| (a) The following provisions of the Insurance Code
are applicable to an approved PEO to the same extent as the provisions
apply to any entity TDI regulates under those provisions:
(1) Insurance Code Chapter 36, Subchapter C, concerning
General Subpoena Powers; Witnesses and Production of Records;
(2) Insurance Code Chapter 36, Subchapter D, concerning
Judicial Review;
(3) Insurance Code §38.001, concerning Inquiries;
(4) Insurance Code Chapter 38, Subchapter F, concerning
Data Collecting and Reporting Relating to Mandated Health Benefits
and Mandated Offers of Coverage;
(5) Insurance Code Chapter 38, Subchapter H, concerning
Health Care Reimbursement Rate Information;
(6) Insurance Code Chapter 40, concerning Duties of
State Office of Administrative Hearings and Commissioner in Certain
Proceedings; Rate Setting Proceedings;
(7) Insurance Code Chapters 82, concerning Sanctions;
(8) Insurance Code Chapter 83, concerning Emergency
Cease and Desist Orders;
(9) Insurance Code Chapter 84, concerning Administrative
Penalties;
(10) Insurance Code Chapter 101, concerning Unauthorized
Insurance;
(11) Insurance Code Chapter 461, concerning General
Provisions;
(12) Insurance Code §521.005, concerning Notice
to Accompany Policy;
(13) Insurance Code Chapter 541, Subchapter A, concerning
General Provisions;
(14) Insurance Code Chapter 541, Subchapter B, concerning
Unfair Methods of Competition and Unfair or Deceptive Acts or Practices
Defined;
(15) Insurance Code Chapter 541, Subchapter B-1, concerning
Advertising Requirements;
(16) Insurance Code Chapter 542, concerning Processing
and Settlement of Claims;
(17) Insurance Code Chapter 543, concerning Prohibited
Practices Related to Policy or Certificate of Membership;
(18) Insurance Code Chapter 544, Subchapter A, concerning
General Prohibitions Against Discrimination by an Insurer or Health
Maintenance Organization;
(19) Insurance Code Chapter 544, Subchapter B, concerning
Other General Prohibitions Against Discrimination by Insurers;
(20) Insurance Code Chapter 544, Subchapter C, concerning
English Fluency;
(21) Insurance Code Chapter 544, Subchapter D, concerning
Family Violence;
(22) Insurance Code Chapter 544, Subchapter E, concerning
Fibrocystic Breast Condition;
(23) Insurance Code Chapter 545, concerning HIV Testing;
(24) Insurance Code Chapter 546, concerning Use of
Genetic Testing Information;
(25) Insurance Code §550.002, concerning Increase
in Certain Premium Payments;
(26) Insurance Code Chapter 558, concerning Refund
of Unearned Premium;
(27) Insurance Code Chapter 560, concerning Prohibited
Rates;
(28) Insurance Code Chapter 601, concerning Privacy;
(29) Insurance Code Chapter 602, concerning Privacy
of Health Information;
(30) Insurance Code Chapter 701, concerning Insurance
Fraud Investigations;
(31) Insurance Code Chapter 705, concerning Misrepresentations
by Policyholders;
(32) Insurance Code Chapter 801, concerning Certificate
of Authority;
(33) Insurance Code Chapter 803, concerning Location
of Books, Records, Accounts, and Offices Outside of this State;
(34) Insurance Code Chapter 804, concerning Service
of Process;
(35) Insurance Code Chapter 823, Subchapter B, concerning
Registration;
(36) Insurance Code Chapter 823, Subchapter C, concerning
Transactions of Registered Insurer;
(37) Insurance Code Chapter 823, Subchapter D, concerning
Control of Domestic Insurer; Acquisition or Merger;
(38) Insurance Code §1201.013, concerning Programs
Promoting Disease Prevention, Wellness, and Health;
(39) Insurance Code §1201.059, concerning Termination
of Coverage Based on Age of Child in Individual, Blanket, or Group
Policy;
(40) Insurance Code §1201.062, concerning Coverage
for Certain Children in Individual or Group Policy or in Plan or Program;
(41) Insurance Code §1201.063, concerning Prohibition
