| (a) Analysis of standards. The department will compare
statutory and regulatory requirements of the department for health
benefit plan issuers with the standards of national accreditation
organizations. The standards of national accreditation organizations
that are the same as, substantially similar to, or more stringent
than the department's statutory and regulatory requirements will be
identified and used to determine the presumption of compliance of
health benefit plan issuers.
(b) Monitoring schedule. The department will, at least
annually, monitor and analyze updates and amendments made to accreditation
standards by national accreditation organizations to ensure that those
standards remain the same as, substantially similar to, or more stringent
than the statutory and regulatory requirements of the department.
(c) Posting of standards. The department will post
a table on its website that contains a summary of its comparison of
national accreditation organization standards with the statutory and
regulatory requirements of the department and indicates which portions
of the examination process the department will presume compliance
for accredited entities. The presumed compliance table listing the
summary of the comparison of national accreditation standards and
department statutory and regulatory requirements may be obtained from:
(1) the department's website at www.tdi.texas.gov;
or
(2) the Financial Regulation Division, MC-FRD, Texas
Department of Insurance, P.O. Box 12030, Austin, Texas 78711-2030.
(d) Updates to standards. The department will update
the table of standards posted on its website on at least an annual
basis, as necessary, to reflect changes made to national accreditation
organization standards.
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