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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 7QUARTERLY AND ANNUAL FILINGS; EXAMINATIONS; HAZARDOUS CONDITIONS
RULE §13.570Financial Filing Requirements

(a) Approved quarterly filing form. TDI adopts by reference PEO Quarterly Report, Form No. FIN409 (rev. 1115). The form is available on TDI's website. An approved PEO must submit its quarterly filings as described in subsection (c) of this section on PEO Quarterly Report, Form No. FIN409, using generally accepted accounting principles of the United States as modified by this subchapter.

(b) Approved annual filing form. TDI adopts by reference PEO Annual Report, Form No. FIN410 (rev. 1115). The form is available on TDI's website. An approved PEO must submit its annual filings as described in subsection (d)(1) of this section on PEO Annual Report, Form No. FIN410, using generally accepted accounting principles of the United States as modified by this subchapter.

(c) Quarterly filings. An approved PEO must file electronically with the commissioner within 45 days of the end of each calendar quarter an unaudited quarterly financial statement of the plan and trust, certified by an appropriate officer or agent of:

  (1) the trustees; or

  (2) the approved PEO.

(d) Annual filings. An approved PEO must file electronically with the commissioner by March 1 of each year:

  (1) an unaudited financial statement of the plan and trust reflecting the financial transactions and results of the four previous quarters, certified by an appropriate officer or agent of:

    (A) the trustees; or

    (B) the approved PEO; and

  (2) an annual actuarial opinion prepared and certified by an actuary who is not an employee of the approved PEO, and who is a fellow of the Society of Actuaries, a member of the American Academy of Actuaries, or an enrolled actuary approved by the Joint Board for the Enrollment of Actuaries to perform actuarial services required under ERISA, 29 U.S.C. §§1001-1191c. The annual actuarial opinion must include:

    (A) a description of the actuarial soundness of the plan and trust, including any recommended actions that the approved PEO should take to improve the plan and trust's actuarial soundness;

    (B) a calculation of reserves as required by §13.560 of this title (relating to Annual and Quarterly Reserves); and

    (C) a recommended minimum level of specific and aggregate stop-loss insurance the plan and trust should maintain.

  (3) Audited financial statements for the plan and trust must be filed annually by June 1 of each year and meet the requirements of Insurance Code Chapter 401, Subchapter A, concerning Independent Audit of Financial Statements, and §7.88 of this title (relating to Independent Audits of Insurer and HMO Financial Statements and Insurer and HMO Internal Control Over Financial Reporting) using generally accepted accounting principles of the United States as modified by this subchapter.


Source Note: The provisions of this §13.570 adopted to be effective May 17, 2016, 41 TexReg 3479

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