Texas Administrative Code

(a) This section applies to a county mutual insurance company that cedes 85 percent or more of the company's direct and assumed risks to one or more nonaffiliated reinsurers and the company is otherwise required to comply with the Insurance Code § 912.056(f) . (b) A county mutual…

(a) Purpose. The purpose of implementing a risk-based capital and surplus provision is to require a minimum level of capital and surplus to absorb the financial, underwriting, and investment risks assumed by a carrier. (b) Scope. (1) Life companies. This section applies to any ca…

The portion of any asset not qualifying as a legal investment shall not be admitted. The companies shall dispose of such inadmissible assets or take such action as is necessary to bring the investment into legal compliance. Companies will not be required to dispose of inadmissibl…

Companies operating under the Insurance Code, Chapter 16, which file the annual statement form adopted by the board for farm mutual insurance companies and that have less than $750,000 total direct plus assumed written premiums during a calendar year, are not required to comply w…

(a) Purpose and Scope. The purpose of this section is to describe the procedure an eligible insurer must follow when it desires to relocate and maintain all or any portion of its books, records, and accounts and its principal offices outside this state at a location within the Un…

The value to be reported for each investment under the Insurance Code, Article 4.11, shall be admitted value reflected in the insurer's annual statement as of December 31 of the tax year, except demand deposits of banks, savings and loans, or other financial institutions. Such de…

(a) On or before the 15th day of February of each year, the Texas Catastrophe Property Insurance Association shall certify to the State Board of Insurance the total amount of assessments paid by members and the total amount of claims paid by the association during the preceding c…

(a) Purpose. This section specifies the requirements for the ultimate controlling person of an insurance holding company system to submit a liquidity stress test framework necessary to report information as required by Insurance Code § 823.0596 . (b) Liquidity stress test framewo…

(a) The ultimate controlling person of an insurer in an insurance holding company system for which Texas is the lead state and that is described by paragraphs (1) or (2) of this subsection must annually file a group capital calculation report: (1) an insurance holding company sys…

(a) Enterprise Risk Report is required as follows. Attached Graphic (b) The registrant/applicant, to the best of its knowledge and belief, must provide information regarding the following areas that could produce enterprise risk as defined in § 7.202 of this title (relating to De…

(a) Notice of Ordinary and Extraordinary Dividends and Other Distributions. Complete subsections (a) and (b) of this section for an Ordinary Dividend under § 7.203 (o) of this title (relating to Registration of Insurers) and complete subsections (a) - (c) of this section for an E…

(a) Prior notice of a transaction. Prior notice of a transaction is required as follows. Attached Graphic (b) Identity of parties to transaction. Furnish the following information for each of the parties to the transaction: (1) name; (2) home office address; (3) principal executi…

(a) Summary of Material Changes to Registration Statement is required as follows. Attached Graphic (b) Furnish a brief description of all items in the current annual registration statement which represent material changes from the prior year's annual registration statement. The d…

(a) Insurance holding company system registration statement. Attached Graphic (b) Identity and control of registrant. Furnish the exact name of each insurer registering or being registered ("the registrant"), the home office address and principal executive offices of each; the da…

(a) Statement regarding the acquisition or change of control of a domestic insurer. Submit information concerning the acquisition or change of control of a domestic insurer as specified in subsections (b) - (n) and (p) of this section. Provide the information required in subsecti…

(a) Filing Requirements. Filing and other regulatory requirements for acquisitions, changes of control, or divestitures and certain other matters as specified in the Act, § 823.153 and § 823.154, are governed by the Act, §823.153 and §823.154. For purposes of this subsection, a d…

(a) Prior approval and notice. (1) The prior written approval of the commissioner is required for the transactions specified in the Act, § 823.102. This section only applies to sales, purchases, exchanges, loans or extensions of credit or guarantees, or investments, including an …

(a) Registration. Except as provided by the Act, every insurer authorized or incorporated to do business in this state and is a member of an insurance holding company system must register in accord with the Act. The exemption from registration for a foreign insurer does not apply…

(a) The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise. (1) Act--The Insurance Code, Chapter 823. (2) Affiliate--An affiliate of, or person affiliated with, a specific person is a person that di…

(a) General requirements. (1) The forms specified in §§ 7.209 - 7.214 of this title (relating to Form A, Form B, Form C, Form D, Form E, and Form F, respectively) are guides for preparing the statements, notices, and applications required by Insurance Code Chapter 823. They provi…

Sponsoring organizations governed by Insurance Code, Article 21.35-B, may solicit voluntary contributions with a membership renewal solicitation when the membership renewal solicitation is separate from an insurance billing. Notes 28 Tex. Admin. Code § 7.2001 The provisions of th…

Any and all charges, by whatever name called, made, imposed, and/or collected from an insured and/or premium payor by a county mutual insurance company, shall constitute taxable premiums to the county mutual; except any interest or finance charge clearly identified in a premium n…

Each cause of action, pending litigation, matter in process before the State Board of Insurance or commissioner of insurance, or matter hereafter arising from an event occurring prior to the time these sections become effective shall be determined in accordance with and governed …

(a) This section applies only to a multiple employer welfare arrangement (MEWA) that offers or seeks to offer a comprehensive health benefit plan and that: (1) was issued an initial certificate of authority under §846.054, concerning Issuance of Initial Certificate of Authority, …

