(a) A health carrier that intends to issue coverage
to a health group cooperative must file with TDI information concerning
the health carrier's offer of coverage no later than 30 days before
the cooperative's initial enrollment period.
(b) A filing required by subsection (a) of this section
must include:
(1) the name of the health carrier;
(2) the name, address, and telephone number or other
contact information of the health group cooperative to which the health
carrier intends to offer coverage;
(3) the county or expanded service area in which the
health carrier intends to offer coverage to the health group cooperative;
(4) any limitations concerning the number of participating
employers or employees in a health group cooperative that the health
carrier is capable of administering; and
(5) the health benefit plan filed for use by the health
carrier as a product available to health group cooperatives, or when
appropriate under subsection (c) of this section, reference to a previously
approved form, including the form number and date of approval.
(c) The form filing required by subsection (b)(5) of
this section must comply, as appropriate, with all applicable filing
requirements under Chapter 3 of this title (relating to Life, Accident
and Health Insurance and Annuities) or Chapter 11 of this title (relating
to Health Maintenance Organizations).
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Source Note: The provisions of this §26.407 adopted to be effective August 31, 2004, 29 TexReg 8360; amended to be effective January 31, 2006, 31 TexReg 512; amended to be effective May 17, 2017, 42 TexReg 2539 |