Texas Administrative Code

(a) In rate proceedings under the Commission's original jurisdiction, rates set by the Commission are prospective only and are observed from the date of the applicable Commission order. (b) In municipal rate appeals, the Commission shall enter a final order establishing rates the…

If the Hearings Division receives a letter or other communication from an affected person concerning a statement of intent filed pursuant to Texas Utilities Code, § 104.102 , the Hearings Division shall, within a reasonable time thereafter, forward to such affected person a form …

(a) Rate setting proceedings. (1) Notice. In all rate proceedings, notice shall be given in the following ways. (A) The Commission shall publish the notice of hearing in the next Bulletin published after the date of issuance of the notice of hearing. (B) The gas utility shall giv…

(a) Rate setting notice. In all proceedings involving rate setting, the gas utility's notice shall include the following information: (1) the proposed revision of rates and schedules; (2) a statement specifying in detail each proposed change; (3) the effect the proposed change is…

Any insurer or HMO withdrawing from writing all premium in all lines of insurance in this state and required to file a plan of orderly withdrawal under Insurance Code Chapter 827, may not resume writing the withdrawn lines in this state before the fifth anniversary of the date of…

(a) As authorized by the Insurance Code § 4151.206(a)(2) , the commissioner adopts a fee of $500 to be paid by an administrator for an examination under the Insurance Code § 4151.201 . The fee is non-refundable. (b) Pursuant to the Insurance Code § 4151.202 , prior to an examiner…

(a) An applicant or administrator may be considered to be operating or conducting business in a hazardous or injurious manner if the administrator or applicant: (1) has failed to file financial statements, documents, records, or reports required under the Insurance Code Chapter 4…

(a) Unless otherwise approved by the commissioner, no later than 30 days from the date of the termination of the relationship or written agreement between an insurer, HMO, plan sponsor, or group and an administrator, the administrator shall provide a complete and accurate origina…

(a) An administrator is prohibited from: (1) misrepresenting the terms or nature of an agreement with an insurer, HMO, plan sponsor, or group; (2) making false, misleading, or incomplete comparisons to the agreements of other administrators or persons in order to induce any perso…

(a) An administrator may not provide administrative services in Texas on behalf of an insurer unless the administrator has entered into a written agreement with the insurer that meets the requirements of the Insurance Code Chapter 4151 and this section. (b) An administrator subco…

(a) Pursuant to the Insurance Code § 4151.106(b) , an administrator shall hold all premium in a fiduciary capacity. (b) An administrator collecting or receiving any premium shall comply with the Insurance Code §§ 4151.105 , 4151.106 , 4151.107 , and 4151.108 and this section. An …

(a) No less than two times each fiscal year, an insurer shall review the operations of each of its administrators that, in the aggregate, administers benefits in Texas on behalf of the insurer for more than 100 certificate holders, injured employees, plan participants, or policyh…

(a) This section applies only to an insurer or HMO that: (1) meets the requirements of § 7.1605 of this subchapter (relating to Notification Requirements); and (2) is subject to the requirements of the Education Code § 22.004(g) . (b) An administrator meeting the requirements of …

(a) Filing of Annual Report. An administrator must file an annual report with the department no later than June 30 each year, accompanied by the non-refundable fee of $200. (b) Forms and Fee. (1) The commissioner adopts by reference the following forms, which are available at www…

(a) An applicant must obtain, and an administrator must maintain, a fidelity bond that complies with the requirements of the Insurance Code § 4151.055 and this section. (b) Applicants and administrators may only obtain a fidelity bond from a surety company authorized to engage in…

(a) For purposes of this section only, a material change in fact or circumstance means any fact or circumstance that impacts the accuracy or completeness of the information filed in an applicant's or administrator's initial application for a certificate of authority under the Ins…

(a) For purposes of this section only, control: (1) means the power to direct, or cause the direction of, the management and policies of a person, other than the power that results from an official position with or corporate office held by the person; (2) may be possessed by vari…

(a) An insurer or HMO that is acting as or holding itself out as an administrator and that is not exempt under the Insurance Code § 4151.002(3) or (4) is subject to all provisions of this subchapter, except §§ 7.1603 , 7.1604 , and 7.1609 (c) and (d)(1) and (2) of this subchapter…

(a) Filing of Application. An applicant who seeks a certificate of authority under the Insurance Code Chapter 4151 must file an application with the department, accompanied by the non-refundable fee of $1,000. The applicant must verify the application by attesting to the truth an…

(a) Unless a person meets an exemption under Insurance Code §§ 4151.002 , concerning Exemptions, 4151.004, concerning Applicability to Certain Insurers and Health Maintenance Organizations, or 4151.0021, concerning Applicability to Certain Processing Agents, a person acting as or…

The following words and terms when used in this subchapter shall have the following meanings unless the context clearly indicates otherwise. (1) Administrator--As defined in the Insurance Code § 4151.001(1) . The term includes administrator contractors and administrator subcontra…

(a) Except as otherwise provided by this subchapter or the Insurance Code Chapter 4151, this subchapter applies to a person acting as or holding itself out as an administrator in any capacity, regardless of whether the person holds another authorization under the Insurance Code o…

(a) Requirement for use of specific forms designating commissioner as attorney for service. When, by meeting the requirements of this subchapter and of the Insurance Code, Article 1.36, a person, insurer, or other entity qualifies to appoint the commissioner as attorney and agent…

