This is a clone of the Texas Administrative Code (TAC) for educational purposes. It is not the official version and should not be used for legal purposes. Site created Wed, 21 May 2025 21:16:34 GMT

Back to Sitemap

Title 28 - Part 1 - TEXAS DEPARTMENT OF INSURANCE

Chapter 1 - GENERAL ADMINISTRATION

Subchapter A - RULES OF PRACTICE AND PROCEDURE

1.1 - Objective and Scope
1.2 - Definitions
1.3 - Construction
1.4 - Records of Official Action
1.5 - Hearings
1.6 - Conduct and Decorum
1.7 - Computation of Time
1.8 - Appearances and Right to Attorney
1.9 - Failure To Appear at Hearing
1.10 - Recordings of Hearings
1.11 - Order of Presentation
1.12 - Testimony under Oath
1.13 - Limitations on Number of Witnesses
1.14 - Motions during Hearings
1.15 - Exhibits
1.16 - Effective Date of Official Acts or Orders in Nonrulemaking and Noncontested Case Matters
1.18 - Stay of Official Acts or Orders
1.27 - Official Action To Be Taken
1.28 - Notice and Service
1.29 - Pleadings
1.30 - Ex Parte Consultations
1.31 - Agreements To Be in Writing
1.32 - Licenses
1.33 - Depositions; Entry on Property; Use of Reports and Statements
1.34 - Written Depositions
1.35 - Mileage and Witness Fees
1.36 - Subpoenaing Witnesses and Materials
1.37 - Prehearing Conference
1.38 - Briefs
1.39 - Form and Content of Briefs, Exceptions, and Replies
1.40 - Motions for Postponement
1.41 - Presentation of Evidence in a Contested Case
1.42 - Witness Placed under Rule
1.43 - Evidence
1.44 - Prepared Testimony
1.45 - Exceptions
1.46 - Excluded Testimony
1.47 - Informal Disposition After Notice of Allegations
1.50 - Record
1.53 - Summary Procedures
1.54 - The Insurance Code, Chapter 5, Subchapter L
1.60 - Petition for Adoption of Rules
1.68 - Initiating Proceedings before the Board
1.78 - Initiating Proceedings before the Commissioner or the Fire Marshal
1.79 - Commissioner's or Fire Marshal's Hearing Docket
1.80 - Setting of Commissioner's or Fire Marshal's Hearings
1.81 - Place of Commissioner's or Fire Marshal's Hearings
1.82 - Forms and Scope of Discovery in Contested Cases
1.83 - Service and Filing of Discovery Requests and Responses
1.84 - Deadlines for Responses to Discovery Requests
1.85 - Requests for Admission
1.86 - Discovery Orders
1.90 - Joint Memorandum of Understanding (MOU) between Texas Department of Insurance (TDI) and State Office of Administrative Hearings (SOAH) Concerning Procedures for Contested Cases before SOAH and Responsibilities of Each Agency
1.201 - Staff Proposals or Petitions for Rule Making
1.202 - Public Proposals or Petitions for Rule Making
1.203 - Publication and Comments on Proposals for Rule Making
1.204 - Final Action for Rule Proposals Where a Hearing Is Neither Requested nor Required
1.205 - Final Action for Rule Proposals Where a Hearing or Meeting Is Requested or Required
1.206 - Post Rule Adoption Procedures by the Office of the Chief Clerk
1.207 - List and Copies of Pending Petitions for Rule Proposals
1.208 - Applicability
1.209 - Telephone, Fax, Email Address, Website Address, and Department Addresses in Rules, Forms
1.210 - Notice to Customers

Subchapter B - FEES, CHARGES, AND COSTS

1.301 - Charges for Copies of Public Records
1.302 - Charges for Affixing the Official Seal and Certifying to the Seal

Subchapter C - ASSESSMENT OF MAINTENANCE TAXES AND FEES

1.414 - Assessment of Maintenance Taxes and Fees

Subchapter D - EFFECT OF CRIMINAL CONDUCT

1.501 - Purpose and Application
1.502 - Licensing Persons with Criminal Backgrounds
1.503 - Application of Fingerprint Requirement
1.504 - Fingerprint Requirement
1.505 - Nonresident Agents and Adjusters
1.506 - Insurance Companies and Related Entities
1.507 - Other Licensees and Registrants
1.508 - Use and Confidentiality of Fingerprints
1.509 - Fingerprint Format and Complete Application

Subchapter E - NOTICE OF TOLL-FREE TELEPHONE NUMBERS AND PROCEDURES FOR OBTAINING INFORMATION AND FILING COMPLAINTS

1.601 - Notice of Toll-Free Telephone Numbers and Information and Complaint Procedures
1.602 - Notice of Website
1.603 - Complaint Information Available through the Texas Department of Insurance's Toll-Free Telephone Number

Subchapter F - SUMMARY PROCEDURES FOR ROUTINE MATTERS

1.701 - Purpose and Scope
1.702 - Designated Activities
1.703 - Delegation
1.704 - Summary Procedure; Notice
1.705 - Review

Subchapter G - NOTICE AND PROCESSING PERIODS FOR PERMIT APPLICATIONS

1.801 - Purpose and Scope
1.802 - Definitions
1.803 - Computation of Time
1.804 - Manner of Notice
1.805 - Written Notice Not Required
1.806 - Agent's License
1.807 - Company License
1.808 - Application for Foreign Admission
1.809 - HMO Certificate of Authority
1.810 - Insurance Premium Finance License
1.811 - Policy Approval
1.812 - State Fire Marshal Permits
1.813 - Appeal
1.814 - Military Service Member, Military Veteran, and Military Spouse

Subchapter H - EMERGENCY CEASE AND DESIST ORDERS

1.901 - Issuance of Emergency Cease and Desist Orders
1.903 - Contents of the Emergency Cease and Desist Order
1.905 - Request for Hearing on Emergency Cease and Desist Orders

Subchapter I - DISCLOSURE OF GUARANTY FUND NONPARTICIPATION

1.1001 - Disclosure of Guaranty Fund Nonparticipation

Subchapter J - PROCEDURES FOR VENDOR PROTESTS OF PROCUREMENTS

1.1101 - Purpose
1.1102 - Filing of Protest
1.1103 - Review of Protest and Determination
1.1104 - Appeal
1.1105 - Failure to File Timely
1.1106 - Status of Procurement During Protest and Appeal
1.1107 - Retention of Documents

Subchapter K - SICK LEAVE POOL

1.1201 - Sick Leave Pool

Subchapter L - ELECTRONIC SUBMISSIONS AND COMMUNICATIONS

1.1301 - Electronic Submissions
1.1302 - Electronic Communications from the Texas Department of Insurance

Subchapter M - PROBATION OF AGENTS BASED ON CERTAIN DISABILITIES

1.1501 - General Provisions and Definitions
1.1502 - Request for Probation in Lieu of Suspension, Revocation, or Cancellation of License
1.1503 - Procedures for Placing an Agent on Probation
1.1504 - Contents of Order Granting Probation
1.1505 - Appeal from Commissioner's Order of Probation
1.1506 - Revocation of Probation

Subchapter N - HISTORICALLY UNDERUTILIZED BUSINESSES

1.1601 - Historically Underutilized Businesses

Subchapter O - COLLECTION OF DELINQUENT DEBTS

1.1701 - Referrals of Delinquent Obligations to the Office of the Attorney General for Collection
1.1702 - Records
1.1703 - Exceptions

Subchapter P - NEGOTIATION AND MEDIATION OF A CLAIM OF BREACH OF CONTRACT

1.1801 - Purpose
1.1802 - Applicability
1.1803 - Definitions
1.1804 - Prerequisites to Suit
1.1805 - Sovereign Immunity
1.1806 - Notice of Claim of Breach of Contract
1.1807 - Agency Counterclaim
1.1808 - Duty to Negotiate
1.1809 - Timetable
1.1810 - Conduct of Negotiation
1.1811 - Settlement Approval Procedures
1.1812 - Settlement Agreement
1.1813 - Costs of Negotiation
1.1814 - Request for Contested Case Hearing
1.1815 - Mediation Timetable
1.1816 - Mediation of Contract Disputes
1.1817 - Qualifications and Immunity of the Mediator
1.1818 - Confidentiality of Mediation and Final Settlement Agreement
1.1819 - Costs of Mediation
1.1820 - Settlement Approval Procedures
1.1821 - Initial Settlement Agreement
1.1822 - Final Settlement Agreement
1.1823 - Referral to the State Office of Administrative Hearings

Subchapter Q - ASSIGNMENT AND USE OF AGENCY VEHICLES

1.1901 - Purpose
1.1902 - Use of Department Vehicles
1.1903 - Assignment of Department Vehicles
1.1904 - Waiver or Exemption

Subchapter U - ENHANCED CONTRACTS AND PERFORMANCE MONITORING

1.2201 - Enhanced Contracts and Performance Monitoring
1.2801 - Purpose and Applicability
1.2802 - Right To Be Informed About Information Collected
1.2803 - Notice About Certain Information Laws and Practices
1.2828 - Advisory Committees
1.3101 - General Provisions
1.3102 - Eligibility requirements
1.3103 - Participation
1.3104 - Obligations
1.3105 - No Effect on At-Will Status

Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES

Subchapter A - SUBMISSION REQUIREMENTS FOR FILINGS AND DEPARTMENTAL ACTIONS RELATED TO SUCH FILINGS

3.1 - Scope
3.2 - Definitions
3.3 - Transmittal Information
3.4 - General Submission Requirements
3.5 - Filing Authorities and Categories
3.6 - Certifications, Attachments, and Additional Information Requirements
3.7 - Form Acceptance and Procedures
3.8 - Effective Date

Subchapter C - APPROVAL, DISAPPROVAL, AND WITHDRAWAL OF APPROVAL OF CERTAIN PARTICIPATING POLICY FORMS

3.201 - Definition of Certain Participating Policies
3.202 - Specification of Certain Participating Policies
3.203 - Instructions to Commissioner
3.204 - Material and Information for the Commissioner To Consider
3.205 - Construction of Rules

Subchapter E - GROUP LIFE, AND/OR GROUP ACCIDENT AND HEALTH INSURANCE POLICIES AND CERTIFICATES

3.408 - Mandatory Policy Provisions

Subchapter F - RATE REVIEW FOR HEALTH BENEFIT PLANS

3.501 - Purpose and Applicability
3.502 - Definitions
3.503 - Rating Standards
3.504 - Geographic Rating Areas
3.505 - Required Rate Filings
3.506 - Review of Rate Filings
3.507 - Public Disclosure and Input

Subchapter G - PLAIN LANGUAGE REQUIREMENTS FOR HEALTH BENEFIT POLICIES

3.601 - Purpose and Scope, Applicability, and Definitions Used in This Subchapter
3.602 - Plain Language Requirements

Subchapter K - MAXIMUM GUARANTEED INTEREST RATES FOR ANNUITIES, PURE ENDOWMENT CONTRACTS, AND MISCELLANEOUS FUNDS

3.1001 - Authority
3.1002 - Purpose
3.1003 - Unallocated Group Annuity
3.1004 - Policy Form Review
3.1005 - Reserve Requirements
3.1006 - Early Warning Requirements
3.1007 - Disclosure Requirements
3.1008 - Application
3.1009 - Effective Date

Subchapter M - DISCRETIONARY CLAUSES

3.1201 - Applicability, Effective Dates, and Severability
3.1202 - Discretionary Clauses Defined
3.1203 - Discretionary Clauses Prohibited

Subchapter R - LIFE SETTLEMENT

3.1701 - Purpose and Severability
3.1702 - Applicability and Scope
3.1703 - Definitions
3.1720 - Forms
3.1721 - License Application; Fees
3.1722 - Renewal; Nonrenewal; Surrender; Change of Information; and Fees
3.1723 - Course and Training Requirements for Brokers
3.1724 - Continuing Education Providers
3.1725 - Life Insurance Agent Notification
3.1726 - Life Expectancy Estimators
3.1727 - Unauthorized Insurance
3.1728 - Life Settlement Broker Fiduciary Duty
3.1729 - Maintenance of Records
3.1730 - Health Status Verification
3.1740 - Form Filing Requirements and Approval, Disapproval, or Withdrawal of Forms; Fees
3.1741 - Required Form Provisions
3.1742 - Shopper's Guide
3.1743 - Prohibited Life Settlements
3.1744 - Advertising, Sales, and Solicitation Materials; Filing Prior to Use
3.1760 - Reporting Requirements

Subchapter S - MINIMUM STANDARDS AND BENEFITS AND READABILITY FOR INDIVIDUAL ACCIDENT AND HEALTH INSURANCE POLICIES

3.3001 - Applicability and Scope
3.3002 - Definitions
3.3005 - Definitions in Policies
3.3006 - Policy Definition of Hospital
3.3007 - Policy Definition of Convalescent Nursing Home or Extended Care Facility
3.3008 - Policy Definitions of Accident, Accidental Injury, Injury
3.3009 - Policy Definitions of Sickness
3.3010 - Policy Definition of Physician
3.3011 - Policy Definition of Nurse
3.3012 - Policy Definition of Total Disability
3.3013 - Policy Definition of Partial Disability
3.3014 - Policy Definition of Residual Disability
3.3015 - Policy Definition of Medicare
3.3016 - Policy Definition of Mental or Nervous Disorders
3.3017 - Policy Definition of One Period of Confinement--Continuous Hospital Confinement
3.3018 - Policy Definition of Preexisting Condition
3.3019 - Policy Definition of Noncancellable
3.3020 - Policy Definition of Guaranteed Renewable and Limited Guarantee of Renewability
3.3021 - Policy Definition of Complication of Pregnancy
3.3038 - Mandatory Guaranteed Renewability Provisions for Individual Hospital, Medical, or Surgical Coverage; Exceptions
3.3039 - Other Mandatory Policy Provisions
3.3040 - Prohibited Policy Provisions
3.3050 - Standards for Renewability Provisions
3.3051 - Initial and Subsequent Conditions of Eligibility Provision
3.3052 - Standards for Termination of Insurance Provision
3.3054 - Preexisting Conditions Provisions
3.3055 - Standards for Probationary or Waiting Period Provision
3.3056 - Standards for Limitations Provision
3.3057 - Standards for Exceptions, Exclusions, and Reductions Provision
3.3058 - Standards for Elimination Period Provision
3.3059 - Standards for Recurrent Disabilities Provision
3.3060 - Standards for Conversion Privileges Provision
3.3061 - Standards for Requirements for Replacement Provision
3.3062 - Conditional Receipts
3.3070 - Minimum Standards for Benefits Generally
3.3071 - Minimum Standards for Basic Hospital Expense Coverage
3.3072 - Minimum Standards for Basic Medical-Surgical Expense Coverage
3.3073 - Minimum Standards for Hospital Confinement Indemnity Coverage
3.3074 - Minimum Standards for Major Medical Expense Coverage
3.3075 - Minimum Standards for Disability Income Protection Coverage
3.3076 - Minimum Standards for Accident Only Coverage
3.3077 - Minimum Standards for Specified Disease and Specified Accident Coverage
3.3079 - Minimum Standards for Limited Benefit Coverage
3.3080 - Supplemental Coverage
3.3081 - Nonconventional Coverage
3.3090 - Outline of Coverage Generally
3.3091 - Notice Requirements for Outline of Coverage of Limited Benefit, Supplemental and Non-conventional Coverages
3.3092 - Format, Content, and Readability for Outline of Coverage
3.3093 - Prescribed Outlines of Coverage
3.3100 - Policy Readability Generally
3.3101 - Organization of Policy Format for Readability
3.3102 - Language Readability
3.3110 - Effective Date; Applicability of Certain Provisions to Policies Deemed Continuous under Insurance Code
3.3111 - Severability Clause

Subchapter T - MINIMUM STANDARDS FOR MEDICARE SUPPLEMENT POLICIES

3.3301 - Purpose
3.3302 - Applicability and Scope
3.3303 - Definitions
3.3304 - Policy Definitions and Terms
3.3305 - Policy Provisions
3.3306 - Minimum Benefit Standards
3.3307 - Loss Ratio Standards and Refund or Credit of Premiums
3.3308 - Required Disclosure Provisions
3.3309 - Requirements for Application Forms and Replacement Coverage
3.3310 - Severability
3.3312 - Guaranteed Issue for Eligible Persons
3.3313 - Filing Requirements for Advertising
3.3315 - Standards for Claims Payment
3.3316 - Filing Requirements for Out-of-State Group Policies
3.3317 - Permitted Compensation Arrangements
3.3319 - Standards for Marketing
3.3320 - Appropriateness of Recommended Purchase and Excessive Insurance
3.3321 - Reporting of Multiple Policies
3.3322 - Filing and Approval of Policies, Certificates and Premium Rates; Discontinuance of Forms
3.3323 - Increases to Premium Rates
3.3324 - Open Enrollment
3.3325 - Medicare Select Policies, Certificates and Plans of Operation
3.3326 - Prohibition Against Use of Genetic Information and Requests for Genetic Testing in Medicare Supplement Policies

