificate of Authority. This form to be submitted in conjunction with a required filing, if the HMOs original Certificate of Authority is lost.

Merger

After receiving TDI approval, the HMO must file with the Texas Secretary of State's Office.

  • FIN363 (HMO Merger Checklist)

Cancel HMO License/Certificate of Authority

An HMO must have zero claims activity prior to officially filing to cancel its license.

  • FIN364 (HMO Dissolution and Cancellation of Certificate of Authority)
  • FIN365 (HMO Withdrawal Guidelines)

Other transactions for HMOs handled by TDI's Financial Analysis Section

The following transactions are handled by TDI's Financial Analysis Section. Direct all inquiries and submit the following to FATransactions@tdi.texas.gov.

  • Agreements with Affiliates
  • Books and Records - Moving out of Texas (TIC 803.001)
  • Cancellation/Fidelity Bonds of Management
  • Capital Commitment Letters, Stock Subscription Agreements
  • Changes in Affiliate Chart
  • Contracts with Officers and Directors
  • Dividends - Filings not currently required
  • Exclusive Agency Contracts
  • Exemption from Change in Control of Affiliates
  • Fidelity Bonds of HMO
  • Form As (Acquisitions)
  • Management / Administrative Service / Marketing / Data Processing / Claims Agreement
  • Material Transaction Filings
  • Modification of Compensation Arrangements / Provider Contracts
  • Parental Guarantees
  • Stop Loss Reinsurance
  • Surplus Debenture Filings

 

For more information, contact: CompanyLicense@tdi.texas.gov

Last updated: 6/6/2024