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TITLE 28INSURANCE
PART 1TEXAS DEPARTMENT OF INSURANCE
CHAPTER 7CORPORATE AND FINANCIAL REGULATION
SUBCHAPTER AEXAMINATION AND FINANCIAL ANALYSIS
RULE §7.88Independent Audits of Insurer and HMO Financial Statements and Insurer and HMO Internal Control over Financial Reporting

(a) Purpose. The purpose of this section is to improve the Texas Department of Insurance's surveillance of the financial condition of insurers and HMOs by:

  (1) specifying the requirements of an annual audit by an accountant of the financial statements reporting the financial condition and the results of operations of each insurer or HMO;

  (2) requiring communication of internal control related matters noted in an audit;

  (3) requiring an insurer or HMO that is required to file an annual audited financial report under Insurance Code Chapter 401, Subchapter A, to have an audit committee; and

  (4) requiring certain insurer or HMO management to report on internal control over financial reporting.

(b) Applicability.

  (1) Except as otherwise specified in this section and in Insurance Code Chapter 401, Subchapter A, this section applies to insurers and HMOs and takes effect beginning with the annual reporting period ending December 31, 2010, which period is reflected in reports and communications required to be filed with the Commissioner during calendar year 2011, and continues in effect each year thereafter.

  (2) Subsection (h)(1) of this section, relating to lead audit partner limitation, is in effect for audits of the year beginning January 1, 2010, which audits are reflected in reports and communications required to be filed with the Commissioner during calendar year 2011, and continues in effect each year thereafter.

  (3) Subsection (k) of this section, relating to audit committee requirements, takes effect on September 1, 2010.

  (4) Subsection (l) of this section, relating to internal audit committee requirements, is applicable beginning January 1, 2021.

(c) Definitions. The following words and terms, when used in this section, have the following meanings, unless the context clearly indicates otherwise.

  (1) Accountant--An independent certified public accountant or accounting firm that meets the requirements of Insurance Code §401.011.

  (2) Affiliate--Has the meaning assigned by Insurance Code §823.003.

  (3) Audit committee--A committee established by the board of directors of an entity for the purpose of overseeing the accounting and financial reporting processes of an insurer or HMO or group of insurers or HMOs and audits of financial statements of the insurer or HMO or group of insurers or HMOs. At the election of the controlling person, the audit committee of an entity that controls a group of insurers or HMOs may be the audit committee for one or more of the controlled insurers or HMOs solely for the purposes of this section. If an audit committee is not designated by the insurer or HMO, the insurer's or HMO's entire board of directors constitutes the audit committee.

  (4) Audited financial report--The annual audit report required by Insurance Code Chapter 401, Subchapter A.

  (5) Group of insurers or HMOs--Those authorized insurers or HMOs included in the reporting requirements of Insurance Code Chapter 823, or a set of insurers or HMOs as identified by management, for the purpose of assessing the effectiveness of internal control over financial reporting.

  (6) Health maintenance organization (HMO)--A health maintenance organization authorized to engage in business in this state.

  (7) Insurer--An insurer authorized to engage in business in this state, including:

    (A) a life, health, or accident insurance company;

    (B) a fire and marine insurance company;

    (C) a general casualty company;

    (D) a title insurance company;

    (E) a fraternal benefit society;

    (F) a mutual life insurance company;

    (G) a local mutual aid association;

    (H) a statewide mutual assessment company;

    (I) a mutual insurance company other than a mutual life insurance company;

    (J) a farm mutual insurance company;

    (K) a county mutual insurance company;

    (L) a Lloyd's plan;

    (M) a reciprocal or interinsurance exchange;

    (N) a group hospital service corporation; and

    (O) a stipulated premium company.

  (8) Internal control over financial reporting--A process implemented by an entity's board of directors, management, and other personnel designed to provide reasonable assurance regarding the reliability of the entity's financial statements. The term includes policies and procedures that:

    (A) relate to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of assets;

    (B) provide reasonable assurance that:

      (i) transactions are recorded as necessary to permit preparation of the financial statements; and

      (ii) receipts and expenditures are made only in accordance with authorizations of management and directors; and

    (C) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of assets that could have a material effect on the financial statements.

  (9) Management--The management of an insurer or HMO or group of insurers or HMOs subject to this section.

  (10) SEC--The United States Securities and Exchange Commission.

  (11) Section 404--Section 404, Sarbanes-Oxley Act of 2002 (15 U.S.C. §7262), and rules adopted under that section.

  (12) Section 404 report--Management's report on internal control over financial reporting as determined by the SEC and the related attestation report of an accountant.

  (13) SOX-compliant entity--An entity that is required to comply with or voluntarily complies with:

    (A) the preapproval requirements provided by 15 U.S.C. §78j-1(i);

    (B) the audit committee independence requirements provided by 15 U.S.C. §78j-1(m)(3); and

    (C) the internal control over financial reporting requirements provided by 15 U.S.C. §7262(b) and Item 308, SEC Regulation S-K.

  (14) Subsidiary--Has the meaning assigned by Insurance Code §823.003.

(d) Filing and extensions for filing of audited financial report.

  (1) Except as provided in paragraphs (2), (3), and (4) of this subsection, an insurer or HMO that is required to have an annual audit performed by an accountant and to file an audited financial report with the Commissioner under Insurance Code Chapter 401, Subchapter A, shall file the audited financial report with the Commissioner on or before June 1 for the preceding calendar year.

  (2) Except as provided in paragraphs (3) and (4) of this subsection, an insurer or HMO that, along with any affiliated insurers or HMOs, is licensed in and does business only in Texas shall file the audited financial report with the Commissioner on or before June 30 for the preceding calendar year. This paragraph does not apply to an insurer or HMO that is a member of a group comprised of one or more insurers or HMOs authorized and actually doing the business of insurance in another state that requires that an audited financial report be filed on or before June 1 for the preceding calendar year.

  (3) In accordance with Insurance Code §401.004(b), the Commissioner may require an insurer or HMO to file an audited financial report on a date that precedes the June 1 deadline in paragraph (1) of this subsection or the June 30 deadline in paragraph (2) of this subsection. The Commissioner must notify the insurer or HMO of the filing date not later than the 90th day before that date.

  (4) The Commissioner may grant an extension of the filing date in accordance with Insurance Code §401.004(c). An extension granted under Insurance Code §401.004(c), relating to the filing date for an audited financial report, also applies to the filing of management's report on internal control over financial reporting required under subsection (n) of this section.

  (5) An insurer or HMO required to file an annual audited financial report under Insurance Code Chapter 401, Subchapter A, and this section must designate a group of individuals to serve as its audit committee. The audit committee of an entity that controls an insurer or HMO may, at the election of the controlling person, be the insurer's or HMO's audit committee for purposes of this section.

(e) Exemption for certain foreign or alien insurers or HMOs.

  (1) A foreign or alien insurer or HMO exempt under Insurance Code §401.007(a) must file with the commissioner a copy of:

    (A) the audited financial report and the accountant's letter of qualifications filed with the insurer's or HMO's state of domicile at the same time these documents are filed with the state of domicile;

Cont'd...

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