Subchapter U - NEWBORN CHILDREN COVERAGE

3.3401 - Purpose
3.3402 - Applicability and Scope
3.3403 - General Rules of Application

Subchapter V - COORDINATION OF BENEFITS

3.3501 - Purpose
3.3502 - Applicability
3.3503 - Definitions
3.3504 - General Prohibition
3.3505 - Allowable Expenses
3.3506 - Use of the Term "Plan" in Contracts
3.3507 - Rules for COB and Order of Benefits
3.3508 - Procedure to be Followed by Secondary Plan
3.3509 - Miscellaneous Provisions
3.3510 - Model COB Contract Provisions

Subchapter W - MISCELLANEOUS RULES FOR GROUP AND INDIVIDUAL ACCIDENT AND HEALTH INSURANCE

3.3601 - Orthodontic Coverages
3.3602 - Requirements for Short-Term Limited-Duration Coverage
3.3603 - Purpose and Scope
3.3604 - Notice for Policies That Provide Benefits for Expenses Incurred for an Accidental Injury Only
3.3605 - Policies That Provide Benefits for Specified Limited Services
3.3606 - Policies That Reimburse Expenses Incurred for Specified Diseases or Impairments
3.3607 - Policies That Pay Fixed Dollar Amounts for Specified Diseases or Impairments
3.3608 - Indemnity or Other Policies That Pay a Fixed Dollar Amount Per Day
3.3609 - Policies That Provide Benefits upon Both an Expense-Incurred and Fixed Indemnity Basis
3.3613 - Other Health Insurance Policies
3.3614 - Notice Regarding Policies or Certificates Which Are Not Medicare Supplement Policies

Subchapter X - PREFERRED AND EXCLUSIVE PROVIDER PLANS

3.3701 - Applicability and Scope
3.3702 - Definitions
3.3703 - Contracting Requirements
3.3704 - Freedom of Choice; Availability of Preferred Providers
3.3705 - Nature of Communications with Insureds; Readability, Mandatory Disclosure Requirements, and Plan Designations
3.3706 - Designation as a Preferred Provider, Decision to Withhold Designation, Termination of a Preferred Provider, Review of Process
3.3707 - Waiver Due to Failure to Contract in Local Markets
3.3708 - Payment of Certain Out-of-Network Claims
3.3709 - Annual Network Adequacy Report
3.3710 - Failure to Provide an Adequate Network
3.3711 - Geographic Regions
3.3712 - Network Configuration Filings
3.3720 - Preferred and Exclusive Provider Benefit Plan Requirements
3.3721 - Preferred and Exclusive Provider Benefit Plan Network Approval Required
3.3722 - Application for Preferred and Exclusive Provider Benefit Plan Approval; Qualifying Examination; Network Modifications
3.3723 - Examinations
3.3724 - Quality Improvement Program

Subchapter Y - STANDARDS FOR LONG-TERM CARE INSURANCE, NON-PARTNERSHIP AND PARTNERSHIP LONG-TERM CARE INSURANCE COVERAGE UNDER INDIVIDUAL AND GROUP POLICIES AND ANNUITY CONTRACTS, AND LIFE INSURANCE POLICIES THAT PROVIDE LONG-TERM CARE BENEFITS WITHIN THE POLICY

3.3801 - Authority
3.3802 - Purpose
3.3803 - Applicability and Severability
3.3804 - Definitions
3.3805 - Standards in Policies
3.3806 - Initial and Subsequent Conditions of Eligibility
3.3807 - Policy or Certificate Standards for Guaranteed Renewability
3.3810 - Policy or Certificate Standards for Noncancellability
3.3812 - Policy Standards for Provider
3.3815 - Standards for Home Health and Adult Day Care Benefits
3.3818 - Standards for Eligibility for Benefits
3.3819 - Requirement for Reserve
3.3820 - Requirement To Offer Inflation Protection
3.3821 - Limits on Group Long-Term Care Insurance
3.3822 - Minimum Standard for Renewability of Long-term Care Coverage
3.3823 - Prohibited Policy Provisions; Required Disclosures
3.3824 - Preexisting Conditions Provisions
3.3825 - Prior Hospitalization or Institutionalization
3.3826 - Limitations and Exclusions
3.3827 - Extension of Benefits
3.3828 - Continuation or Conversion; Discontinuance and Replacement
3.3829 - Required Disclosures
3.3830 - Requirements for Application Forms and Replacement Coverage
3.3831 - Standards and Rates
3.3832 - Outline of Coverage
3.3833 - Group Certificates; Outline of Coverage Required
3.3834 - Organization of Policy Format for Readability
3.3835 - Language Readability
3.3836 - Standards for Policy Certificates Submitted for Approval
3.3837 - Reporting Requirements
3.3838 - Filing Requirements for Advertising
3.3839 - Standards for Marketing
3.3840 - Requirements To Deliver Shopper's Guide
3.3841 - Unintentional Lapse and Reinstatement
3.3842 - Appropriateness of Recommended Purchase
3.3843 - Premium Rate Restrictions
3.3844 - Nonforfeiture and Contingent Nonforfeiture Benefits
3.3845 - Permitted Refunds of Premium Provisions
3.3846 - Incontestability Period
3.3847 - Qualified Long-Term Care Insurance Contracts: Prohibited Representations
3.3848 - Requirements for Limited Premium Payment Options in Long-Term Care Policies, Certificates, and Riders
3.3849 - Requirements for Insurers that Issue Long-Term Care Policies to Associations and Marketing Standards for Associations that Market the Policies
3.3860 - Policy Summary Requirements for Non-Partnership Life Insurance Policies and Annuity Contracts that Provide Long-Term Care Benefits
3.3870 - Exchange Requirements for Long-Term Care Partnership Policies
3.3871 - Standards and Reporting Requirements for Approved Long-Term Care Partnership Policies and Certificates
3.3872 - Inflation Protection Requirements for Long-Term Care Partnership Policies and Certificates
3.3873 - Filing Requirements for Long-Term Care Partnership Policies
3.3874 - Insurer Requirements for Agents That Market Partnership Policies and Certificates

Subchapter Z - EXEMPTION FROM REVIEW AND APPROVAL OF CERTAIN LIFE, ACCIDENT, HEALTH AND ANNUITY FORMS AND EXPEDITION OF REVIEW

3.4001 - Purpose
3.4002 - All Forms To Be Filed for Review Unless Specifically Exempted
3.4004 - Exempt Forms
3.4005 - General Information
3.4006 - New, Uncommon, and Unusual Forms
3.4007 - Newly Licensed Insurers
3.4008 - Procedures for Corrections to Non-Compliant Exempt Forms
3.4009 - Sanctions
3.4020 - Appendix
3.4101 - Purpose
3.4102 - Coverage Which May Be Exempted
3.4103 - Obtaining Exemptions
3.4104 - Duration of Exemptions
3.4105 - Disciplinary Measures
3.4201 - Scope
3.4202 - Definitions
3.4203 - Notification and Information to Pharmacies and Pharmacists
3.4204 - Pharmacy Application and Recertification
3.4205 - Contracts for Pharmaceutical Services
3.5001 - Authority and Scope
3.5002 - Definitions
3.5101 - Debtor's Choice of Insurer
3.5102 - Delivery to Debtor
3.5103 - Policy Provisions
3.5104 - Benefits and Refunds
3.5105 - Application Provisions
3.5106 - Prohibited Provisions and Practices
3.5108 - Termination of Coverage
3.5109 - Interest on Premiums
3.5111 - Open-End Transaction Forms
3.5201 - Submission of Form and Rate Filings
3.5202 - Reasonable Relation of Benefits to Premiums for Approved Deviations
3.5203 - Earned Premiums
3.5204 - Claims Incurred
3.5205 - Policies and Applications
3.5206 - Presumptive Premium Rates
3.5302 - Joint Credit Life Insurance
3.5304 - Premiums for Obligations Paid in Other Than Equal Monthly Installments
3.5305 - Conditions of Life Insurance Benefits
3.5306 - Premiums Based on Age
3.5307 - Standard for Additional Benefits
3.5501 - Standards and Principles for the Application of the Rates
3.5502 - Joint Credit Accident and Health Insurance
3.5601 - Deviation by Case Allowed
3.5602 - Request for an Approved Deviated Premium Rate
3.5603 - Credibility Table
3.5604 - Minimum Change
3.5605 - Effective Date of Deviated Rate
3.5606 - Effective Period of Downward Deviated Case Rate
3.5607 - Termination of Upward Deviated Case Rate
3.5608 - Annual Review of Approved Deviated Rates
3.5609 - Notice of Change of Insurer on Deviated Rates Required
3.5610 - Determination of Approved Deviated Case Rates
3.5701 - Statistical Data
3.5801 - Proposal for Other Types of Coverage
3.5901 - Refund of Unearned Premiums
3.5902 - Procedures for Payment of Refunds
3.5903 - Responsibility for Refunds
3.5904 - Refund Formula in Policy
3.5905 - Refunds
3.5906 - Treatment of Partial Months
3.6001 - Responsibilities of Insurers
3.6002 - Delegation by Insurer of Responsibilities of Policy Issuance and Premium Collection
3.6003 - Restrictions on Interest of Creditors under Group and Individual Policies
3.6004 - Delegation by Insurer of Certain Functions
3.6005 - Claim Files Maintained by Insurer
3.6006 - Proofs of Loss
3.6007 - Method of Claims Payment
3.6008 - Additional Restrictions on Settlement and Adjustment of Claims
3.6009 - Insurer's Annual Audit of Credit Insurance Operations
3.6010 - Availability of Source Documents
3.6011 - Responsibility and Obligation of Insurers to Provide Copies of Consumer Bill of Rights for Credit Life, Credit Disability, and Credit Involuntary Unemployment Insurance to Each Insured
3.6101 - Policy Reserves
3.6102 - Claims Reserves
3.6201 - Unfair Methods of Competition
3.6301 - Experience Refunds
3.6401 - Effective Date
3.6402 - Savings Clause
3.6403 - Severability
3.7001 - Introduction
3.7002 - Claim Reserves
3.7003 - Premium Reserves
3.7004 - Contract Reserves
3.7005 - Reinsurance
3.7006 - Specific Standards for Morbidity, Interest, and Mortality
3.7007 - Glossary of Technical Terms Used
3.7008 - Reserves for Waiver of Premium
3.7009 - Purchase or Assumption of Existing Business
3.7010 - Severability
3.8001 - Chemical Dependency Treatment Standards
3.9201 - Application
3.9202 - Definitions
3.9203 - Policy and Premium Rates
3.9204 - Contracting with Health Care Providers
3.9205 - Compliance of Limited Provider Network
3.9206 - Quality Improvement and Utilization Management
3.9207 - Credentialing Requirements for Health Care Providers
3.9208 - Provider Network: Accessibility and Availability
3.9209 - Mandatory Disclosure Requirements
3.9210 - Complaints System
3.9211 - Filing of Complaints
3.9212 - Appeal of Non-Medicaid Adverse Determinations
3.9301 - Purpose
3.9302 - Definitions
3.9303 - Acceptance of Donations
3.9304 - Limitations on Offerees and Donors
3.9305 - Limitations on Entities Subject to Department Regulation
3.9306 - Procedures for Acceptance of Donations
3.9801 - Definitions and General Provisions
3.9802 - Provider Network Contracting Entity Registration Form Required
3.9803 - Provider Network Contracting Entity Exemption of Affiliates Form Required
3.9804 - Required Fees
3.9805 - Express Authority
3.9901 - Valuation Manual
3.9902 - Single State Company Exemptions

Chapter 4 - LIFE AND ANNUITY

Subchapter C - CONSUMER NOTICES FOR LIFE INSURANCE POLICY AND ANNUITY CONTRACT REPLACEMENTS

4.201 - Purpose
4.202 - Definitions
4.203 - Consumer Notice Content and Format Requirements
4.204 - Consumer Notice Regarding Replacement for Insurers Using Agents
4.205 - Direct Response Consumer Notices
4.206 - Filing Procedures for Substantially Similar Consumer Notices

Subchapter F - INDIVIDUAL LIFE INSURANCE POLICY FORM CHECKLIST AND AFFIRMATIVE REQUIREMENTS

4.601 - Payment of Premiums
4.602 - Grace Period
4.603 - Entire Contract
4.604 - Incontestable Clause
4.605 - Statements of the Insured
4.606 - Misstatement of Age
4.607 - Policy Loans
4.608 - Automatic Nonforfeiture Benefits
4.609 - Automatic Premium Loans
4.610 - Cash Value
4.611 - Reinstatement
4.612 - Payment of Claims
4.613 - Family Group Special Requirements
4.614 - Dependent Child Riders and Family Term Riders
4.615 - Requirements for a Package Consisting of a Deferred Life Policy with an Accidental Death Rider Attached
4.616 - Substitute or Change of Insured Riders
4.617 - Preliminary Term Life Insurance
4.618 - Conversion Provision
4.619 - Limitations of Lawsuits
4.620 - Backdating Policies
4.621 - Settlement at Maturity
4.622 - Tontine Provisions
4.623 - Assignment Provisions
4.624 - Provisions Relating to Dividends, Coupon Benefits, or Other Guaranteed Returns
4.625 - Premiums Paid in Advance
4.626 - Annuity Contracts
4.627 - Certain Prohibited Provisions
4.628 - Renewal Premium on Term Policies

Subchapter J - INDETERMINATE PREMIUM REDUCTION POLICIES

4.1001 - Purpose and Scope
4.1002 - Policy Form Submission
4.1003 - Solicitation and Advertising
4.1004 - Summary of Provisions
4.1005 - Relation of Initial to Later Premium Charge
4.1006 - Premium Redetermination
4.1007 - Reclassification of Policyholders
4.1008 - Minimum Nonforfeiture Values
4.1010 - Artificial Maximum Premiums Prohibited
4.1011 - General Enforcement

Subchapter K - STANDARDS FOR ACCELERATION-OF-LIFE-INSURANCE BENEFITS FOR INDIVIDUAL AND GROUP POLICIES AND RIDERS

4.1101 - Purpose; Severability
4.1102 - Acceleration-of-Life-Insurance: Scope of Benefits
4.1103 - Required Policy Definitions; Evidence of Total and Permanent Disability
4.1104 - Standards for Medical Diagnoses
4.1105 - Termination of Benefit upon Exercise of Nonforfeiture Option
4.1106 - Methods for Determining Benefits and Allowable Charges and Fees
4.1107 - Limitations on Reduction of Cash Values
4.1108 - Pro Rata Reduction of Loan upon Acceleration of Benefits
4.1109 - Effect of Acceleration of Benefits on Nonforfeiture Calculations
4.1110 - Calculation of Reserves
4.1111 - Unfair, Discriminatory or Deceptive Practices Prohibited
4.1112 - Notice and Disclosure Requirements for Life Insurance Contracts Containing Acceleration-of-Life-Insurance Benefits
4.1113 - Notice and Disclosure Requirements for Marketing Materials
4.1114 - Requirements for Acceleration-of-Life-Insurance Benefits That Fund Long-Term Care Expenses
4.1115 - Requirements for Benefits Represented To Be Qualified for Favorable Federal Tax Treatment
4.1116 - Disclosures Related to Tax Qualification of Benefits and Benefits' Effect on Public Assistance

Subchapter L - INSURANCE SOLD IN CONNECTION WITH PREPAID FUNERAL CONTRACTS

4.1201 - Introduction to Joint Memorandum of Understanding
4.1202 - Joint Memorandum of Understanding

Subchapter O - VARIABLE LIFE INSURANCE

4.1501 - Purpose and Scope
4.1502 - Definitions
4.1503 - Qualifications of Insurer to Issue Variable Life Insurance
4.1504 - Insurance Contract and Filing Requirements
4.1505 - Reserve Liabilities for Variable Life Insurance
4.1506 - Separate Accounts
4.1507 - Information Furnished to Applicants
4.1508 - Application
4.1509 - Reports to Contract Holders
4.1510 - Separability
4.1511 - Savings Clause