of Certain Criteria Relating to a Child's Coverage in Individual or
Group Policy;
(42) Insurance Code §1201.064, concerning Coverage
for Child of Spouse in Individual or Group Policy;
(43) Insurance Code Chapter 1203, concerning Coordination
of Benefits Provisions;
(44) Insurance Code Chapter 1204, Subchapter A, concerning
Payments to Certain Public Hospitals;
(45) Insurance Code Chapter 1204, Subchapter B, concerning
Assignment of Benefit Payments;
(46) Insurance Code Chapter 1204, Subchapter D, concerning
Payments for Certain Publicly Provided Services;
(47) Insurance Code Chapter 1204, Subchapter E, concerning
Exclusionary Clauses;
(48) Insurance Code Chapter 1204, Subchapter F, concerning
Payment of Benefits to Conservator of Minor;
(49) Insurance Code Chapter 1205, concerning Certificate
of Creditable Coverage;
(50) Insurance Code Chapter 1206, concerning Denial
of Health Benefit Plan Enrollment Based on Existing Coverage Prohibited;
(51) Insurance Code Chapter 1207, concerning Enrollment
of Medical Assistance Recipients and Children Eligible for State Child
Health Plan;
(52) Insurance Code Chapter 1208, concerning Identity
of Available Employee of Health Benefit Plan Issuer;
(53) Insurance Code Chapter 1210, concerning Notice
of Certain Policy Provisions;
(54) Insurance Code Chapter 1213, concerning Electronic
Health Care Transactions;
(55) Insurance Code Chapter 1214, concerning Advertising
for Certain Health Benefits;
(56) Insurance Code Chapter 1215, concerning Reporting
of Claims Information;
(57) Insurance Code Chapter 1216, concerning Out-of-Country
Coverage Prohibited;
(58) Insurance Code Chapter 1251, Subchapter C, concerning
Group Accident and Health Insurance: Required Provisions;
(59) Insurance Code Chapter 1251, Subchapter D, concerning
Group Accident and Health Insurance: Coverage for Dependents;
(60) Insurance Code Chapter 1251, Subchapter E, concerning
Group Accident and Health Insurance: General Provisions;
(61) Insurance Code Chapter 1251, Subchapter F, concerning
Continuation or Conversion Privilege on Termination of Coverage under
Group Policy, except that an approved PEO may not offer a conversion
policy under Insurance Code §1251.256, concerning Conversion
of Group Policy;
(62) Insurance Code Chapter 1251, Subchapter G, concerning
Continuation of Group Coverage for Certain Family Members and Dependents;
(63) Insurance Code Chapter 1252, concerning Discontinuation
and Replacement of Group and Group-Type Health Benefit Plan Coverage;
(64) Insurance Code Chapter 1274, concerning Electronic
Transmission of Eligibility and Payment Status;
(65) Insurance Code Chapter 1301, concerning Preferred
Provider Benefit Plans, except that a small PEO plan is not subject
to §1301.009, concerning Annual Report;
(66) Insurance Code Chapter 1351, concerning Home Health
Services;
(67) Insurance Code Chapter 1352, concerning Brain
Injury;
(68) Insurance Code Chapter 1355, concerning Benefits
for Certain Mental Disorders;
(69) Insurance Code Chapter 1356, concerning Low-Dose
Mammography;
(70) Insurance Code Chapter 1357, concerning Mastectomy;
(71) Insurance Code Chapter 1358, concerning Diabetes;
(72) Insurance Code Chapter 1359, concerning Formulas
for Individuals with Phenylketonuria or Other Heritable Diseases;
(73) Insurance Code Chapter 1360, concerning Diagnosis
and Treatment Affecting Temporomandibular Joint;
(74) Insurance Code Chapter 1361, concerning Detection
and Prevention of Osteoporosis;
(75) Insurance Code Chapter 1362, concerning Certain
Tests for Detection of Prostate Cancer;
(76) Insurance Code Chapter 1363, concerning Certain
Tests for Detection of Colorectal Cancer;
(77) Insurance Code Chapter 1364, concerning Coverage
Provisions Relating to HIV, Aids, or HIV-Related Illnesses;
(78) Insurance Code Chapter 1365, concerning Loss or
Impairment of Speech or Hearing;
Cont'd... |
