Texas Administrative Code

Texas Administrative Code

TITLE 28	INSURANCE
PART 1	TEXAS DEPARTMENT OF INSURANCE
CHAPTER 26	EMPLOYER-RELATED HEALTH BENEFIT PLAN REGULATIONS
SUBCHAPTER C	LARGE EMPLOYER HEALTH INSURANCE REGULATIONS
RULE §26.309	Refusal to Renew and Application to Reenter Large Employer Market

(a) A large employer carrier may elect to refuse to renew all large employer health benefit plans delivered or issued for delivery by the large employer carrier in this state or in a geographic service area. The large employer carrier must notify the commissioner and each affected covered large employer of the election as provided in Insurance Code §1501.109 (concerning Refusal to Renew; Discontinuation of Coverage).

(b) The large employer carrier may not write a new large employer health benefit plan in this state or in the geographic service area, as applicable, for five years after notice to the commissioner of the election to refuse to renew. A large employer carrier that elects not to renew all large employer health benefit plans under Insurance Code §1501.109 and this section may not resume offering health benefit plans to large employers in this state or in the geographic area for which the election was made until it has filed a petition with the commissioner to be reinstated as a large employer carrier and the petition has been approved. In reviewing the petition, the commissioner may ask for information and assurances as the commissioner finds reasonable and appropriate.

(c) A large employer carrier may elect to discontinue a particular type of large employer coverage, only if the large employer carrier:

(1) before the 90th day preceding the date of the discontinuation of the coverage:

(A) provides notice of the discontinuation to each employer and TDI; and

(B) offers to each employer the option to purchase other large employer coverage offered by the large employer carrier at the time of the discontinuation; and

(2) acts uniformly without regard to the claims experience of the employer or any health-status-related factors of employees or dependents who are or may become eligible for the coverage.

Source Note: The provisions of this §26.309 adopted to be effective March 5, 1998, 23 TexReg 2297; amended to be effective April 6, 2005, 30 TexReg 1931; amended to be effective May 17, 2017, 42 TexReg 2539