(a) Citations served on the commissioner shall be forwarded by certified mail to the address provided by the plaintiff. (b) Citations received by certified or registered mail must be served in accordance with the Texas Rules of Civil Procedure, Rule 103 and Rule 106. (c) Citation…

(a) A surplus lines insurer may be sued on any cause of action arising in this state under any surplus lines insurance contract issued by it or under any certificate, cover note, or other confirmation of that insurance issued by the surplus lines agent, under the same procedure p…

Section 7.1410 and § 7.1411 of this title (relating to Service of Process on Commissioner on Behalf of Unauthorized Persons or Insurers; and Service of Process, Notice, Order, or Pleading on Secretary of State on Behalf of Unauthorized Persons and Insurers) do not limit or abridg…

(a) Service of process may be effected on the secretary of state in those actions, suits, or other proceedings brought: (1) in court by the State Board of Insurance or by the state against unauthorized persons or insurers; or (2) before the State Board of Insurance by notice, ord…

(a) Any act of doing an insurance business as provided by the Insurance Code, Article 1.14-1, §2, by an unauthorized person or insurer is equivalent to and constitutes an irrevocable appointment by that person or insurer of the commissioner to be the lawful attorney for service o…

If a court of competent jurisdiction has appointed the liquidator as receiver of any person, insurer, or other entity, service of process with respect to that person, insurer, or other entity must be made on the person designated liquidator as receiver. This service of process ha…

Foreign third party administrators doing business in Texas under the Insurance Code, Article 21.07-5, must appoint the commissioner as their agent for service of process and receipt of legal documents. The procedures and fees for service on a third party administrator are governe…

Foreign purchasing groups registered to do business in Texas under the Insurance Code, Article 21.54, must appoint the commissioner as their agent for service of process and receipt of legal documents. Procedures and fees for service of process on purchasing groups are governed b…

A foreign risk retention group registered in this state under the Insurance Code, Article 21.54, must designate the commissioner as its agent for service of process and receipt of legal documents. Procedures and fees for service of process on a risk retention group are governed b…

(a) Requirements for appointment of person in Texas for service of process. As a condition of being issued a certificate of authority to conduct the business of insurance in this state, foreign or alien insurance carriers, including a life, mutual life, nonprofit life, fire, mutu…

(a) Person, place, and time for service. If service of legal process, notice, or demand is to be effected on a company or organization by serving the commissioner, the process, notice, or demand may be served personally or by certified or registered mail. Personal service must be…

(a) Person and place for service. Except as provided by subsection (b) and subsection (c) of this section, a domestic insurance carrier, including a casualty, county mutual, farm mutual, fire, fraternal, life, Lloyd's, mutual other than life, reciprocal, stipulated premium, or ti…

The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise: Commissioner--The commissioner of insurance. Notes 28 Tex. Admin. Code § 7.1402 The provisions of this §7.1402 adopted to be effective A…

The purpose of this subchapter is to clarify and consolidate the procedure for effecting service of process on persons, companies, and other entities doing the business of insurance or conducting related business in the state of Texas, whether licensed or not; to provide general …

(a) The following regulated entities shall be subject to the billing system established by this section: (1) regulated entities submitting filings requiring a fee pursuant to §§3.1, et seq, of this title (relating to Scope); and (2) regulated entities submitting filings requiring…

(a) Regulated entities subject to fees. The regulated entities subject to the fees imposed by this section include all authorized insurers writing any class of insurance in this state that are regulated by Insurance Code Title 2, concerning Texas Department of Insurance; Title 6,…

(a) Requirement for use of specific forms. Life insurance companies reinsuring property and casualty risks under the Insurance Code, Article 5.75-1(h), must effect any reinsurance by using forms promulgated by the State Board of Insurance. (b) Adoption of forms by reference. The …

Each life insurance company engaging in property and casualty reinsurance shall maintain accounting records which adequately reflect the operations of this line of business in a manner similar to that of a property and casualty insurer doing the same kind of business. Notes 28 Te…

(a) No risk, as determined by reserves for unearned premiums, nor any reserve for unpaid losses nor any loss adjustment expenses shall exceed 10% of the life insurance company's total capital and surplus as of the end of the preceding year or impair the dedicated capital and surp…

(a) The conventional operations of any life insurance company shall be accounted for separately from the company's property and casualty reinsurance business. Accordingly, each life insurance company proposing to engage in property and casualty reinsurance shall account for this …

(a) Any authorized life insurance company which, pursuant to the Insurance Code, Article 5.75-1(h), intends to enter into the reinsurance business shall file a notice of intention with the commissioner of insurance for prior approval and shall include each treaty or request to ac…

The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise: Reinsurance--Indemnity reinsurance contracts only. Notes 28 Tex. Admin. Code § 7.1201 The provisions of this §7.1201 adopted to be effec…

(a) Under Insurance Code § 843.156 and for purposes of this section, the term "insurance company" includes a health maintenance organization as defined in Insurance Code § 843.002 . (b) An insurer not organized under the laws of Texas (foreign insurance company) must pay the cost…

These sections are supplementary to and cumulative of existing statutes and sections of the State Board of Insurance. In the case of an ambiguity or contradiction between these sections and any statute, the provisions of the statute control. Notes 28 Tex. Admin. Code § 7.1 The pr…