(a) Any authorized insurer or HMO must file with the
Commissioner of Insurance a plan of orderly withdrawal before the
insurer or HMO undertakes a withdrawal.
(1) The insurer or HMO undertakes a withdrawal when
it takes any action on its own initiative that will result in the
insurer or HMO meeting the criteria under Insurance Code §827.003.
(2) An insurer or HMO will not be held to have acted
on its own initiative in effecting a withdrawal when it acts under
a Commissioner disciplinary or administrative directive or order,
or when the insurer or HMO acts under a directive of a supervisor,
conservator, or receiver. If an out-of-state directive or order is
not provided to the Commissioner within 30 days of the issuance of
such directive or order, the insurer or HMO will be held to have acted
on its own initiative.
(b) An insurer or HMO is not required to file a plan
of orderly withdrawal, but must instead notify the department, when:
(1) the line of business is written by a stipulated
premium company unless such line is written under Insurance Code §884.303
and §884.307 or Chapter 884, Subchapter I; or
(2) the line of insurance from which the HMO is withdrawing
is Medicare, a Medicare+Choice plan or a Medicaid contract as provided
in §7.1803(a) of this title (relating to What Constitutes a Line
of Insurance).
(c) If an insurer or HMO comes within an exception
provided in subsection (b) of this section, such notification must
be sent to the department simultaneously with any notification required
to be provided to any other state or federal agency. The notification
will be accepted for information only and must affirm that any appropriate
state or federal agency has been notified of the company's intent
to withdraw, and must include the effective date of nonrenewal, the
names of the Texas counties affected, and the number of insureds or
enrollees affected.
(d) This subchapter does not modify or supercede any
requirement under the Insurance Code or any other state or federal
law to notify policyholders or enrollees that an insurer or HMO will
not renew any coverage; however, before any such notice is given a
withdrawal plan must be filed with the department and approved by
the department under §7.1806 of this title (relating to Withdrawal
Plan Submission and Approval Procedures) when a plan is required by
this section.
|
Source Note: The provisions of this §7.1804 adopted to be effective July 22, 1993, 18 TexReg 4504; amended to be effective January 30, 2002, 27 TexReg 610; amended to be effective June 19, 2018, 43 TexReg 3902 |