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TITLE 28INSURANCE
PART 1TEXAS DEPARTMENT OF INSURANCE
CHAPTER 13MISCELLANEOUS INSURERS AND OTHER REGULATED ENTITIES
SUBCHAPTER FPROFESSIONAL EMPLOYER ORGANIZATIONS SPONSORING SELF-FUNDED EMPLOYEE HEALTH BENEFIT PLANS
DIVISION 3CERTIFICATE OF APPROVAL
RULE §13.533Actuarial Opinion Requirements

The independent actuarial opinion submitted with the application must:

  (1) describe the extent to which projected plan contributions:

    (A) are not excessive;

     (B) are not unfairly discriminatory;

     (C) are adequate to pay all of the plan's:

      (i) benefit payments;

       (ii) administrative expenses;

       (iii) other operational expenses; and

     (D) are sufficient to maintain the required reserves and surplus to be held in trust for the plan's participants; and

   (2) include a statement allocating the projected plan contributions to be charged to clients for plan coverage for:

    (A) the plan's administrative expenses;

     (B) plan reserves; and

     (C) all other expenses associated with operation of the applicant's plan.
Source Note: The provisions of this §13.533 adopted to be effective May 17, 2016, 41 TexReg 3479

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