Subchapter P - REQUIRED REINSTATEMENT RELATING TO MENTAL INCAPACITY OF THE INSURED FOR INDIVIDUAL LIFE POLICIES WITHOUT NONFORFEITURE BENEFITS

4.1601 - Purpose and Scope
4.1602 - Applicability
4.1603 - Severability
4.1604 - Definitions
4.1605 - Eligibility Requirements
4.1606 - Payment of Past Due Premiums
4.1607 - Coverage Dates Back to Date of Lapse
4.1608 - Exceptions to Reinstatement
4.1609 - Notification and Disclosure Requirements
4.1610 - Reinstatement Procedures
4.1611 - Reduced Benefits
4.1612 - Form Filing Procedures
4.1613 - Notice and Disclosure Form

Subchapter Q - NONFORFEITURE STANDARDS FOR INDIVIDUAL LIFE INSURANCE IN EMPLOYER PENSION PLANS

4.1701 - Purpose
4.1702 - Definitions
4.1703 - Standard
4.1704 - Alternate Rule
4.1705 - Unfair Discrimination
4.1706 - Severability
4.1707 - 2001 CSO Mortality Table

Subchapter U - VARIABLE ANNUITIES

4.2101 - Purpose and Scope
4.2102 - Definitions
4.2103 - Qualifications of Insurer To Issue Variable Annuities
4.2104 - Separate Accounts
4.2105 - Contract Requirements
4.2106 - Separability

Subchapter W - ANNUITY DISCLOSURES

4.2301 - Purpose
4.2302 - Applicability and Scope
4.2303 - Effective Date
4.2304 - Definitions
4.2305 - Determinable Elements
4.2306 - Guaranteed and Non-Guaranteed Elements
4.2307 - Effect on Other Law
4.2308 - Required Consumer Notices
4.2309 - Disclosure Document
4.2310 - Buyer's Guide
4.2311 - Free Look Period
4.2312 - Report to Contract Owners
4.2321 - Purpose
4.2322 - Required Forms
4.2701 - Purpose
4.2702 - Definitions
4.2703 - Individual Annuity or Pure Endowment Contracts
4.2704 - Group Annuity or Pure Endowment Contracts
4.2705 - Application of the 1994 GAR Table
4.2706 - Application of the 2012 IAR Mortality Table
4.2711 - Purpose
4.2712 - Definitions
4.2713 - Alternate Tables
4.2714 - Conditions
4.2715 - Severability
4.2716 - 2001 CSO Mortality Table
4.2721 - Purpose
4.2722 - Definitions
4.2723 - 2001 CSO Mortality Table
4.2724 - Conditions
4.2725 - Applicability of the 2001 CSO Mortality Table to Chapter 4, Subchapter BB, Division 3 of this Title
4.2726 - Gender-Blended Tables
4.2731 - Purpose
4.2732 - Definitions
4.2733 - 2001 CSO Preferred Class Structure Table
4.2734 - Conditions
4.2801 - Purpose
4.2802 - Scope and Applicability
4.2803 - Commissioner Discretion
4.2804 - Definitions
4.2805 - General Requirements
4.2806 - Statement of Actuarial Opinion Based on an Asset Adequacy Analysis
4.2807 - Description of Actuarial Memorandum Including an Asset Adequacy Analysis and Regulatory Asset Adequacy Issues Summary
4.2808 - Asset Adequacy Analysis Exemption
4.2811 - Strengthened Reserves Under Insurance Code §425.067
4.2821 - Purpose
4.2822 - Adoption of Tables of Select Mortality Factors
4.2823 - Applicability
4.2824 - Definitions
4.2825 - General Calculation Requirements for Basic Reserves and Premium Deficiency Reserves
4.2826 - Calculation of Minimum Valuation Standard for Policies with Guaranteed Nonlevel Gross Premiums or Guaranteed Nonlevel Benefits (Other than Universal Life Policies)
4.2827 - Calculation of Minimum Valuation Standard for Flexible Premium and Fixed Premium Universal Life Insurance Policies That Contain Provisions Resulting in the Ability of a Policyowner to Keep a Policy in Force Over a Secondary Guarantee Period
4.2828 - Effective Date
4.2829 - 2001 CSO Mortality Table
4.2831 - Purpose and Applicability
4.2832 - Definitions
4.2833 - Minimum Valuation Mortality Standards
4.2834 - Minimum Valuation Interest Rate Standards
4.2835 - Minimum Valuation Method Standards
4.2836 - Transitional Use of the 2001 CSO Mortality Table

Chapter 5 - PROPERTY AND CASUALTY INSURANCE

Subchapter A - AUTOMOBILE INSURANCE

5.11 - Certificates of Assumption
5.101 - Permissible Dividend Classes, Motor Vehicle Insurance
5.102 - Other Restrictions on the Payment of Dividends, Motor Vehicle Insurance
5.103 - Dividend Application Form, Motor Vehicle Insurance
5.201 - Texas Automobile Insurance Plan
5.202 - Physical Examinations in Motor Vehicle Insurance Underwriting
5.203 - Certificates of Insurance to Third Parties, Automobile Insurance
5.204 - Motor Vehicle Safety Responsibility
5.205 - Motor Vehicle Crime Prevention Authority Pass-Through Fee
5.206 - Designation of Underserved ZIP Codes
5.207 - Financial Responsibility Consumer Outreach Program
5.208 - Terminology Describing Transportation-Related Accidents (Collisions)
5.301 - Loss Control Information
5.302 - Methods of Providing Loss Control Information
5.303 - Evaluation and Inspection of Loss Control Information and Services
5.311 - Qualifications of Personnel Providing Loss Control Information and Services
5.401 - Temporary and Permanent Requirements Regarding Underwriting Treatment of and Disclosure to Applicants for Private Passenger Automobile Liability Insurance
5.501 - Notice Requirements to Claimants Regarding Motor Vehicle Repairs
5.601 - Purpose and Scope
5.602 - Definitions
5.603 - Financial Responsibility Verification Program Guide and User Manual
5.604 - Reporting Requirements for Insurers Using the Database Program
5.605 - Data Error Correction Requirements for Insurers Using the Database Program
5.606 - Requirements for Insurers Using the Web Services Program
5.607 - Web Services Program System Requirements
5.608 - Web Services Program Performance Requirements
5.609 - Delegation and New Insurers
5.610 - Penalties
5.611 - Participation in Voluntary Testing Transmission System

Subchapter B - INSURANCE CODE, CHAPTER 5, SUBCHAPTER B

5.1101 - Permissible Dividend Classes, the Insurance Code, Chapter 5, Subchapter B
5.1102 - Other Restrictions on the Payment of Dividends, the Insurance Code, Chapter 5, Subchapter B
5.1103 - Dividend Application Form, the Insurance Code, Chapter 5, Subchapter B
5.1501 - Procedure for Reconsideration
5.1502 - Grievance and Hearing Procedures
5.1503 - Appeal to the State Board of Insurance
5.1701 - Qualifications for Designation as Field Safety Representative with Specialty in Hospitals
5.1702 - Course of Training for Field Safety Representatives with Specialty in Hospitals
5.1703 - Designation of Field Safety Representative with Specialty in Hospitals
5.1711 - Methods of Providing Loss Control Facilities
5.1712 - Loss Control Services
5.1713 - Evaluation and Inspection of Loss Control Facilities and Services
5.1721 - Loss Control Information
5.1722 - Methods of Providing Loss Control Information
5.1723 - Evaluation and Inspection of Loss Control Information and Services
5.1731 - Qualifications of Personnel Providing Loss Control Information and Services
5.1740 - Purpose and Scope
5.1741 - Best Practices for Risk Management and Loss Control

Subchapter C - TEXAS MEDICAL LIABILITY INSURANCE UNDERWRITING ASSOCIATION

5.2001 - Definitions
5.2002 - Operation of the Texas Medical Liability Insurance Underwriting Association
5.2003 - Members' and Policyholders' Participation in the Texas Medical Liability Insurance Underwriting Association
5.2004 - Medical Liability Insurance and General Liability Insurance
5.2005 - Amendments
5.2006 - Reinsurance

Subchapter D - FIRE AND ALLIED LINES INSURANCE

5.3104 - Policyholder Dividends
5.3201 - Joint Insurance
5.3501 - Statistical Reporting of Property and Multiperil Insurance by Insurers Regulated under the Insurance Code, Chapters 17-19
5.3700 - Designation of Underserved Areas for Residential Property Insurance for Purposes of the Insurance Code, Articles 5.35-3 and 21.49-12
5.3701 - Designation of Underserved Areas for Residential Property Insurance for Purposes of the Insurance Code Article 21.49A
5.3702 - Designation of Underserved Areas for Residential Property Insurance for Purposes of the Insurance Code Article 5.13-2C
5.3800 - Voluntary Inspection Program Plan of Operation

Subchapter E - TEXAS WINDSTORM INSURANCE ASSOCIATION

5.4001 - Plan of Operation
5.4007 - Applicable Building Code Standards in Designated Catastrophe Areas for Structures Constructed, Repaired or to Which Additions Are Made Prior to September 1, 1998
5.4008 - Applicable Building Code Standards in Designated Catastrophe Areas for Structures Constructed, Repaired or to Which Additions Are Made On and After September 1, 1998, and before February 1, 2003
5.4009 - Applicable Building Code Standards in Designated Catastrophe Areas for Structures Constructed, Repaired or to Which Additions Are Made On and After February 1, 2003 and before January 1, 2005
5.4010 - Applicable Building Code Standards in Designated Catastrophe Areas for Structures Constructed, Repaired or to Which Additions Are Made On and After January 1, 2005, and before January 1, 2008
5.4011 - Applicable Building Code Standards in Designated Catastrophe Areas for Structures Constructed, Repaired or to Which Additions Are Made On and After January 1, 2008, and before April 1, 2020
5.4012 - Applicable Building Code Standards in Designated Catastrophe Areas for Structures Constructed, Repaired, or to Which Additions Are Made on or after April 1, 2020
5.4021 - Agent Requirements
5.4023 - Per Risk Reinsured Excess Coverage
5.4029 - Applicability and Effective Date of 28 TAC §§5.4029 - 5.4041
5.4030 - Definitions Applicable to §§5.4029 - 5.4041
5.4031 - Wind Damage Evaluation
5.4032 - Property Database
5.4033 - Hazard Module
5.4034 - Hazard Module - Wind Measurements
5.4035 - Hazard Module - Wind Field Model
5.4036 - Hazard Module - Storm Surge and Wave Measurements
5.4037 - Hazard Module - Storm Surge and Wave Model
5.4038 - Use of Damage Estimation Module
5.4039 - Economic Loss Module
5.4040 - Report Generation Module
5.4041 - Incorporation by Reference
5.4101 - Applicability
5.4102 - Definitions
5.4111 - Operation of the Catastrophe Reserve Trust Fund
5.4112 - Termination of Catastrophe Reserve Trust Fund
5.4113 - Investments of Catastrophe Reserve Trust Fund
5.4114 - Disbursements from the Catastrophe Reserve Trust Fund
5.4121 - Financing Arrangements
5.4123 - Public Securities Request, Approval, and Issuance
5.4124 - Issuance of Class 1 Public Securities before a Catastrophic Event
5.4125 - Issuance of Public Securities after a Catastrophic Event
5.4126 - Determination of the Association Surcharge Percentage
5.4127 - Contingent Sources of Payment for Class 2 and Class 3 Public Securities
5.4133 - Public Security Proceeds
5.4134 - Excess Public Security Proceeds
5.4135 - Marketable Public Securities; the Amount of Class 1 Public Securities that Cannot be Issued; Market Conditions and Requirements; and Cost-Benefit Analysis
5.4136 - Association Rate Filings
5.4141 - Class 1 Public Security Trust Fund
5.4142 - Class 2 and Class 3 Public Security Trust Funds
5.4143 - Premium Surcharge Trust Fund
5.4144 - Excess Premium Surcharge Revenue
5.4145 - Excess Net Premium and Other Revenue
5.4160 - Member Assessments to Pay for Reinsurance in Excess of the Association's Statutory Minimum Funding Level
5.4161 - Member Assessments Other than Assessments for Reinsurance in Excess of the Association's Statutory Minimum Funding Level
5.4162 - Amount of Assessment
5.4163 - Notice of Assessment
5.4164 - Payment of Assessment
5.4165 - Failure to Pay Assessment
5.4166 - Contest After Payment of Assessment
5.4167 - Inability to Pay Assessment by Reason of Insolvency
5.4171 - Premium Surcharge Requirements
5.4172 - Premium Surcharge Definitions
5.4173 - Determination of the Contingent Surcharge Percentage
5.4181 - Premiums to be Surcharged
5.4182 - Method for Determining the Premium Surcharges
5.4184 - Application of Premium Surcharges
5.4185 - Mandatory Premium Surcharge Collection
5.4186 - Remittance of Contingent Surcharges
5.4187 - Offsets
5.4188 - Association Surcharges not Subject to Commissions or Premium Taxes; Contingent Surcharges Not Subject to Commissions
5.4189 - Notification Requirements
5.4190 - Annual Premium Surcharge Report
5.4191 - Premium Surcharge Reconciliation Report
5.4192 - Data Collection
5.4200 - Definitions
5.4201 - Coastal Outreach and Assistance Services Team (COAST) Program
5.4202 - Good Cause Extensions Under Insurance Code §2210.205
5.4203 - Good Cause Extensions for Insurance Code §2210.573(b) and (d) and §2210.5741(b)
5.4204 - Supplemental Payments
5.4211 - Appraisal Process
5.4212 - Appraisal Process - Appraiser Qualifications and Conflicts of Interest
5.4213 - Appraisal Process - Appraiser Obligations
5.4214 - Appraisal Process - Umpire Qualifications and Conflicts of Interest
5.4215 - Appraisal Process - Umpire Roster
5.4216 - Appraisal Process - Removal of Umpire from Roster
5.4217 - Appraisal Process - Umpire Selection by Department
5.4218 - Appraisal Process - Umpire Obligations
5.4219 - Appraisal Process - Additional Obligations for Department-Selected Umpires
5.4220 - Appraisal Process - Prohibited Communications
5.4221 - Appraisal Process - Costs
5.4222 - Appraisal Process - Extensions of Deadlines
5.4231 - Mediation Process
5.4232 - Mediation Process - Mediator Qualifications and Conflicts of Interest
5.4233 - Mediation Process - Mediator Roster
5.4234 - Mediation Process - Removal of Mediator from Roster
5.4235 - Mediation Process - Mediator Selection by Department
5.4236 - Mediation Process - Mediator Obligations
5.4237 - Mediation Process - Additional Obligations for Department-Selected Mediators
5.4238 - Mediation Process - Association Obligations
5.4239 - Mediation Process - Claimant Obligations and Privileges
5.4240 - Mediation Process - Costs
5.4241 - Mediation Process - Deadlines and Extensions
5.4251 - Requests and Submissions to the Department
5.4252 - Objections
5.4253 - Contract Administrator
5.4260 - Composition of the Expert Panel
5.4261 - Qualifications and Application
5.4262 - Conflicts of Interest
5.4263 - Selection
5.4264 - Expert Panel Term
5.4265 - Removal of Expert Panel Member
5.4266 - Expert Panel Duties
5.4267 - Expert Panel Meetings
5.4268 - Contracting, Compensation, and Expenses
5.4301 - Definitions
5.4302 - Policy Forms, Endorsements, and Rates
5.4303 - Generally Comparable Coverage
5.4304 - Limited Service Agreement
5.4305 - Electronic Information Repository
5.4306 - Voluntary Market Depopulation Program
5.4307 - Assumption Reinsurance Program
5.4308 - Effect on Existing Contracts
5.4309 - Repository Information
5.4601 - Definitions
5.4603 - Windstorm Inspection Forms
5.4604 - Certification Form for Completed Improvement
5.4605 - Items Not Requiring an Inspection for the Purposes of Windstorm and Hail Insurance Coverage through the Texas Windstorm Insurance Association
5.4606 - Supporting Evidence for Sealed Postconstruction Evaluation Report and Design for Certificate of Compliance for Completed Improvement
5.4607 - Requirements for the Appointment of Temporary Qualified Windstorm Inspectors for a Limited Period on an As-needed Basis
5.4608 - Certification by TDI-Employed Windstorm Inspectors
5.4609 - Application for Qualified Inspector Appointment
5.4610 - Renewal of Qualified Inspector Appointment
5.4612 - Appointment as Qualified Inspector
5.4615 - General Responsibilities of Appointed Qualified Inspectors
5.4620 - Accountability of Appointed Qualified Inspector
5.4621 - Certification of Ongoing Improvements Inspected by Appointed Qualified Inspectors
5.4622 - Inspection Verification
5.4623 - Information Required to Inspect to Design Documents
5.4625 - Inspection Reports
5.4626 - Substantiating Information
5.4640 - Oversight
5.4642 - Disciplinary Action
5.4700 - Rate Reduction
5.4701 - Requests for Additional Supporting Information
5.4702 - Requirement for Vote of Rate Filing and Prohibition on Purchasing Reinsurance from Certain Insurers or Brokers
5.4902 - Additional Requirements
5.4903 - Declination of Coverage
5.4904 - Flood Insurance
5.4905 - Minimum Retained Premium
5.4906 - Renewal Premium Grace Period
5.4908 - Alter and Alteration
5.4911 - Insurance Policy Forms, Endorsements, Manual Rules, Application Forms, and Underwriting Guidelines
5.4912 - Filing and Issuance of Policy Forms Relating to Premium Surcharges under Insurance Code §§2210.612, 2210.613, and 2210.6131

