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TITLE 28INSURANCE
PART 1TEXAS DEPARTMENT OF INSURANCE
CHAPTER 26EMPLOYER-RELATED HEALTH BENEFIT PLAN REGULATIONS
SUBCHAPTER DCOOPERATIVES
DIVISION 1NONPROFIT HEALTH GROUP COOPERATIVES
RULE §26.408Issuance of Coverage to Health Group Cooperatives

(a) Subject to the limitations identified in §26.411 of this title (relating to Service Areas for Health Carriers Offering Coverage Through a Health Group Cooperative), a health carrier may elect to not offer or issue coverage to health group cooperatives or may elect to offer or issue coverage to one or more health group cooperatives of its choosing.

(b) Notwithstanding subsection (a) of this section, a health carrier must comply with the guaranteed issuance requirements of Insurance Code Chapter 1501 (concerning Health Insurance Portability and Availability Act) and this chapter with respect to offering and issuing coverage to a health group cooperative that:

  (1) consists of only small employers;

  (2) has elected to restrict membership in the cooperative to 50 employees; and

  (3) has notified TDI consistent with §26.401(e) of this title (relating to Establishment of Health Group Cooperatives).


Source Note: The provisions of this §26.408 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

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