| (a) A qualifying group health benefit plan is renewable at the option of a participating small employer so long as: (1) the Healthy Texas Program is active and operational; (2) the small employer continues to meet eligibility requirements that are set forth in the Insurance Code Chapter 1508 and §26.521 of this subchapter (relating to Small Employer Participation); and (3) the small employer timely provides a participating health benefit plan issuer the initial or renewal certification information as addressed in §26.512(c) of this division (relating to Application, Initial Certification of Eligibility, and Enrollment), §26.513(b) and (c) of this division (relating to Annual Recertification of Eligibility), and §26.521(j) of this subchapter. (b) In accordance with subsection (a) of this section, a participating health benefit plan issuer shall renew any small employer health benefit plan for any covered small employer at the option of the small employer, unless: (1) the premium has not been paid as required by the terms of the plan; (2) the small employer has committed fraud or intentional misrepresentation of a material fact not related to health status; (3) the small employer has not complied with a provision of the health benefit plan relating to premium contribution, group size, or participation requirements as set forth in the Insurance Code Chapter 1508 and this subchapter; or (4) membership of an employer in an association terminates, but only if coverage is terminated uniformly without regard to a health status related factor of a covered individual. (c) A participating health benefit plan issuer may not cancel a qualifying group health benefit plan except for the reasons specified for refusal to renew under subsection (b) of this section. A participating health benefit plan issuer may not cancel the coverage of an eligible employee or dependent except for the reasons specified for refusal to renew under subsection (b) of this section. (d) A participating health benefit plan issuer shall provide written notice to the contract holder and any covered employees of a nonrenewal or termination at least 45 days prior to its effective date. Notice of the nonrenewal or termination shall state the basis for the nonrenewal or termination and include a description of any available conversion opportunities. Notice of the nonrenewal or termination also shall include a description of other coverage options available for purchase from the participating health benefit plan issuer. (e) A qualifying group health benefit plan is subject to the continuation of coverage provisions of the Insurance Code, Chapter 1251, Subchapters F and G, except that a plan issued by a participating health benefit plan issuer that elects to discontinue Healthy Texas coverage by withdrawing from participation in the Healthy Texas Program pursuant to §26.515 of this subchapter (relating to Notice of Discontinuance of Health Plan; Issuer Withdrawal from Participation) is not subject to such continuation of coverage provisions. |