Subchapter F - INLAND MARINE INSURANCE, MULTI-PERIL INSURANCE, AND COMMERCIAL LINES

5.5001 - Purpose and Classification Procedure
5.5002 - Inland Marine Insurance -- Imports
5.5003 - Inland Marine Insurance -- Exports
5.5004 - Inland Marine Insurance -- Domestic Shipments
5.5005 - Inland Marine Insurance -- Bridges, Tunnels, and Other Instrumentalities of Transportation and Communication
5.5006 - Inland Marine Insurance -- Consumer Credit Property Insurance
5.5007 - Inland Marine Insurance -- Commercial Credit Property Insurance
5.5008 - Inland Marine Insurance -- Other Inland Marine Risks
5.5101 - Rates for Commercial Multi-peril Policies
5.5201 - Exempt Commercial Lines

Subchapter G - WORKERS' COMPENSATION INSURANCE

5.6401 - Purpose and Scope
5.6402 - Definitions
5.6403 - Application for Initial Certificate of Approval
5.6404 - Notification to the Department and Responsibility for Continued Compliance
5.6405 - Excess Insurance
5.6406 - Indemnity Agreement
5.6407 - Acknowledgement of Indemnity Agreement
5.6408 - Fidelity and Performance Bonds
5.6409 - Books and Records
5.6410 - Investments
5.6411 - Contract Provisions
5.6412 - Operational Review Plan
5.6413 - Membership Cancellation or Termination
5.6501 - Special Instructions for Preparation of Workers' Compensation Insurance Policies for Lloyds Plan Insurers, Mutual Insurers, Reciprocal Exchanges, and Participating Policies Issued by Stock Insurance Companies
5.6601 - Texas Detailed Claim Information Statistical Plan

Subchapter H - CANCELLATION, DENIAL, AND NONRENEWAL OF CERTAIN PROPERTY AND CASUALTY INSURANCE COVERAGE

5.7001 - Applicability
5.7002 - Cancellations
5.7003 - Calculation of Time Period
5.7004 - Certain Acts Regarded as Cancellation
5.7005 - Special One-Year Rule Applicable Only to Personal Automobile Policies
5.7006 - Discontinuing the Writing of Certain Lines or Classes, Withdrawing from a Geographical Area, or Withdrawing from an Agency
5.7007 - Renewal of Policies
5.7008 - Records Required
5.7009 - Insurance Code Chapter 4051, Subchapter H
5.7010 - Endorsement Forms
5.7011 - Violations
5.7012 - Reason for Declination, Cancellation, or Nonrenewal
5.7013 - Notice Requirements for Cancellation and Nonrenewal for General Liability and Certain Automobile Insurance Policies
5.7014 - Exceptions to Cancellation and Nonrenewal Notice Requirements for General Liability and Certain Automobile Insurance Policies
5.7015 - Refund of Unearned Premium
5.7016 - Prohibition of Nonrenewal for Not-at-Fault Accidents or Claims--Personal Auto Policy
5.7018 - Notice to Lienholders
5.7101 - Division Purpose and Applicability
5.7102 - Definition
5.7103 - Reasonable Efforts
5.7104 - Notice Timing
5.7105 - Prohibited Nonrenewal and Cooperation Timeframe
5.7106 - Extension of Term and Additional Premium
5.7107 - Notice of Mandatory Nonrenewal and Opportunity to Cooperate Under Insurance Code §551.1053
5.7108 - Sample Notice of Mandatory Nonrenewal and Opportunity to Cooperate
5.7109 - Mandatory Nonrenewal Under Insurance Code §551.1053
5.7110 - Nonrenewal Under Other Statutes

Subchapter I - RULES SUPPLEMENTARY TO THE INSURANCE CODE, CHAPTER 5, SUBCHAPTER L

5.8001 - Purpose and Scope
5.8003 - Written Petitions
5.8004 - Interpretations

Subchapter J - RULES TO IMPLEMENT THE AMUSEMENT RIDE SAFETY INSPECTION AND INSURANCE ACT

5.9001 - Purpose and Scope
5.9002 - Definitions
5.9003 - Administration and Enforcement
5.9004 - Amusement Ride Operation Requirements
5.9005 - Personnel Conducting Safety Inspections of Amusement Rides and Devices
5.9006 - Public Information Sign
5.9007 - Quarterly Reports
5.9008 - Filing Affidavit
5.9009 - Information Request
5.9010 - Confirmation of Required Insurance and Inspection Certificate; Rule Construction
5.9011 - Standards and Compliance
5.9012 - Denial of Entry to Amusement Rides; Prohibiting Operation of Amusement Rides
5.9013 - Injunctions
5.9014 - Penalties; Enforcement

Subchapter K - TERMINATION OF FINANCIAL ASSURANCE FOR UNDERGROUND STORAGE TANKS

5.9101 - Purpose
5.9102 - Definitions
5.9103 - Applicability
5.9104 - Content of Notice
5.9105 - Submission of Notice
5.9106 - Rescindment of Cancellation or Non-Renewal
5.9107 - Disciplinary Actions by the Commissioner of Insurance

Subchapter M - FILING REQUIREMENTS

5.9301 - Commercial Risks Shared by Two or More Insurers
5.9303 - Definition of Catastrophe
5.9310 - Property and Casualty Transmittal Information and General Filing Requirements
5.9311 - Copyright, Public Inspection, and Confidential Filings
5.9312 - Personally Identifiable Information
5.9313 - Filing Format Requirements
5.9320 - Purpose and Definitions
5.9321 - General Filing Requirements
5.9322 - Additional Information
5.9323 - Requirements for Reference Filings
5.9324 - Incomplete Filings
5.9325 - Request for Deemer Period Waiver
5.9326 - Insurers Providing Coverage through a Purchasing Group
5.9327 - Additional Requirements for Personal Automobile and Residential Property Forms
5.9328 - Insurers Writing Commercial Group Property Insurance
5.9330 - Purpose
5.9331 - Definitions
5.9332 - Categories of Supporting Information
5.9333 - Categories of Supplementary Rating Information
5.9334 - Requirements for Rate and Rule Filing Submissions
5.9335 - Requests for Information
5.9336 - Request for Information Limit Waiver
5.9337 - Insurers Providing Coverage Through a Purchasing Group
5.9340 - Purpose
5.9341 - Definitions
5.9342 - Filing Requirements
5.9350 - Purpose
5.9351 - Definitions
5.9352 - Filing Requirements
5.9355 - Purpose
5.9356 - Definitions
5.9357 - Filing Requirements
5.9360 - Purpose
5.9361 - Additional Requirements
5.9370 - Purpose and Scope
5.9371 - Definitions
5.9372 - Preparation and Submission of Certificate of Insurance Form Filings
5.9373 - Certificate of Insurance Form Filing Transmittal Information
5.9374 - Incomplete Filings
5.9375 - Use of Certificate of Insurance Forms
5.9376 - Restrictions on the Content of Certificates of Insurance

Subchapter N - RESIDENTIAL PROPERTY INSURANCE MARKET ASSISTANCE PROGRAM

5.9400 - Residential Property Insurance Market Assistance Program Executive Committee
5.9401 - Purpose and Scope
5.9402 - Authority
5.9403 - Definitions
5.9404 - Policy Forms and Types of Coverage
5.9405 - Rates
5.9406 - Eligibility for Referral
5.9407 - Participating Insurers
5.9408 - Participating Agents
5.9409 - Operations
5.9410 - Executive Committee
5.9411 - Criteria and Procedures for Mandatory Participation by Insurers
5.9412 - Amendments to Plan of Operation
5.9413 - Immunity from Liability
5.9414 - Termination of MAP
5.9415 - Severability
5.9416 - Forms Promulgated for Use in the Residential Property Insurance Market Assistance Program

Subchapter O - STATISTICAL PLANS

5.9501 - Texas Commercial Lines Statistical Plan
5.9502 - Texas Catastrophe Event Statistical Plan for Personal and Commercial Risks

Subchapter Q - GENERAL PROPERTY AND CASUALTY RULES

5.9700 - Residential Property Declarations Pages and Deductible Disclosures
5.9750 - Notice of Material Change-Applicability and Examples
5.9751 - Notice of Material Change-Requirements
5.9752 - Notice of Material Change-Change from Replacement Cost to Actual Cash Value

Subchapter T - FAIR PLAN

5.9910 - Purpose
5.9911 - Definitions
5.9912 - Governing Committee
5.9913 - Authority of Agents and Commissions
5.9914 - Maximum Limits of Liability and Limitations
5.9915 - Inspections
5.9916 - Application Forms, Underwriting Rules, Rates, Policy Forms and Endorsements
5.9917 - Application, Binder, Policy Issuance, Renewal and Cancellation
5.9918 - Servicing of Policies
5.9919 - Right to Appeal
5.9920 - Immunity from Liability and Indemnification
5.9921 - Fidelity Bonds
5.9922 - Relationship with Member Insurers
5.9923 - Assessments, Recoupments, Member Insolvency and Withdrawal
5.9924 - Reinsurance and Other Financing
5.9925 - Statistics
5.9927 - Annual and Quarterly Financial Statements
5.9928 - Additional Powers of the Association
5.9929 - Severability
5.9930 - Designated Area for Property Owners' Association Policies
5.9931 - Petition Requirements for Underserved Area for Property Owners' Association Insurance
5.9932 - Petition Procedures for Underserved Area for Property Owners' Association Insurance
5.9933 - Determining Underserved Areas for Property Owners' Association Insurance

Subchapter U - USE OF CREDIT INFORMATION OR CREDIT SCORES

5.9940 - Disclosure Form Required Concerning Use of Credit Information
5.9941 - Differences in Rates Charged Due Solely to Difference in Credit Scores

Subchapter V - TERRITORY RATING REQUIREMENTS

5.9960 - Exception to Rating Territory Requirements under §2253.001 of the Insurance Code

Subchapter W - CONSUMER RIGHTS NOTICES

5.9970 - Personal Automobile Insurance Consumer Bill of Rights
5.9971 - Homeowners, Dwelling, and Renters Insurance Consumer Bill of Rights

Subchapter X - PRIOR APPROVAL OF RATES UNDER CERTAIN CIRCUMSTANCES

5.9980 - Financial Conditions
5.9981 - Rating Practices
5.9982 - Statewide Insurance Emergency

Chapter 6 - CAPTIVE INSURANCE

Subchapter A - GENERAL MATTERS

6.1 - Definitions
6.2 - Submissions and Notifications to the Commissioner and Department

Subchapter B - CAPTIVE MANAGEMENT COMPANIES

6.101 - Registration of Captive Management Companies
6.102 - Maintenance and Duration of the Registration
6.103 - Designated Responsible Party
6.104 - Administrative Services Contracts
6.105 - Agreements to Provide Administrative Services

Subchapter C - CAPTIVE INSURANCE COMPANY APPLICATION PROCESS

6.201 - Captive Insurance Company Certificate of Authority Required
6.202 - Captive Insurance Company Certificate of Authority Application Contents and Process
6.203 - Issuance of Captive Insurance Company Certificate of Authority

Subchapter D - MAINTENANCE OF A CAPTIVE INSURANCE COMPANY'S CERTIFICATE OF AUTHORITY

6.301 - Ongoing Requirements
6.302 - Governing Body
6.303 - Captive Insurance Company Biographical Information
6.304 - Material Change in the Plan of Operations
6.305 - Sale of a Covered Affiliate
6.306 - Books and Records
6.307 - Changes to Formation Documents

Subchapter E - FINANCIAL INFORMATION AND REPORTING

6.401 - Annual Report
6.402 - Basis of Accounting
6.403 - Audited Financial Statements
6.404 - Captive Insurance Companies Using Other Than Calendar Year Fiscal Years
6.405 - Capital and Surplus Requirements
6.406 - Financial Projections
6.407 - Loans to Affiliates
6.408 - Letters of Credit
6.409 - Dividends and Distributions
6.410 - Application of Holding Company Requirements
6.411 - Reinsurance under Insurance Code §964.052(f)

Subchapter F - WORKERS' COMPENSATION

6.501 - Workers' Compensation

Subchapter G - TAXES

6.601 - Waiver of Taxes

Subchapter H - DISCIPLINARY ACTION

6.701 - Disciplinary Action

Chapter 7 - CORPORATE AND FINANCIAL REGULATION

Subchapter A - EXAMINATION AND FINANCIAL ANALYSIS

7.1 - Scope
7.2 - Savings Clause
7.4 - Admissible Assets
7.5 - Discrimination as to Premium Notices to Accident or Health Insurance Policyholders
7.6 - Unearned Premium Reserve for Inland Marine Insurance
7.7 - Subordinated Indebtedness, Surplus Debentures, Surplus Notes, Premium Income Notes, Bonds, or Debentures, and Other Contingent Evidences of Indebtedness
7.9 - Examination of Actuarial Opinion for Property and Casualty Insurers
7.18 - National Association of Insurance Commissioners Accounting Practices and Procedures Manual
7.20 - Premium Notes and Premium Income, Chapter 17 Companies
7.22 - Certification of Assessments/Claims Paid, and Credit against Premium Taxes for Members of the Texas Catastrophe Property Insurance Association under the Insurance Code, Article 21.49
7.24 - Valuation Date for Investments under the Insurance Code, Article 4.11
7.25 - Out of State Books and Records
7.31 - Annual Statement Instructions for Farm Mutual Insurance Companies
7.65 - Requirements for Filing the 2008 Annual Statements, the 2009 Quarterly Statements, Other Reporting Forms, and Electronic Data Filings with the Texas Department of Insurance and the NAIC
7.66 - Requirements for Filing the 2009 Annual Statements, the 2010 Quarterly Statements, Other Reporting Forms, and Electronic Data Filings with the Texas Department of Insurance and the NAIC
7.67 - Requirements for Filing the 2010 Annual Statements, the 2011 Quarterly Statements, Other Reporting Forms, and Electronic Data Filings with the Texas Department of Insurance and the NAIC
7.68 - Requirements for Filing the Annual Statements, the Quarterly Statements, Other Reporting Forms, and Electronic Filings with the Texas Department of Insurance and the NAIC
7.69 - Requirements for Filing the 2006 Quarterly and 2006 Annual Statements, Other Reporting Forms, and Electronic Data Filings with the Texas Department of Insurance and the NAIC
7.70 - Requirements for Filing the 2007 Quarterly and 2007 Annual Statements, the 2008 Quarterly Statements, Other Reporting Forms, and Electronic Data Filings, with the Texas Department of Insurance and the NAIC
7.83 - Appeal of Examination Reports
7.84 - Examination Frequency
7.85 - Audited Financial Reports
7.86 - Custodied Securities
7.87 - Risk Pool Audits
7.88 - Independent Audits of Insurer and HMO Financial Statements and Insurer and HMO Internal Control over Financial Reporting
7.89 - Corporate Governance Annual Disclosure

Subchapter B - INSURANCE HOLDING COMPANY SYSTEMS

7.201 - Forms Filings
7.202 - Definitions
7.203 - Registration of Insurers
7.204 - Transactions Subject to Prior Notice
7.205 - Acquisition or Divestiture Statements--Filing Requirements
7.209 - Form A
7.210 - Form B
7.211 - Form C
7.212 - Form D
7.213 - Form E
7.214 - Form F
7.216 - Liquidity Stress Test Framework

Subchapter D - RISK-BASED CAPITAL AND SURPLUS AND OTHER REQUIREMENTS

7.402 - Risk-Based Capital and Surplus Requirements for Insurers and HMOs
7.403 - Transition Period for Certain County Mutual Insurance Companies
7.404 - Transition Period for Stipulated Premium Insurance Companies

