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Texas Department of Insurance
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The Commissioner of Insurance will consider amendments proposed by the staff of the Data Services Division of the Property and Casualty Insurance program at the Texas Department of Insurance (Department) to the Texas Workers' Compensation Statistical Plan (the Plan). The 79th Texas Legislature enacted House Bill 7 which, in pertinent part, authorized the establishment of workers' compensation health care networks for the provision of workers' compensation medical benefits and provided the statutory framework for the establishment of standards for the certification, administration, evaluation and enforcement of the delivery of health care services to injured employees by workers' compensation health care networks. The purpose of these proposed amendments to the Plan is to provide a means for insurers to report the premium credit that is addressed by the proposed amendments to Rule VI of the Texas Basic Manual of Rules, Classifications and Experience Rating Plan for Workers' Compensation and Employers' Liability Insurance by adding a new Section K to be entitled "Certified Workers' Compensation Health Care Networks." Those proposed amendments were published for comment in the Texas Register on February 17, 2006.


Staff's petition (Ref. No. W-0206-03-I) was filed on February 27, 2006.


A public hearing on this matter will not be held unless a separate request for a hearing is submitted to the Office of the Chief Clerk during the comment period as specified herein.


The proposed amendments to the Plan are filed pursuant to Texas Insurance Code Articles 5.58 and 5.96. Article 5.58(a) requires the Commissioner to develop reasonable statistical plans. Article 5.96 authorizes the Commissioner to prescribe, promulgate, adopt, approve, amend or repeal standard and uniform manual rules, rating plans, classification plans, statistical plans and policy and endorsement forms for workers' compensation insurance.


The staff has proposed amendments to the Plan as follows:


1. Amend Part III of the Plan (relating to Exposure and Premium) to add Item 17 to the reporting instructions to explain how the certified workers' compensation health care network premium credit is to be reported using Statistical Code 9874.

2. Amend Part X of the Plan (relating to Statistical Codes) to include Code 9874 Certified Workers' Compensation Health Care Network Premium Credit in the listing of statistical codes for Premium Not Subject to Experience Rating - Reported on Lines D, E, F, or G.


The staff requests that the proposed amendments to the Texas Workers' Compensation Statistical Plan described herein be adopted 15 days after notice of adoption is published in the Texas Register.


The Commissioner has jurisdiction over this matter pursuant to the Insurance Code Articles 5.58 and 5.96.


A copy of the full text of the proposed amendments is available for review in the Office of the Chief Clerk of the Texas Department of Insurance, 333 Guadalupe Street, Austin, Texas 78714-9104. For further information or to request copies of the proposed amendments, please contact Sylvia Gutierrez at 512-463-6327 (refer to Ref. No. 0206-03-I).


Written comments to these proposed amendments may be submitted no later than 5:00 p.m. on April 10, 2006 to Gene C. Jarmon, General Counsel and Chief Clerk, Texas Department of Insurance, P. O. Box 149104, MC 113-2A, Austin, Texas 78714-9104. An additional copy of the comments must be submitted to Clare Pramuk, Data Services Director, Texas Department of Insurance, P. O. Box 149104, MC 105-5D, Austin, Texas 78714-9104.


This notification is made pursuant to the Insurance Code Article 5.96, which exempts it from the requirements of the Government Code, Chapter 2001 (Administrative Procedure Act).

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