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TITLE 28INSURANCE
PART 1TEXAS DEPARTMENT OF INSURANCE
CHAPTER 21TRADE PRACTICES
SUBCHAPTER PMENTAL HEALTH AND SUBSTANCE USE DISORDER PARITY
DIVISION 3COMPLIANCE ANALYSIS FOR MH/SUD PARITY
RULE §21.2433Compliance Analysis for Quantitative Parity: General Requirements

(a) Template and instructions. Except as provided in §21.2431 of this title (relating to Required Analyses for Quantitative and Nonquantitative Parity; Alternative Tools), an issuer must use the QTL template and associated technical instructions to:

  (1) provide the information required by §21.2434 of this title (relating to Quantitative Parity Analysis: Issuer and Plan Information), §21.2435 of this title (relating to Quantitative Parity Analysis: Methodology for Determining Expected Payments), and §21.2436 of this title (relating to Quantitative Parity Analysis: Covered Benefits); and

  (2) perform the compliance analysis for quantitative parity required by §21.2437 of this title (relating to Quantitative Parity Analysis: "Substantially All" and "Predominant" Tests).

(b) Template programming. TDI may program the QTL template to populate some information and complete some steps of the analysis automatically.

(c) Compliance analysis for plans with the same plan design. An issuer may complete a single analysis for multiple plans with the same plan design.

(d) Retention of completed template. An issuer must retain its completed quantitative parity analysis for each plan, plan design, or modified plan design. The completed analysis must be available to TDI upon request for any plan or plan design that is available for purchase, and for at least five years after coverage terminates for the last enrollee covered.

(e) Version control. The issuer must use a version control system to ensure that the issuer can provide to TDI upon request the version of the completed analysis that applied to a plan on a given date.


Source Note: The provisions of this §21.2433 adopted to be effective September 7, 2021, 46 TexReg 5571

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