Subchapter E - ADMISSION PROCEDURES FOR FOREIGN INSURANCE COMPANIES

7.501 - Reservation of Name
7.502 - General Requirements
7.503 - Certificate of Similarity
7.504 - Disposition of Applications
7.505 - Applicant To Submit Information
7.506 - Documents To Be Verified
7.507 - Forms Incorporated by Reference
7.508 - Biographical Affidavit Requirements

Subchapter F - REINSURANCE

7.601 - Scope
7.602 - Definitions
7.603 - Prohibition against Reinsurance with Assuming Insurers not Authorized to do the Business of Insurance in Texas
7.604 - Assumption Reinsurance
7.605 - Fees
7.606 - Accredited Assuming Insurer
7.607 - Trusteed Assuming Insurer
7.608 - Insurance Ceded to Assuming Insurers not Authorized in Texas, or Accredited, Trusteed, or Certified under this Subchapter
7.609 - Trust Agreement Requirements
7.610 - Letter of Credit Requirements
7.611 - Indemnity Reinsurance Agreements--Required Provisions
7.612 - Reinsurance Agreements Affected
7.614 - Posting of Information, Submissions, and Adoption of Forms by Reference
7.615 - Credit for Reinsurance--Reciprocal Jurisdictions
7.616 - Term and Universal Life Insurance Reserve Financing
7.621 - Certified Assuming Insurers
7.622 - Certification and Rating
7.623 - Change in Rating and Suspension or Revocation of Certification
7.624 - Qualified Jurisdictions
7.625 - Recognition of Certification Issued by an NAIC Accredited Jurisdiction
7.626 - Section Mandatory Funding Clause
7.627 - Additional NRSRO

Subchapter G - REVIEW OF CORPORATE NAMES

7.701 - Standards Governing Approval of Corporate Names
7.702 - General Rules and Policies

Subchapter H - VOLUNTARY DEPOSITS REQUIRED BY THE FEDERAL GOVERNMENT OR ITS AGENCIES

7.801 - Voluntary Deposits
7.802 - Interpretation of Article 1.10, §17

Subchapter I - INSIDER TRADING AND PROXY SOLICITATION

7.901 - Insider Trading and Proxy Solicitation

Subchapter J - EXAMINATION EXPENSES AND ASSESSMENTS

7.1001 - Examination Assessments for Domestic and Foreign Insurance Companies and Self-Insurance Groups Providing Workers' Compensation Insurance

Subchapter L - PROCEDURES AND REQUIREMENTS FOR LIFE INSURANCE COMPANIES WRITING REINSURANCE FOR PROPERTY AND CASUALTY RISKS

7.1201 - Definitions
7.1202 - Application Process; Notice of Intention
7.1203 - Financial Requirements
7.1204 - Risk Limitations
7.1205 - Records
7.1206 - Forms Required for Life Insurance Companies Reinsuring Property and Casualty Insurance Risks

Subchapter M - REGULATORY FEES

7.1301 - Regulatory Fees
7.1302 - Billing System

Subchapter N - SERVICES OF PROCESS

7.1401 - Purpose
7.1402 - Definitions
7.1403 - Service on Domestic Insurance Companies Licensed by the State Board of Insurance and on Related Entities Authorized to Conduct Business in Texas
7.1404 - Service of Process Procedure for Domestic Insurers Approved To Operate under the Insurance Code, Article 1.28, Foreign and Alien Insurance Companies, Risk Retention Groups, Purchasing Groups, Third Party Administrators, Unauthorized Persons or Insurers, Organizations Formed under the Insurance Code, Article 3.71, and Surplus Lines Insurers
7.1405 - Service of Process on Foreign and Alien Insurance Companies Licensed by State Board of Insurance
7.1406 - Service of Process on Foreign Risk Retention Groups Registered with the State Board of Insurance
7.1407 - Service of Process on Foreign Purchasing Groups Doing Business in Texas Pursuant to the Insurance Code, Article 21.54
7.1408 - Service Process on Third Party Administrators Doing Business in Texas Pursuant to the Insurance Code, Article 21.07-5
7.1409 - Service of Process on Persons, Insurers, or Other Entities in Receivership
7.1410 - Service of Process on Commissioner on Behalf of Unauthorized Persons or Insurers
7.1411 - Service of Process, Notice, Order, or Pleading on Secretary of State on Behalf of Unauthorized Persons and Insurers
7.1412 - Other Methods of Service
7.1413 - Service of Process on Surplus Lines Insurers
7.1414 - Administrative Procedures
7.1415 - Forms Required To Administer Service of Process

Subchapter P - ADMINISTRATORS

7.1601 - Scope
7.1602 - Definitions
7.1603 - Certificate of Authority Required
7.1604 - Application for Certificate of Authority
7.1605 - Notification Requirements
7.1606 - Requirements Related to Ownership Interest and Change of Control
7.1607 - Facts and Circumstances Affecting Issuance of Certificate of Authority
7.1608 - Fidelity Bond
7.1609 - Annual Report
7.1610 - Financial Statements under the Education Code
7.1611 - Operational Review and On-Site Audit
7.1612 - Fiduciary Bank Accounts
7.1613 - Written Agreements Between Administrators and Insurers
7.1614 - Prohibited Acts
7.1615 - Transfer of Books and Records
7.1616 - Hazardous or Injurious Operating Conditions
7.1617 - Examinations
7.1618 - Severability

Subchapter R - WITHDRAWAL PLAN REQUIREMENTS AND PROCEDURES

7.1801 - Purpose
7.1802 - Definitions
7.1803 - What Constitutes a Line of Insurance
7.1804 - When a Withdrawal Plan is Required
7.1805 - Contents of Withdrawal Plan
7.1806 - Withdrawal Plan Submission and Approval Procedures
7.1807 - Filing of Annual Financial Statement and Other Required Data and Information
7.1808 - Requirements To Resume Writing Insurance
7.1809 - Restriction Plan Contents and Submission Requirements

Subchapter S - MULTIPLE EMPLOYER WELFARE ARRANGEMENTS REQUIREMENTS FOR OBTAINING AND MAINTAINING CERTIFICATE OF AUTHORIZATION

7.1901 - Scope and Applicability
7.1902 - Definitions
7.1904 - Application for Initial Certificate of Authority
7.1905 - Commissioner Review of Application; Issuance of Initial Certificate of Authority
7.1906 - Application for Final Certificate of Authority
7.1907 - Denial of Final Certificate of Authority and Extension of Initial Certificate of Authority
7.1908 - Required Filing Fees
7.1909 - Benefits Allowed To Be Provided by Multiple Employer Welfare Arrangements
7.1910 - Required Notice to Participants
7.1911 - Name Eligibility and Proof of Existence
7.1912 - Filings by Multiple Employer Welfare Arrangements; Report of Cash Reserves; Approval by Commissioner; Additional Actuarial Review
7.1913 - Examination of Multiple Employer Welfare Arrangements
7.1914 - Duties and Compensation of Trustees, Officers, or Directors
7.1915 - Suspension, Revocation, or Limitation of Certificate of Authority and Other Remedies
7.1916 - Election for the Application of Certain Laws
7.1917 - Comprehensive Health Benefit Plans

Subchapter T - PERMISSIBLE PAYMENTS TO INSURERS, AGENTS AND SPONSORING ORGANIZATIONS

7.2001 - Solicitation of Voluntary Contributions by Sponsoring Organizations

Chapter 8 - HAZARDOUS CONDITION

Subchapter A - HAZARDOUS CONDITIONS AND REMEDY OF HAZARDOUS CONDITIONS

8.1 - Authority, Scope, and Purpose
8.2 - Definitions
8.3 - Hazardous Conditions and Remedy of Hazardous Conditions
8.4 - Hazardous Conditions Related to Negotiated Deductible Workers' Compensation Policies

Chapter 9 - TITLE INSURANCE

Subchapter A - BASIC MANUAL OF RULES, RATES AND FORMS FOR THE WRITING OF TITLE INSURANCE IN THE STATE OF TEXAS

9.1 - Basic Manual of Rules, Rates and Forms for the Writing of Title Insurance in the State of Texas
9.2 - Texas Disclosure

Subchapter C - TEXAS TITLE INSURANCE STATISTICAL PLAN

9.401 - Texas Title Insurance Statistical Plan

Chapter 10 - WORKERS' COMPENSATION HEALTH CARE NETWORKS

Subchapter A - GENERAL PROVISIONS AND DEFINITIONS

10.1 - Purpose and Scope
10.2 - Definitions
10.3 - Contact Information

Subchapter B - CERTIFICATION

10.20 - Certification Required
10.21 - Certificate Application
10.22 - Contents of Application
10.23 - Action on Application
10.24 - Network Financial Requirements
10.25 - Filing Requirements
10.26 - Modifications to Service Area
10.27 - Modifications to Network Configuration

Subchapter C - CONTRACTING

10.40 - Management Contracts
10.41 - Network-Carrier Contracts
10.42 - Network Contracts with Providers

Subchapter D - NETWORK REQUIREMENTS

10.60 - Notice of Network Requirements; Employee Information
10.61 - Employees Who Live Within the Network Service Area, Employee Access, and Insurance Carrier Liability for Health Care
10.62 - Dispute Resolution for Employee Requirements Related to In-Network Care
10.63 - Plain Language Requirements

Subchapter E - NETWORK OPERATIONS

10.80 - Accessibility and Availability Requirements
10.81 - Quality Improvement Program
10.82 - Credentialing
10.83 - Guidelines and Protocols
10.84 - Treating Doctor
10.85 - Selection of Treating Doctor; Change of Treating Doctor
10.86 - Telephone Access

Subchapter F - UTILIZATION REVIEW AND RETROSPECTIVE REVIEW

10.100 - Applicability
10.101 - General Standards for Utilization Review
10.104 - Independent Review of Adverse Determination

Subchapter G - COMPLAINTS

10.120 - Complaint System Required
10.121 - Complaints; Deadlines for Response and Resolution
10.122 - Submitting Complaints to the Department

Subchapter H - EXAMINATIONS

10.200 - Fee for Examination of a Certified Workers' Compensation Health Care Network

Chapter 11 - HEALTH MAINTENANCE ORGANIZATIONS

Subchapter A - GENERAL PROVISIONS

11.1 - General Provisions
11.2 - Definitions

Subchapter B - NAME APPLICATION PROCEDURE

11.101 - How to Obtain Forms
11.102 - Information Required
11.104 - Criteria
11.105 - Use of the Term "HMO," Service Marks, Trademarks, and Assumed Name
11.106 - Time Limits; Extension Requirements
11.107 - Effect of Filing for or Receiving Certificate of Authority
11.108 - Effect of Withdrawing Application for Certificate of Authority
11.109 - Situations in Which Name Applications Will Cease

Subchapter C - APPLICATION FOR CERTIFICATE OF AUTHORITY

11.201 - Filing Fee
11.202 - Binding, Indexing, and Numbering Requirements
11.203 - Revisions During Review Process
11.204 - Contents
11.205 - Additional Documents to be Available for Review
11.206 - Review of Application; Examination
11.207 - Withdrawal of an Application

Subchapter D - REGULATORY REQUIREMENTS FOR AN HMO AFTER ISSUANCE OF CERTIFICATE OF AUTHORITY

11.301 - Filing Requirements
11.302 - Service Area Expansion or Reduction Applications
11.303 - Examination

Subchapter F - EVIDENCE OF COVERAGE

11.501 - Contents of the Evidence of Coverage
11.502 - Filing Requirements for Evidence of Coverage Filed as Part of an Application for a Certificate of Authority
11.503 - Filing Requirements for Evidence of Coverage after Receipt of Certificate of Authority
11.504 - Disapproval of an Evidence of Coverage
11.505 - Specifications for Evidence of Coverage Including Insert Pages and Matrix Filings
11.506 - Mandatory Contractual Provisions: Group, Individual, and Conversion Agreement and Group Certificate
11.507 - Additional Mandatory Contractual Provisions: Conversion and Individual Agreements
11.508 - Basic Health Care Services and Mandatory Benefit Standards: Group, Individual, and Conversion Agreements
11.509 - Additional Mandatory Benefit Standards: Individual and Group Agreements
11.511 - Optional Provisions
11.512 - Optional Benefits

Subchapter G - ADVERTISING AND SALES MATERIAL

11.602 - HMOs Subject to Insurance Code Chapters 541, 542, and 547, and Related Rules
11.603 - Filings

Subchapter H - SCHEDULE OF CHARGES

11.701 - Schedule of Charges Must be Filed Before Use
11.702 - Actuarial Certification
11.703 - Filings and Supporting Documentation
11.704 - Conversion Rates

Subchapter I - FINANCIAL REQUIREMENTS

11.801 - Accounting Guidance
11.802 - Minimum Net Worth
11.803 - Statutory Deposit Requirements
11.804 - Invested Assets
11.805 - Other Assets
11.806 - Investment Management by Affiliate Companies
11.807 - Fiduciary Responsibility
11.808 - Liabilities
11.810 - Guarantee from a Sponsoring Organization
11.811 - Action under Insurance Code §843.157 and Insurance Code §843.461

Subchapter J - PHYSICIAN AND PROVIDER CONTRACTS AND ARRANGEMENTS

11.900 - Nonprimary Care Physician Specialists as Primary Care Physician
11.901 - Required and Prohibited Provisions
11.902 - Prohibited Actions
11.903 - Physician or Provider Communication
11.904 - Provision of Services Related to Immunizations and Vaccinations

Subchapter K - REQUIRED FORMS

11.1001 - Required Forms

Subchapter M - ACQUISITION, CONTROL, OR MERGER OF A DOMESTIC HMO

11.1201 - Acquisition, Control, or Merger of a Domestic HMO

Subchapter O - ADMINISTRATIVE PROCEDURES

11.1401 - Commissioner's Authority to Require Additional Information
11.1402 - Notification to Physicians and Providers
11.1403 - Requirement for Notifying Enrollees of Toll-free Telephone Number for Complaints about Psychiatric or Chemical Dependency Services of Private Psychiatric Hospitals, General Hospitals, and Chemical Dependency Treatment Centers
11.1404 - Pharmacy Application and Recertification

Subchapter P - PROHIBITED PRACTICES

11.1500 - Discrimination Based on Health Status-Related Factors

Subchapter Q - OTHER REQUIREMENTS

11.1600 - Information to Prospective and Current Contract Holders and Enrollees
11.1601 - Enrollee Identification Cards
11.1602 - Enrollment Form and Access to Certain Information
11.1603 - Notification of Change in Payment Arrangements
11.1604 - Requirements for Certain Contracts Between Primary HMOs and ANHCs and Between Primary HMOs and Provider HMOs
11.1605 - Pharmaceutical Services
11.1606 - Organization of an HMO
11.1607 - Accessibility and Availability Requirements
11.1610 - Annual Network Adequacy Report
11.1611 - Out-of-Network Claims; Non-Network Physicians and Providers
11.1612 - Mandatory Disclosure Requirements

Subchapter R - APPROVED NONPROFIT HEALTH CORPORATIONS

11.1702 - Requirements for Issuance of Certificate of Authority to an ANHC
11.1703 - Requirements for Agents of an ANHC Certificate of Authority Holder
11.1704 - Statutes and Rules Applicable to ANHC with a Certificate of Authority

Subchapter S - SOLVENCY STANDARDS FOR MANAGED CARE ORGANIZATIONS PARTICIPATING IN MEDICAID OR CHILDREN'S HEALTH INSURANCE PROGRAM

11.1801 - Entities Covered
11.1806 - Additional Information That May be Requested from an MCO Participating in Medicaid

Subchapter T - QUALITY OF CARE

11.1901 - Quality Improvement Structure for Basic, Single Service, and Limited Service HMOs
11.1902 - Quality Improvement Program for Basic, Single Service, and Limited Service HMOs

Subchapter V - STANDARDS FOR COMMUNITY MENTAL HEALTH CENTERS

11.2101 - Community Health Maintenance Organization
11.2102 - General Provisions
11.2103 - Requirements for Issuance of Certificate of Authority to a CHMO
11.2104 - Minimum Standards for Community Health Centers

Subchapter W - SINGLE SERVICE HMOS

11.2200 - Definitions
11.2201 - General Provisions
11.2202 - Limitations and Exclusions
11.2203 - Minimum Standards - Dental Care Services and Benefits
11.2204 - Minimum Standards - Vision Care Services and Benefits
11.2205 - Prohibited Practices
11.2206 - Mandatory Disclosure Statements; Certification of Compliance
11.2208 - Single Service Accessibility and Availability