(a) A multiple employer welfare arrangement (MEWA) that was issued a certificate of authority under Insurance Code Chapter 846, concerning Multiple Employer Welfare Arrangements, before January 1, 2024, may elect to be subject to certain Insurance Code provisions under Insurance …

In addition to any requirements or remedies set out in Insurance Code § 846.003 , concerning Limited Exemption from Insurance Laws; Applicability of Certain Laws, the commissioner may suspend, revoke, or limit the certificate of authority of a multiple employer welfare arrangemen…

(a) The trustees or directors of a multiple employer welfare arrangement (MEWA) must give the attention and exercise the vigilance, diligence, care, and skill that prudent persons use in like or similar circumstances. Trustees or directors are responsible for all operations of th…

(a) The commissioner or any person appointed by the commissioner will have the power to examine the affairs and conduct of any multiple employer welfare arrangement (MEWA) and for such purposes will have free access to all the books, records, and documents that relate to the busi…

(a) Each multiple employer welfare arrangement (MEWA) transacting business in this state must file annually with the commissioner statements and reports described as follows: (1) within 90 days of the end of the MEWA's fiscal year, financial statements audited by a certified publ…

(a) A multiple employer welfare arrangement (MEWA) licensed under this subchapter may not take any name that is the same as or closely resembles the name of another MEWA possessing a certificate of authority and doing business in this state. A MEWA must complete a name applicatio…

(a) In addition to any other notices required by law, a multiple employer welfare arrangement (MEWA), in connection with an employee welfare benefit plan, must provide to each participating employee or former employee covered by the plan a written notice at the time the coverage …

(a) A multiple employer welfare arrangement (MEWA) licensed under Insurance Code Chapter 846, concerning Multiple Employer Welfare Arrangements, and this subchapter will be limited to providing any one or more of the benefits described as follows: (1) medical, dental, vision, sur…

The commissioner will collect, and the applicant affected must pay to the commissioner, the following fees: (1) filing fee for filing an application for the initial certificate of authority--$5,000; (2) filing fee for final certificate of authority--$1,500; (3) filing fee for app…

(a) If the commissioner refuses to grant a final certificate of authority to an applicant that fails to meet the requirements of § 7.1906 of this title (relating to Application for Final Certificate of Authority), notice of refusal will be in writing. Such notice will set forth t…

(a) A multiple employer welfare arrangement (MEWA) that has received its initial certificate of authority must apply for a final certificate of authority no later than one year after the issuance of its initial certificate of authority. The MEWA must submit a complete application…

(a) The commissioner will promptly review the documentation submitted by the applicant and may conduct any necessary investigation and examine under oath any persons interested in or connected with the multiple employer welfare arrangement (MEWA). Within 60 days of the filing of …

(a) Any person seeking to establish a multiple employer welfare arrangement (MEWA) that is not fully insured, as that term is defined in Insurance Code § 846.002(a) , concerning Applicability of Chapter, must submit a complete application for initial certificate of authority to t…

The following words and terms, when used in this subchapter, have the following meanings unless the context clearly indicates otherwise. (1) Business plan--The comprehensive, detailed plan by which the multiple employer welfare arrangement conducts or proposes to conduct its busi…

(a) This subchapter applies to any multiple employer welfare arrangement that is subject to Insurance Code Chapter 846, concerning Multiple Employer Welfare Arrangements. (b) This subchapter does not apply to any arrangement or plan that is established or maintained: (1) under on…

(a) An insurer that meets the criteria under Insurance Code § 827.008 must file a proposed restriction plan with the Commissioner for review and approval. (b) The plan must be signed by at least one officer of the insurer and must contain the following: (1) identification, in acc…

Any insurer or HMO filing a withdrawal plan must continue to file all annual financial statement data, other required statistical and data filings, other reporting, and any other department-requested information applicable to any withdrawn line until all policyholder obligations …

(a) The department will post forms and instructions on its website to assist persons in complying with the requirements of this subchapter. Any insurer or HMO filing a plan of orderly withdrawal must submit the plan at the location specified on the department website. (b) The wit…

(a) Except for withdrawing HMOs, which are addressed under subsection (b) of this section and insurers meeting the criteria under § 7.1804 (b) of this title (relating to When a Plan is Required), a withdrawing insurer must file a plan of orderly withdrawal with the Commissioner t…

(a) Any authorized insurer or HMO must file with the Commissioner of Insurance a plan of orderly withdrawal before the insurer or HMO undertakes a withdrawal. (1) The insurer or HMO undertakes a withdrawal when it takes any action on its own initiative that will result in the ins…

(a) For purposes of this subchapter, a line of insurance is defined as each line of business as specified in paragraphs (1)(A)-(P), (2)(A)-(PP), and (3)(A)-(K) of this subsection, and including any line written in by the insurer or HMO on the annual statement pages specified in t…

The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise. (1) Annual Statement--Annual statement most recently filed by the insurer or HMO with the Texas Department of Insurance. (2) Association cover…

The purpose of this subchapter is to provide orderly and uniform procedures, as required by law and dictated by sound public policy, for any authorized insurer or HMO filing a plan of withdrawal with the Commissioner of Insurance under Insurance Code Chapter 827. Nothing in this …