| (a) An evidence of coverage or an amendment to an evidence
of coverage may not be issued, delivered, or used in Texas unless
it has been filed for review and has received the approval of the
commissioner. The following forms are always considered to be part
of the evidence of coverage:
(1) group agreement;
(2) certificate issued to each subscriber who is enrolled
through a group (the same form may be used as both the group agreement
and the group certificate);
(3) conversion and individual agreements;
(4) group, conversion, and individual applications
for coverage;
(5) group subscriber enrollment form;
(6) riders, endorsements, amendments, and letters of
agreement;
(7) matrix filings;
(8) schedule of benefits; and
(9) any other form attached to or made a part of the
evidence of coverage.
(b) Each of the forms described in subsection (a) of
this section must be identified with a unique form number and individually
approved by the commissioner before being issued, delivered, or used
in Texas. Each form described in subsection (a) of this section will
be considered a separate evidence of coverage filing and, except as
provided in subsection (c) of this section, is subject to the filing
fee prescribed in §7.1301(g)(4) of this title (relating to Regulatory
Fees) for initial submissions.
(c) The filing fee for matrix filings is $100 per individual
evidence of coverage provision, with a maximum fee of $500, whether
the filing is an initial submission or a resubmission.
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