Subchapter Y - LIMITED SERVICE HMOS

11.2401 - Definitions
11.2402 - General Provisions
11.2403 - Prohibited Practices
11.2405 - Minimum Standards - Mental Health and Chemical Dependency Services and Benefits
11.2406 - Minimum Standards- Long-Term Care Services and Benefits

Subchapter Z - POINT-OF-SERVICE RIDERS

11.2501 - Definitions
11.2502 - Issuance of Point-of-Service Riders
11.2503 - Coverage Relating to Point-of-Service Rider Plans
11.2601 - General Provisions
11.2602 - Definitions
11.2603 - Requirements for Delegation by HMOs
11.2604 - Delegation Agreements - General Requirements and Information to be Provided to HMO
11.2605 - Delegation Agreements - Information to be Provided by HMO to Delegated Entity
11.2606 - Reporting Requirements
11.2607 - Examinations of Delegated Entities
11.2608 - Department May Order Corrective Action
11.2609 - Reserve Requirements for Delegated Networks
11.2610 - Penalties for Noncompliance
11.2611 - Filing of Delegation Agreements

Chapter 12 - INDEPENDENT REVIEW ORGANIZATIONS

Subchapter A - GENERAL PROVISIONS

12.1 - Statutory Basis
12.2 - Severability Clause
12.3 - Effect of Chapter
12.4 - Applicability
12.5 - Definitions
12.6 - Independent Review of Adverse Determinations of Health Care Provided Under Labor Code

Subchapter B - CERTIFICATE OF REGISTRATION FOR INDEPENDENT REVIEW ORGANIZATIONS

12.101 - Certificate of Registration for Independent Review
12.102 - IRO Application Form
12.103 - Information Required in Original Application for Certificate of Registration
12.104 - Review of Original Application
12.105 - Revisions During Review Process
12.106 - Examinations
12.107 - Withdrawal of an Original Application Before Granting a Certificate of Registration and Subsequent Renewal Applications
12.108 - Renewal of Certificate of Registration
12.109 - Appeal of Denial of Application or Renewal
12.110 - Effect of Sale or Transfer of Ownership of an Independent Review Organization
12.111 - Regulatory Requirements Subsequent to a Certificate of Registration

Subchapter C - GENERAL STANDARDS OF INDEPENDENT REVIEW

12.201 - Independent Review Plan
12.202 - Personnel and Credentialing
12.203 - Conflicts of Interest Prohibited
12.204 - Prohibitions of Certain Activities and Relationships of Independent Review Organizations and Individuals or Entities Associated with Independent Review Organizations
12.205 - Independent Review Organization Contact with and Receipt of Information from Health Care Providers and Patients
12.206 - Notice of Determinations Made by Independent Review Organizations
12.207 - Independent Review Organization Telephone Access
12.208 - Confidentiality

Subchapter D - ENFORCEMENT OF INDEPENDENT REVIEW STANDARDS

12.301 - Complaints, Oversight, and Information
12.302 - Administrative Violations
12.303 - Surrender of Certificate of Registration

Subchapter E - FEES AND PAYMENT

12.401 - Fees
12.402 - Classification of Specialty
12.403 - Fee Amounts
12.404 - Payment of Fees
12.405 - Failure To Pay Invoice
12.406 - Application and Renewal of Certificate of Registration Fees

Subchapter F - RANDOM ASSIGNMENT OF INDEPENDENT REVIEW ORGANIZATIONS

12.501 - Requests for Independent Review
12.502 - Random Assignment

Subchapter G - INDEPENDENT REVIEW OF PREAUTHORIZATION EXEMPTIONS

12.601 - Preauthorization Exemptions

Chapter 13 - MISCELLANEOUS INSURERS AND OTHER REGULATED ENTITIES

Subchapter A - STATEWIDE MUTUAL ASSESSMENT COMPANIES, LOCAL MUTUAL AID ASSOCIATIONS, AND BURIAL ASSOCIATIONS

13.1 - Creation of New Groups, Clubs or Classes
13.2 - Voting by Proxy
13.3 - Policy Approval
13.4 - Requirement of Certain Descriptive Words as a Part of the Corporate Name
13.5 - Organization of a Local Mutual Aid Association or Local Mutual Burial Association
13.6 - Movement of Home Office
13.7 - Membership Fees
13.8 - Operation and Management of Companies and Associations
13.9 - Books and Records, Minimum Requirements
13.10 - Merger under the Insurance Code, Article 14.13
13.11 - Status of Exempt Associations
13.12 - Assessments and Rate Schedules
13.13 - The Use of Mortuary Funds for the Purpose of Defending Contested Claims
13.14 - Ownership and Investment of Assets
13.15 - Beneficiaries under Burial Policies
13.16 - Connection Between Two or More Companies Through Common Management
13.17 - Conversion or Reinsurance of Entire Membership into Legal Reserve Companies under the Insurance Code, Article 14.61
13.18 - Reinsurance Agreements under the Insurance Code, Article 14.62
13.19 - Certain Prohibited Practices
13.20 - Availability of Company Records to the Membership
13.21 - Liabilities
13.22 - Minutes of Directors and Membership Meetings
13.23 - Rate Increases
13.24 - Procedure for Amending Constitution and Bylaws
13.25 - Conversion or Change of Name From a Burial Association to a Local Mutual Aid Association
13.26 - Computation of Time
13.27 - Reserve Requirements
13.28 - Uncollected Premiums
13.29 - Establishment and Maintenance of Permissive Deficiency Reserves

Subchapter B - STIPULATED PREMIUM INSURANCE COMPANIES

13.101 - Establishment and Maintenance of Permissive Deficiency Reserve
13.102 - Life Policy Forms

Subchapter C - LLOYD'S PLAN INSURERS

13.201 - Approval of Attorney in Fact
13.202 - Distinction between Attorney in Fact and Deputy Attorney in Fact

Subchapter D - RISK RETENTION GROUPS AND PURCHASING GROUPS

13.301 - Purpose
13.302 - Definitions
13.303 - Scope
13.304 - General Prohibition
13.305 - Registration
13.306 - Operation by Members Only
13.307 - Providing Other Than Liability Insurance
13.308 - Requirement of Similar or Related Liability Exposure
13.309 - Sanctions
13.310 - Cease and Desist Orders
13.311 - Deceptive Acts or Practices
13.312 - Regulatory Fees
13.313 - Forms Required for Risk Retention Groups and Purchasing Groups

Subchapter E - HEALTH CARE COLLABORATIVES

13.401 - Purpose
13.402 - Definitions
13.403 - Filing and Required Forms; How to Obtain Forms
13.404 - Use of the Term "HCC;" Service Mark; Trademarks; d/b/a
13.411 - Filing Fee; Annual Assessments; Open Records
13.412 - Revisions During Review Process
13.413 - Contents of the Application
13.414 - Limited Exemption from Certain Information Filing Requirements
13.415 - Documents to be Available for Quality of Care and Financial Examinations
13.416 - Review of Original or Renewal Application; Commissioner Discretion
13.417 - Withdrawal of an Application
13.421 - Examination; Fee for Expenses
13.422 - Filing Requirements That Apply After Issuance of Certificate of Authority
13.423 - Service Area Change Applications
13.424 - Certificate of Authority Renewal Requirements
13.425 - Compensation Arrangements
13.426 - Confidentiality
13.429 - HCCs Subject to Insurance Code Chapters 541 and 542 and Related Rules
13.431 - Reserves and Working Capital Requirements
13.432 - Fiduciary Responsibility
13.441 - General Provisions
13.451 - Definitions
13.452 - Determination of Control
13.453 - Filing Requirements
13.454 - Commissioner Action
13.455 - Change of Control with Increased Market Share
13.461 - Commissioner's Authority to Require Additional Information
13.471 - Notification of Change in Payment Arrangements
13.472 - Requirements for Certain Delegation Contracts
13.473 - Organization of an HCC
13.474 - Requirements for HMO or Insurer Delegation of Functions to HCCs
13.481 - Quality Improvement Structure for HCCs
13.482 - Quality Assurance and Quality Improvement
13.483 - Credentialing
13.491 - Complaint Systems
13.492 - Complaints; Deadlines for Response and Resolution
13.493 - Rights of Physicians
13.494 - Limitations and Prohibition

Subchapter F - PROFESSIONAL EMPLOYER ORGANIZATIONS SPONSORING SELF-FUNDED EMPLOYEE HEALTH BENEFIT PLANS

13.510 - Purpose
13.511 - Regulated PEOs; Approval Required
13.512 - ERISA's Applicability; Severability of Subchapter's Provisions
13.513 - Definitions
13.520 - Applicability of Insurance Code Provisions to an Approved PEO, Plan, or Trust
13.521 - Applicable Insurance Code and Administrative Code Terms
13.522 - Delegation of Functions to a Contracting Regulated Entity
13.523 - Applicable Insurance Code Provisions
13.524 - Applicability of Administrative Code Provisions to an Approved PEO, Plan, or Trust
13.530 - Certificate of Approval Required
13.531 - Forms and Fees
13.532 - Application Requirements
13.533 - Actuarial Opinion Requirements
13.534 - Application Review, Approval, and Denial
13.540 - Governance and Operation of Approved PEO
13.541 - Stop-Loss Insurance
13.542 - PEO's Fidelity Coverage
13.543 - Approved PEO's Conduct with Respect to the Plan and Trust
13.544 - Marketing Materials; Offers of Enrollment
13.545 - Representations to Clients and Participants
13.550 - Plan Formation
13.551 - Trust Formation
13.552 - Required Filings
13.553 - Plan and Trust Governance and Operation
13.554 - Board of Trustees
13.555 - Trustees' Responsibility and Authority
13.556 - Protection of Plan and Trust Assets
13.557 - Disputes Arising Under the Plan or Trust
13.560 - Annual and Quarterly Reserves
13.561 - Authorized Investments
13.562 - Deposit or Letter of Credit Required
13.563 - Form of Deposit
13.564 - Annual Recalculation; Changes to Deposit
13.565 - Letter of Credit
13.566 - Annual Recalculation; Changes to Letter of Credit
13.567 - Stop-Loss Insurance
13.568 - Standards for Fidelity Coverage
13.570 - Financial Filing Requirements
13.571 - Annual Fee
13.572 - Examination of Approved PEO, Plan, and Trust
13.573 - Hazardous Condition; Violations of Statute
13.580 - Withdrawal from Market
13.581 - Limitation, Suspension, or Cancellation of Certificate of Approval in Response to TDLR Action
13.582 - Limitation, Suspension, or Cancellation of Certificate of Approval in Response to TDI Action
13.583 - Cancellation of Certificate of Approval

Chapter 15 - SURPLUS LINES INSURANCE

Subchapter A - GENERAL PROVISIONS

15.1 - Applicability
15.2 - Definitions
15.3 - Regulation of Policies
15.4 - Sanctions
15.5 - Minimum Content of Contracts
15.6 - Forms
15.7 - Submission of Applications, Notices, and Correspondence
15.8 - Filing Requirements
15.9 - Becoming an Eligible Insurer

Subchapter B - SURPLUS LINES AGENTS

15.101 - Licensing of Surplus Lines Agents
15.102 - Conduct of Agent's Business
15.103 - Surplus Lines Stamping Fee
15.104 - Reasonable Duty in Placing Coverage
15.105 - Evidence of Insurance
15.106 - Stamping Office Filing and Fees
15.107 - Requests for Information
15.108 - Recordkeeping
15.109 - Policy Number
15.110 - Contract File
15.111 - Exempt Commercial Purchaser Documentation
15.112 - Industrial Insured Documentation
15.113 - Agent Accounting Records
15.114 - Untimely Filed Policies
15.115 - Surplus Lines Policies for Purchasing Groups

Subchapter C - SURPLUS LINES STAMPING OFFICE PLAN OF OPERATION

15.201 - Commissioner Approval

Subchapter D - SURPLUS LINES INSURERS

15.301 - Evaluation Requirements of Surplus Lines Insurance Coverage

Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS

Subchapter A - DISCIPLINARY HEARINGS IN RESPECT OF INSURANCE AGENTS

19.1 - Purpose
19.2 - Effect of Surrendering or Attempting To Surrender Agent's License

Subchapter B - MEDICARE ADVANTAGE PLANS, MEDICARE ADVANTAGE PRESCRIPTION DRUG PLANS, AND MEDICARE PART D PLANS

19.101 - Definitions
19.102 - Agent Authority to Market Medicare Advantage Plans, Medicare Advantage Prescription Drug Plans, and Medicare Prescription Drug Plans
19.103 - Reporting Requirements

Subchapter G - LICENSING OF INSURANCE ADJUSTERS

19.601 - Fees for Examination
19.602 - Types of Adjuster's Licenses
19.603 - Interpretations of the Act

Subchapter H - LICENSING OF PUBLIC INSURANCE ADJUSTERS

19.701 - Definitions
19.702 - Type of Public Insurance Adjuster Licenses
19.704 - Public Insurance Adjuster Licensing
19.705 - Financial Responsibility Requirement
19.706 - Demonstrating Financial Responsibility
19.707 - Type of Financial Responsibility
19.708 - Public Insurance Adjuster Contracts
19.709 - Nonresident Applicants and License Holders
19.710 - Nonresidents Required to File Biographical Information
19.711 - Fingerprint Requirement
19.712 - Advertisement
19.713 - Public Insurance Adjuster Code of Ethics

Subchapter I - GENERAL PROVISIONS REGARDING FEES, APPLICATIONS, AND RENEWALS

19.801 - General Provisions
19.802 - Amount of Fees
19.804 - Application for a New Entity License
19.805 - Application for a New Individual License
19.806 - Application for a Provisional Permit
19.807 - Application for a Temporary License
19.808 - The Initial Term of a New License and Renewal License Expiration
19.809 - Nonresident Licensees Relocating to Texas
19.810 - License Renewal and Application for an Expired License

Subchapter J - STANDARDS OF CONDUCT FOR LICENSED AGENTS

19.901 - Definitions Concerning Conduct of Licensed Agents
19.902 - One Agent, One License
19.903 - Concurrent Eligibility for Managing General Agent's License and Other Licenses
19.904 - Joint Advertising by Similarly Licensed Agents
19.905 - Referral Business and Insurance Company Appointments
19.906 - Last Known Address

Subchapter K - CONTINUING EDUCATION, ADJUSTER PRELICENSING EDUCATION PROGRAMS, AND CERTIFICATION COURSES

19.1001 - General Provisions
19.1002 - Definitions
19.1003 - Licensee Hour and Completion Requirements
19.1004 - Licensee Exemption from and Extension of Time for Continuing Education
19.1005 - Provider Registration, Instructor, and Speaker Criteria
19.1006 - Course Criteria
19.1007 - Course Certification Submission Applications, Course Expirations, and Resubmissions
19.1008 - Certified Course Advertising, Modification, and Assignment
19.1009 - Types of Courses
19.1010 - Hours of Credit
19.1011 - Requirements for Successful Completion of Continuing Education Courses
19.1012 - Forms and Fees
19.1013 - Licensee Record Maintenance
19.1014 - Provider Compliance Records
19.1015 - Failure to Comply
19.1016 - Automatic Fines
19.1017 - Adjuster Prelicensing Education Course Content and Examination Requirements
19.1018 - Adjuster Prelicensing Examination Topics
19.1020 - State and National Insurance Association Credit
19.1021 - Flood Insurance Education Course
19.1022 - Long-Term Care Partnership Certification Course
19.1023 - Long-Term Care Partnership Continuing Education
19.1024 - Medicare-Related Product Certification Course
19.1025 - Medicare-Related Product Continuing Education
19.1026 - Small Employer Health Benefit Plan Specialty Certification Course
19.1027 - Small Employer Health Benefit Plan Specialty Continuing Education
19.1028 - Annuity Certification Course
19.1029 - Annuity Continuing Education
19.1030 - Effect of License Expiration, Revocation, or Refusal to Renew on Certification Requirements

Subchapter L - SELECTION OF A TESTING SERVICES VENDOR FOR ADMINISTRATION OF LICENSING EXAMINATIONS

19.1101 - Vendor Selection Process
19.1102 - Evaluation
19.1103 - Selection of Vendor
19.1104 - Objection to Selection Process

Subchapter M - LICENSING AND REGULATION OF MANAGING GENERAL AGENTS

19.1201 - General Provisions
19.1202 - Definitions Concerning Licensing and Regulation of Managing General Agents
19.1203 - Adoption by Reference of Forms Relating to Licensing and Regulation of Managing General Agents
19.1204 - Contract Provisions
19.1205 - Escrow Accounts
19.1206 - Errors and Omissions Policies

