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TITLE 28INSURANCE
PART 1TEXAS DEPARTMENT OF INSURANCE
CHAPTER 7CORPORATE AND FINANCIAL REGULATION
SUBCHAPTER SMULTIPLE-EMPLOYER WELFARE ARRANGEMENTS REQUIREMENTS FOR OBTAINING AND MAINTAINING CERTIFICATE OF AUTHORIZATION
RULE §7.1910Required Notice to Participants

(a) A multiple-employer welfare arrangement, in connection with an employee welfare benefit plan, shall provide to each participating employee or former employee covered by the plan the written notice containing, at a minimum, the items described in paragraphs (1)-(5) of this subsection, at the time the coverage of such participating employee or former employee becomes effective:

  (1) that individuals covered by the plan are only partially insured;

  (2) that in the event the plan or the multiple-employer welfare arrangement does not ultimately pay medical expenses that are eligible for payment under the plan for any reason, the participating employer or its participating employee covered by the plan may be liable for those expenses;

  (3) that, if applicable, the plan does not participate in the guaranty fund; such disclosure being provided in the same notice format required of insurers and health maintenance organizations in §1.1001 of this title (relating to Disclosure of Guaranty Fund Nonparticipation);

  (4) the toll-free telephone number for the complaints section of the Texas Department of Insurance consumer services division; and

  (5) that a copy of the summary plan description may be obtained from the plan administrator, employer, or trustee, as applicable.

(b) The notice shall also briefly explain the types of information in the summary plan description.


Source Note: The provisions of this §7.1910 adopted to be effective May 27, 1994, 19 TexReg 3686.

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