(a) All final Orders of the Board or its designee shall
be in writing and shall be signed by the chairman of the Board or
by the Board's designee. A final decision shall include, adopt or
reference findings of fact and conclusions of law separately stated.
Findings of fact, if set forth in statutory language, shall be accompanied
by a concise and explicit statement of the underlying facts supporting
the findings.
(b) Acting in its capacity as fiduciary of the employee
benefit plans for which it serves as trustee, the Board or its designee
may, in their sole discretion, modify, refuse to accept, or delete
any adopted finding of fact or conclusion of law, or make alternative
findings of fact or conclusions of law, if it is determined by the
Board or its designee that all or part of the proposal for decision
submitted by the Examiner, or a adopted finding of fact or conclusion
of law contained therein, is:
(1) clearly erroneous or illogical;
(2) against the weight of the evidence;
(3) based on a misapplication of the rules of evidence
or an insufficient review of the evidence;
(4) based on a medical opinion that is not supported
by objective medical evidence, or is not based on reasonable medical
probability;
(5) inconsistent with the terms or intent, as determined
by the Board or its designee, of an applicable statute, benefit plan
or insurance policy provision;
(6) confusing, incomplete or misleading;
(7) immaterial or irrelevant to the issues; or
(8) not sufficient to protect the interests of the
plans and programs for which the Board is trustee, or the interests,
as a group, of the Members, retirees or participants covered by such
plans and programs. The Order shall contain or reference a written
statement of the reason and legal basis for each change made based
on the foregoing policy reasons. Correction of nonsubstantive typographical
errors do not need to be explained.
(c) A copy of the Board's or its designee's decision
or Order shall be served on each Party or his Authorized Representative.
|
Source Note: The provisions of this §67.91 adopted to be effective March 19, 1986, 11 TexReg 1149; amended to be effective January 10, 1999, 24 TexReg 165; amended to be effective September 14, 2006, 31 TexReg 7359; amended to be effective December 24, 2015, 40 TexReg 9302 |