Subchapter N - LICENSING AND REGULATION OF RISK MANAGERS

19.1301 - Purpose, Scope, and Interpretation of This Subchapter
19.1302 - Definitions
19.1304 - Last Known Address
19.1305 - License Requirement
19.1306 - Qualifications for Risk Manager's License
19.1307 - Exemption
19.1308 - Application for License
19.1309 - Place of Business
19.1310 - Examination
19.1311 - Examination and License Fees and Charges
19.1312 - License Renewal; Renewal Fee
19.1313 - Denial, Suspension, or Revocation of a License
19.1314 - Duration of Suspension
19.1315 - Reinstatement or Relicensing
19.1316 - Nonresident License
19.1317 - License by Endorsement
19.1318 - Dual Compensation
19.1319 - Penalty

Subchapter O - PROCEDURES AND REQUIREMENTS FOR REINSURANCE INTERMEDIARIES (BROKERS AND MANAGERS)

19.1401 - Purpose and Scope
19.1402 - Definitions
19.1403 - Requirements for Bond or Errors and Omissions Policy
19.1404 - Requirements for Interim Profit-Sharing by a Manager
19.1405 - Requirements for Form of Audited Statements
19.1406 - Fees for Examinations
19.1407 - Approval of Reinsurance Intermediary Manager's Contracts

Subchapter P - FEES CHARGED BY LOCAL RECORDING AGENTS

19.1501 - General Provisions
19.1502 - Definitions
19.1503 - Procedures for Charging Fees

Subchapter Q - DISCOUNT HEALTH CARE PROGRAM REGISTRATION AND RENEWAL REQUIREMENTS

19.1601 - Definitions
19.1602 - Registration Requirement
19.1603 - Financial Responsibility Requirement
19.1604 - Renewal
19.1605 - Requirements Related to Discount Health Care Program Information
19.1606 - Severability

Subchapter R - UTILIZATION REVIEWS FOR HEALTH CARE PROVIDED UNDER A HEALTH BENEFIT PLAN OR HEALTH INSURANCE POLICY

19.1701 - General Provisions
19.1702 - Applicability
19.1703 - Definitions
19.1704 - Certification or Registration of URAs
19.1705 - General Standards of Utilization Review
19.1706 - Requirements and Prohibitions Relating to Personnel
19.1707 - URA Contact with and Receipt of Information from Health Care Providers
19.1708 - On-Site Review by a URA
19.1709 - Notice of Determinations Made in Utilization Review
19.1710 - Requirements Prior to Issuing an Adverse Determination
19.1711 - Written Procedures for Appeal of Adverse Determinations
19.1712 - URA's Telephone Access
19.1713 - Confidentiality
19.1714 - Regulatory Requirements Subsequent to Certification or Registration
19.1715 - Administrative Violations
19.1716 - Specialty URA
19.1717 - Independent Review of Adverse Determinations
19.1718 - Preauthorization for Health Maintenance Organizations and Preferred Provider Benefit Plans
19.1719 - Verification for Health Maintenance Organizations and Preferred Provider Benefit Plans
19.1730 - Definitions
19.1731 - Preauthorization Exemption
19.1732 - Notice of Preauthorization Exemption Grants, Denials, or Rescissions
19.1733 - Retrospective Reviews and Appeals of Preauthorization Exemption Rescissions

Subchapter S - FORMS TO REQUEST PRIOR AUTHORIZATION

19.1801 - Applicability
19.1802 - Exception
19.1803 - Definitions
19.1804 - Severability
19.1810 - Prior Authorization Request Form for Health Care Services, Required Acceptance, and Use
19.1820 - Prior Authorization Request Form for Prescription Drug Benefits, Required Acceptance, and Use

Subchapter T - SPECIALTY INSURANCE LICENSE

19.1901 - Purpose
19.1902 - Definitions
19.1903 - Qualifications
19.1904 - Application
19.1906 - Expiration and Renewal of Licenses
19.1907 - Non-Residents
19.1908 - Notice to Department
19.1909 - Employee Training
19.1910 - Denial Or Refusal Of Specialty License Application; Suspension Or Revocation Of Specialty Licenses; Discipline Of Specialty License Holders

Subchapter U - UTILIZATION REVIEWS FOR HEALTH CARE PROVIDED UNDER WORKERS' COMPENSATION INSURANCE COVERAGE

19.2001 - General Provisions
19.2002 - Applicability
19.2003 - Definitions
19.2004 - Certificate or Registration of URAs
19.2005 - General Standards of Utilization Review
19.2006 - Requirements and Prohibitions Relating to Personnel
19.2007 - URA Contact with and Receipt of Information from Health Care Providers
19.2008 - On-Site Review by a URA
19.2009 - Notice of Determinations Made in Utilization Review
19.2010 - Requirements Prior to Issuing Adverse Determination
19.2011 - Written Procedures for Appeal of Adverse Determinations
19.2012 - URA's Telephone Access and Procedures for Certain Drug Requests and Post-Stabilization Care
19.2013 - Confidentiality
19.2014 - Regulatory Requirements Subsequent to Certification or Registration
19.2015 - Administrative Violations
19.2016 - Specialty URA
19.2017 - Independent Review of Adverse Determinations

Chapter 21 - TRADE PRACTICES

Subchapter A - UNFAIR COMPETITION AND UNFAIR PRACTICES OF INSURERS, AND MISREPRESENTATION OF POLICIES

21.1 - Deceptive Acts or Practices of Insurers, Agents, and Connected Persons
21.2 - Interpretations
21.3 - Unfair Trade Practices Prohibited
21.4 - Misrepresentation Defined; Standards for Determining Misrepresentation
21.5 - Enforcement
21.6 - Prohibition against the Use of Guaranty Fund Protection in the Sale of Insurance

Subchapter B - ADVERTISING, CERTAIN TRADE PRACTICES, AND SOLICITATION

21.101 - Purpose
21.102 - Scope
21.103 - Required Form and Content of Advertisements
21.104 - Requirement of Identification of Policy or Insurer
21.105 - Description of Benefits, Coverage, and Policy Provisions
21.106 - Premiums
21.107 - Testimonials, Appraisals, or Analyses
21.108 - Use of Statistics and Citations
21.109 - Unlawful Inducement
21.110 - Disparagements
21.111 - Comparisons
21.112 - General Prohibition
21.113 - Rules Pertaining Specifically to Accident and Health Insurance Advertising and Health Maintenance Organization Advertising
21.114 - Rules Pertaining Specifically to Life Insurance and Annuity Advertising
21.115 - Rules Pertaining Specifically to Property and Casualty Insurance Advertising
21.116 - Special Enforcement Procedures for Rules Governing Advertising and Solicitation of Insurance
21.117 - Conflict with and Affect on Other Regulations
21.118 - Severability
21.119 - Savings Clause
21.120 - Filing for Review
21.121 - Lead Solicitations
21.122 - System of Control and Home Office Approval of Advertising Material Naming an Insurer
21.151 - Purpose and Scope
21.152 - Definitions
21.153 - Content of Advertisement
21.154 - Severability

Subchapter C - UNFAIR CLAIMS SETTLEMENT PRACTICES

21.201 - Short Title
21.202 - Definitions
21.203 - Unfair Claim Settlement Practices
21.204 - Special Claim Reports and Statistical Plan
21.205 - Minimum Standard of Performance

Subchapter D - STATISTICAL AGENTS

21.301 - Performance Standards for Designated Statistical Agent

Subchapter E - UNFAIR DISCRIMINATION BASED ON SEX OR MARITAL STATUS

21.401 - Purpose
21.402 - Applicability and Scope
21.403 - Definitions
21.404 - Underwriting
21.405 - Policy Terms and Conditions
21.406 - Rates
21.407 - Continuance of Coverage
21.408 - Amendments
21.409 - Severability Clause

Subchapter F - ELECTRONIC TRANSACTIONS

21.501 - Notices of Termination

Subchapter H - UNFAIR DISCRIMINATION

21.701 - Purpose
21.702 - Unfairly Discriminatory Acts or Practices
21.703 - Definitions Concerning Discrimination
21.704 - Unfair Discrimination
21.705 - Nondiscriminatory Testing for Human Immunodeficiency Virus

Subchapter I - PROHIBITED AGENT PRACTICES

21.901 - Prohibition Against Solicitation or Acceptance of Power of Attorney

Subchapter J - PROHIBITED TRADE PRACTICES

21.1001 - Prohibition against Insurer's Non-renewing Personal Auto Policy Solely Because of Age of Young Driver
21.1004 - Restrictions on Certain Claims in Residential Property Insurance and Transition Plan Requirement
21.1005 - Prohibition of Underwriting Guidelines Based on the Purchase of Types or Amounts of Coverage in Excess of Minimum Limits Liability Coverage
21.1006 - Prohibition Against Declining to Write Residential Property Insurance Based on the Age or Value of the Property
21.1007 - Restrictions on Using Guidelines Based on a Water Damage Claim, Previous Mold Damage, or a Mold Damage Claim

Subchapter K - CERTIFICATION OF CREDITABLE COVERAGE

21.1101 - Definitions
21.1102 - Certification of Coverage
21.1103 - Timing of Issuance of a Written Certificate of Creditable Coverage to an Individual
21.1104 - Form and Content of Written Certificate of Creditable Coverage
21.1105 - Delivery of Certificate of Creditable Coverage
21.1106 - Dependent Coverage
21.1107 - Creditable Coverage Established Through Means Other Than Written Certificate
21.1108 - Notification of Creditable Coverage and Preexisting Condition Exclusion
21.1109 - Severability
21.1110 - Form CCC

Subchapter L - MEDICAL CHILD SUPPORT, UNFAIR PRACTICES

21.2001 - Definitions
21.2002 - Prohibition Against Denial of Enrollment
21.2004 - Enrollment of Child Who Is the Subject of a Medical Support Order
21.2005 - Prohibition on Cancellation or Nonrenewal
21.2006 - Notice of Availability of Continuation or Conversion Coverage
21.2007 - Assignment of Medical Support Rights to State Agency
21.2008 - Information Provided by an Insurer
21.2009 - Submission and Payment of Claims
21.2010 - Prohibition on Service Area Restrictions
21.2011 - Unfair or Deceptive Practices

Subchapter M - MANDATORY BENEFIT NOTICE REQUIREMENTS

21.2101 - Scope
21.2102 - Definitions
21.2103 - Mandatory Benefit Notices
21.2105 - Delivery of Mandatory Benefit Notices
21.2106 - Forms
21.2107 - Right To Medicare Supplement Coverage Notice

Subchapter N - LIFE INSURANCE ILLUSTRATIONS

21.2201 - Purpose
21.2202 - Authority
21.2203 - Applicability and Scope
21.2204 - Definitions
21.2205 - Policies To Be Illustrated
21.2206 - General Rules and Prohibitions
21.2207 - Standards for Basic Illustrations
21.2208 - Standards for Supplemental Illustrations
21.2209 - Delivery of Illustration and Record Retention
21.2210 - Annual Report; Notice to Policy Owners
21.2211 - Annual Certification
21.2212 - Penalties
21.2213 - Separability, Conflict with and Effect on Other Regulations
21.2214 - Effective Date

Subchapter P - MENTAL HEALTH AND SUBSTANCE USE DISORDER PARITY

21.2401 - Purpose and Scope
21.2402 - Applicability
21.2403 - Coordination of Statutory Language
21.2404 - Differences from Federal Rules
21.2405 - Corrective Action; Severability
21.2406 - Definitions
21.2407 - Parity Requirements with Respect to Aggregate Lifetime and Annual Dollar Limits
21.2408 - Parity Requirements with Respect to Financial Requirements and Treatment Limitations
21.2409 - Nonquantitative Treatment Limitations
21.2411 - Availability of Plan Information
21.2413 - Sale of Nonparity Health Benefit Plans
21.2414 - Source-of-Injury Exclusions
21.2421 - Definitions - Division 2
21.2422 - Deadline for Reporting Data
21.2423 - Collecting and Reporting Data
21.2424 - Issuer and Plan Information
21.2425 - Claims and Utilization Review: Reporting Classifications
21.2426 - Claims and Utilization Review: Aggregate Data Fields
21.2427 - Plan Reimbursement Rates Compared with Medicare Rates
21.2431 - Required Analyses for Quantitative and Nonquantitative Parity; Alternative Tools
21.2432 - Due Dates for Analyses
21.2433 - Compliance Analysis for Quantitative Parity: General Requirements
21.2434 - Quantitative Parity Analysis: Issuer and Plan Information
21.2435 - Quantitative Parity Analysis: Methodology for Determining Expected Payments
21.2436 - Quantitative Parity Analysis: Covered Benefits
21.2437 - Quantitative Parity Analysis: "Substantially All" and "Predominant" Tests
21.2438 - Compliance Analysis for Nonquantitative Parity: General Instructions
21.2439 - Nonquantitative Treatment Limitations Generally
21.2440 - Nonquantitative Parity Analysis: Issuer and Plan Information
21.2441 - Four-Step Analysis of Nonquantitative Treatment Limitations
21.2451 - Applicability
21.2452 - Coordination of Provisions in Insurance Code Chapter 1355, Concerning Benefits for Certain Mental Disorders

Subchapter Q - COMPLAINT RECORDS TO BE MAINTAINED

21.2501 - Applicability and Purpose
21.2502 - Definitions
21.2503 - Compliance Standard
21.2504 - Complaint Record; Required Elements; Explanation and Instructions
21.2505 - Complaint Record Form
21.2506 - Maintenance Basis and Compilation Frequency of the Complaint Record
21.2507 - Effective Date

Subchapter R - DIABETES

21.2601 - Definitions
21.2602 - Required Benefits for Persons with Diabetes
21.2603 - Out of Pocket Expenses
21.2604 - Minimum Standards for Benefits for Persons with Diabetes, Requirement for Periodic Assessment of Physician and Organizational Compliance
21.2605 - Diabetes Equipment and Supplies
21.2606 - Diabetes Self-Management Training

Subchapter S - ASSOCIATION PLANS

21.2701 - Scope
21.2702 - Definitions
21.2703 - Health Care Plans Issued to Associations and Bona Fide Associations
21.2704 - Mandatory Guaranteed Renewability Provisions for Health Benefit Plans Issued to Members of an Association or Bona Fide Association
21.2705 - Certification of Creditable Coverage
21.2706 - Coverage and Issuance Requirements to Bona Fide Associations

Subchapter T - SUBMISSION OF CLEAN CLAIMS

21.2801 - Purpose and Scope
21.2802 - Definitions
21.2803 - Elements of a Clean Claim
21.2804 - Requests for Additional Information from Treating Preferred Provider
21.2805 - Requests for Additional Information from Other Sources
21.2806 - Claims Filing Deadline
21.2807 - Effect of Filing a Clean Claim
21.2808 - Effect of Filing Deficient Claim
21.2809 - Audit Procedures
21.2810 - Date of Claim Payment
21.2811 - Disclosure of Processing Procedures
21.2812 - Denial of Clean Claim Prohibited for Change of Address
21.2813 - Requirements Applicable to Other Contracting Entities
21.2814 - Electronic Adjudication of Prescription Benefits
21.2815 - Failure to Meet the Statutory Claims Payment Period
21.2816 - Date of Receipt
21.2817 - Terms of Contracts
21.2818 - Overpayment of Claims
21.2819 - Catastrophic Event
21.2820 - Identification Cards
21.2821 - Reporting Requirements
21.2822 - Administrative Penalties
21.2823 - Applicability to Certain Noncontracting Physicians and Providers
21.2824 - Applicability
21.2825 - Severability
21.2826 - Waiver

Subchapter U - ARRANGEMENTS BETWEEN INDEMNITY CARRIERS AND HMOS FOR POINT-OF-SERVICE COVERAGE

21.2901 - Definitions
21.2902 - Arrangements between Indemnity Carriers and HMOs to Provide Coverage

Subchapter V - PHARMACY BENEFITS

21.3001 - Applicability and Severability
21.3002 - Definitions; Pharmacy Identification Cards
21.3003 - Standard Identification Cards
21.3004 - Issuance of Standard Identification Cards
21.3010 - Definitions; Coverage of Off-Label Drugs
21.3011 - Minimum Standards of Coverage for Off-Label Drug Use
21.3020 - Definitions; Prescription Drug Formulary
21.3022 - Continuation of Benefits
21.3023 - Nonformulary Prescription Drugs; Adverse Determination
21.3030 - Availability of Formulary Information
21.3031 - Formulary Information for Individual Health Benefit Plans on Issuer's Website
21.3032 - Formulary Disclosure Requirements for Individual Health Benefit Plans
21.3033 - Facilitating Comparison Shopping for Individual Health Benefit Plans

Subchapter W - COVERAGE FOR ACQUIRED BRAIN INJURY

21.3101 - General Provisions
21.3102 - Definitions
21.3103 - Coverage for Services
21.3104 - Training
21.3105 - Provision of CPT Codes
21.3106 - Small Employer Health Benefit Plans
21.3107 - Mandatory Annual Notice to Insureds and Enrollees

Subchapter X - EVALUATION OF NETWORK PHYSICIANS AND PROVIDERS

21.3201 - Texas Standardized Credentialing Application for Physicians, Advanced Practice Nurses, and Physician Assistants
21.3202 - Physician Ranking Requirements

Subchapter Y - UNFAIR DISCRIMINATION IN COMPENSATION FOR WOMEN'S HEALTH CARE

21.3301 - Purpose
21.3302 - Definitions
21.3303 - Applicability
21.3304 - Reimbursements
21.3305 - Complaints

Subchapter Z - DATA COLLECTING AND REPORTING RELATING TO MANDATED HEALTH BENEFITS AND MANDATED OFFERS OF COVERAGE

21.3401 - Purpose and Scope
21.3402 - Definitions
21.3403 - Collection of Data Necessary to Provide Report
21.3404 - Deadline for Submission of Reports
21.3405 - Exceptions to Required Reporting and Justification for Exceptions
21.3406 - Mandates for Which Data Must Be Reported
21.3407 - Reporting of Required Information
21.3408 - Compliance
21.3409 - Severability
21.3501 - Statement of Purpose
21.3502 - Definitions
21.3503 - Authority to Offer
21.3504 - Severability
21.3505 - Application Date
21.3506 - State-Mandated Health Benefits in Blanket Indemnity Policies
21.3529 - Duty of Agent
21.3530 - Health Carrier Disclosure
21.3535 - Retention of Disclosure
21.3540 - Direct Access to Services
21.3541 - Basic Health Care Services
21.3542 - Offer of State-Mandated Plan
21.3543 - Required Plan Filings
21.3544 - Required Annual Reporting
21.3601 - Scope
21.3602 - Definitions
21.3603 - Right to Choose Dentist
21.3604 - Payment of Benefits for Dental Care Services
21.3605 - Applicability
21.3606 - Severability
21.3701 - Electronic Claims Filing Requirements
21.3801 - Scope and Applicability
21.3802 - Definitions
21.3803 - Method for Requesting Eligibility Statements
21.3804 - Requests for Eligibility Statements
21.3805 - Requirement to Provide Eligibility Statements
21.3806 - Privacy Issues
21.3807 - Effect of Eligibility Statement
21.3808 - Severability
21.3901 - Purpose
21.3902 - Definitions
21.3903 - Applicability of State Mandates to High Deductible Health Plans
21.3904 - Exemption from State Mandates for High Deductible Health Plans
21.3905 - Applicability
21.4001 - Purpose and Scope
21.4002 - Definitions
21.4003 - Group Policyholder, Group Contract Holder, and Carrier Premium Payment and Coverage Obligations
21.4101 - Purpose and Scope
21.4102 - Definitions
21.4103 - Presumed Compliance
21.4104 - Health Benefit Plan Issuers Contracting with Delegated Entities, Delegated Third Parties, and Utilization Review Agents
21.4105 - Department Monitoring and Analysis of National Accreditation Organization Standards
21.4106 - Confidentiality
21.4201 - Purpose
21.4202 - Scope
21.4203 - Exemptions
21.4204 - Definitions
21.4205 - Practices Declared False, Misleading, Deceptive or Unfair on a Military Installation
21.4206 - Practices Declared Deceptive or Unfair Regardless of Location
21.4207 - Severability
21.4301 - Recognition
21.4501 - Purpose
21.4502 - Applicability
21.4503 - Definitions
21.4504 - Geographic Regions
21.4505 - Requirement to Collect Data
21.4506 - Submission of Report
21.4507 - Data Required
21.4701 - Applicability and Scope
21.4702 - Definitions
21.4703 - Wellness Programs Exception
21.4704 - Purposes
21.4705 - General Provisions Applicable to Wellness Programs
21.4706 - Wellness Programs With Participation as Sole Basis for Reward Eligibility
21.4707 - Activity-only Wellness Programs
21.4708 - Outcome-Based Wellness Programs
21.4801 - Applicability and Scope
21.4802 - Definition of Noninsurance Benefit
21.4803 - Purpose
21.4804 - Reasonable Relation to Policy, Contract or Certificate
21.4805 - Disclosure Requirements for Form Filings that Include Noninsurance Benefits
21.4806 - Additional Provisions Applicable to Noninsurance Benefits
21.4807 - Noninsurance Benefits Composed of Certain Discount Programs
21.4901 - Purpose and Applicability
21.4902 - Definitions
21.4903 - Out-of-Network Notice and Disclosure Requirements
21.4904 - Health Benefit Plan Issuer and Administrator Responsibility
21.5001 - Purpose
21.5002 - Scope
21.5003 - Definitions
21.5010 - Qualified Mediation Claim Criteria
21.5011 - Mediation Request Procedure
21.5012 - Informal Settlement Teleconference
21.5013 - Mediation Participation
21.5020 - Qualified Arbitration Claim Criteria
21.5021 - Arbitration Request Procedure
21.5022 - Informal Settlement Teleconference
21.5023 - Arbitration Participation
21.5030 - Complaint Resolution
21.5040 - Required Explanation of Benefits and Enrollee Identification Card Information
21.5050 - Submission of Information
21.5060 - Election Submission Requirements
21.5070 - Rate Database for Emergency Medical Services Providers
21.5071 - Payments to Emergency Medical Services Providers
21.5201 - Identification Cards - Health Coverage for Motorcycle Injuries
21.5301 - Purpose
21.5302 - Definitions
21.5310 - Mandatory Group Continuation Privilege
21.5311 - Notification Requirement of Insurers, Employer and Group Policyholders, and HMOs
21.5312 - Continuation Election and Effective Dates
21.5313 - Continuation Premium
21.5314 - Mandatory Group Continuation Provisions
21.5320 - Offer of Conversion
21.5321 - Notice of Conversion Options
21.5322 - Coverage for Children
21.5401 - Applicability
21.5402 - Definitions
21.5403 - Texas APCD Common Data Layout and Submission Guide
21.5404 - Data Submission Requirements
21.5405 - Timing and Frequency of Data Submissions
21.5406 - Stakeholder Advisory Group Terms
21.5501 - Applicability and Effective Date
21.5502 - Form and Method of Publishing Machine-Readable Files
21.5503 - Data Schemas

Chapter 22 - PRIVACY

Subchapter A - INSURANCE CONSUMER FINANCIAL INFORMATION PRIVACY

22.1 - Purpose and Scope
22.2 - Definitions
22.3 - Exceptions to Applicability of Subchapter
22.4 - Determination of Consumer Status
22.5 - Examples of Continuing Relationship
22.6 - Notice Requirements
22.7 - Determination of Reasonable Basis
22.8 - Initial Privacy Notice
22.9 - Annual Privacy Notice
22.10 - Information to be Included in Privacy Notices
22.11 - Form of Opt Out Notice to Consumers and Opt Out Methods
22.12 - Revised Privacy Notices
22.13 - Delivery
22.14 - Limits on Disclosure of Nonpublic Personal Financial Information to Nonaffiliated Third Parties
22.15 - Limits on Redisclosure and Reuse of Nonpublic Personal Financial Information
22.16 - Limits on Sharing Account Number Information for Marketing Purposes
22.17 - Exception to Opt Out Requirements for Disclosure of Nonpublic Personal Financial Information for Service Providers and Joint Marketing
22.18 - Exceptions to Notice and Opt Out Requirements for Disclosure of Nonpublic Personal Financial Information for Processing and Servicing Transactions
22.19 - Other Exceptions to Notice and Opt Out Requirements for Disclosure of Nonpublic Personal Financial Information
22.20 - Protection of Fair Credit Reporting Act
22.21 - Nondiscrimination
22.22 - Violation
22.23 - Severability
22.24 - Effective Date
22.25 - Preservation of Existing Privacy Law
22.26 - Model Privacy Notice Form and Examples
22.27 - General Instructions

Subchapter B - INSURANCE CONSUMER HEALTH INFORMATION PRIVACY

22.51 - Purpose and Scope
22.52 - Definitions
22.53 - Authorization Required for Disclosure of Nonpublic Personal Health Information
22.54 - Authorizations
22.55 - Delivery of Requests for Authorization & Authorization Forms
22.56 - Revocation of Authorizations
22.57 - Exceptions
22.60 - Responsibility for Disclosure to Third Parties
22.61 - Relationship to Federal Rules
22.62 - Protection of Fair Credit Reporting Act
22.63 - Relationship to State Laws
22.64 - Violation; Disciplinary Action
22.65 - Nondiscrimination
22.66 - Severability
22.67 - Effective date

Chapter 24 - DISCOUNT HEALTH CARE PROGRAM PRINCIPLES OF REGULATION

Subchapter A - DISCOUNT HEALTH CARE PROGRAM PRINCIPLES OF REGULATION

24.1 - Purpose, Scope, and Construction
24.2 - Definitions
24.3 - Principles
24.4 - Severability

Chapter 25 - INSURANCE PREMIUM FINANCE

Subchapter A - GENERAL PROVISIONS

25.1 - Definitions
25.2 - Place of Business
25.3 - Responsibility for Acts of Employees
25.4 - Knowledge of Laws and Regulations Required
25.6 - Motor Clubs
25.8 - Notice by Insurance Companies of Additional or Return Premium Charge
25.9 - Texas Automobile Insurance Plan Association Financing Disclosure and Premium Finance Comparison Disclosure Form
25.10 - Premium Refunds
25.11 - Surplus Lines Insurance Agents and Agencies
25.12 - Savings Clause
25.13 - Severability

Subchapter B - LICENSING AND REGULATION

25.21 - When a Premium Finance License Is Required
25.22 - Forms Relating to Regulation of Premium Finance Companies under the Insurance Code, Chapter 24
25.23 - Bank and Savings and Loan Association Premium Finance Application
25.24 - License Application
25.25 - Additional Location License Application
25.26 - Relocation of Licensed Offices
25.27 - Change of Mailing Address
25.28 - Ownership Change
25.29 - Name Change
25.30 - Renewal
25.31 - Insurance Premium Finance Business Operation Forms
25.32 - Financial Responsibility
25.33 - Summary of Fees

Subchapter C - OPERATIONS

25.41 - Unacceptable Loans
25.42 - Rate and Refund Chart
25.43 - Acceptance or Rejection
25.44 - Prompt Processing Required
25.45 - Duplication of Loans
25.46 - Quotation of Net Payoffs
25.47 - Policies Issued through the Texas Medical Liability Insurance Underwriting Association
25.48 - Notification of Account Adjustment to Insured
25.49 - Increase in Financed Premiums
25.50 - Premium Decrease Due to Improper Rating
25.51 - Changes in Finance Rate
25.52 - Effective Date of Adjusted Premium Finance Changes
25.53 - Computation of Finance Charge upon Cancellation
25.54 - Finance Charge Earnings upon Acceleration
25.55 - Notification to Insured of Offset
25.56 - Alternative Methods of Adjusting Accounts
25.57 - Cancellation of Policy Through Power of Attorney
25.58 - Notice of Intent To Cancel Insurance Because of Default
25.59 - Notice of Cancellation Because of Default
25.60 - Collection Practices
25.61 - Record of Contacts
25.62 - Compliance with Statutory, Regulatory, or Contractual Requirements
25.63 - Filing of Power of Attorney on Assignment with Insurer
25.64 - Notification to Insurers
25.65 - Relocation of Accounts

Subchapter D - ADVERTISING

25.71 - Advertisements in General
25.72 - Place of Loan
25.73 - Advertisement File
25.74 - Full Disclosure Requirements in Advertising
25.75 - Misleading Advertising
25.76 - Multiple Page Advertisements

Subchapter E - EXAMINATIONS AND ANNUAL REPORTS

25.81 - Examinations
25.82 - Examination Charges
25.83 - Access to Books and Records
25.84 - Individual Account Records
25.85 - Retention of Records
25.86 - Filing of Account Records
25.87 - Annual Reports
25.88 - General Administrative Expense Assessment
25.89 - File for Official Correspondence and Reports
25.90 - Escheat Account

Chapter 26 - EMPLOYER-RELATED HEALTH BENEFIT PLAN REGULATIONS

Subchapter A - DEFINITIONS, SEVERABILITY, AND SMALL EMPLOYER HEALTH REGULATIONS

26.3 - Severability
26.4 - Definitions
26.5 - Applicability and Scope
26.6 - Status of Health Carriers as Small Employer Carriers
26.7 - Requirement to Insure Entire Groups
26.8 - Guaranteed Issue, Contribution, and Participation Requirements
26.9 - Exclusions, Limitations, Waiting Periods, Affiliation Periods, Preexisting Conditions, and Restrictive Riders
26.10 - Establishment of Classes of Business
26.11 - Restrictions Relating to Premium Rates
26.12 - Disclosure
26.13 - Fair Marketing
26.14 - Coverage
26.15 - Renewability of Coverage and Cancellation
26.16 - Refusal to Renew and Application to Reenter Small Employer Market
26.18 - Election and Application to be Risk-Assuming or Reinsured Carrier
26.19 - Filing Requirements
26.20 - Reporting Requirements
26.25 - Unfair Competition and Unfair Practices
26.28 - Territorial Exclusions
26.30 - Composite Premiums

Subchapter B - TEXAS HEALTH REINSURANCE SYSTEM PLAN OF OPERATION

26.201 - The Texas Health Reinsurance System Plan of Operation

Subchapter C - LARGE EMPLOYER HEALTH INSURANCE REGULATIONS

26.301 - Applicability, Definitions, and Scope
26.302 - Status of Health Carriers as Large Employer Carrier
26.303 - Coverage Requirements
26.304 - Requirement to Insure Entire Groups
26.305 - Enrollment
26.306 - Exclusions, Limitations, Waiting Periods, Affiliation Periods, Preexisting Conditions, and Restrictive Riders
26.307 - Fair Marketing
26.308 - Renewability of Coverage and Cancellation
26.309 - Refusal to Renew and Application to Reenter Large Employer Market
26.310 - Unfair Competition and Unfair Practices
26.312 - Point-of-service Coverage
26.313 - Filing Requirements
26.314 - Territorial Exclusions

Subchapter D - COOPERATIVES

26.400 - Definitions and Filing
26.401 - Establishment of Health Group Cooperatives
26.402 - Membership of Health Group Cooperatives
26.403 - Marketing Activities of Health Group Cooperatives
26.405 - Premium Tax Exemption for Previously Uninsured
26.406 - Standard Presentation Form
26.407 - Health Carrier Filing Before Issuance of Coverage to a Health Group Cooperative
26.408 - Issuance of Coverage to Health Group Cooperatives
26.409 - Health Benefit Plans Offered Through Health Group Cooperatives
26.410 - Expedited Approval for Plans Offered Through a Health Group Cooperative
26.411 - Service Areas for Health Carriers Offering Coverage Through a Health Group Cooperative
26.421 - Election to Permit Single-Employee Businesses to Participate in a Health Group Cooperative
26.422 - Condition Precedent to Filing Election to Admit Single-Employee Businesses as Members
26.423 - Initial and Annual Enrollment Periods
26.424 - Membership Eligibility Requirements for Single-Employee Businesses
26.425 - Plan Issuance, Rating Requirements, and Mandated Benefits
26.426 - Rescission of Election
26.431 - Election to Treat Members as Separate Employers for Rating Purposes
26.441 - Private Purchasing Cooperatives
26.442 - Powers and Duties of Texas Health Benefits Purchasing Cooperative and Private Purchasing Cooperatives

Subchapter E - HEALTHY TEXAS PROGRAM

26.501 - Purpose
26.502 - Definitions
26.511 - Health Benefit Plan Issuer Participation
26.512 - Application, Initial Certification of Eligibility, and Enrollment
26.513 - Annual Recertification of Eligibility
26.514 - Health Plan Renewal Provisions
26.515 - Notice of Discontinuance of Health Plan; Issuer Withdrawal from Participation
26.516 - Grace Period
26.517 - Health Plan Contact Information
26.521 - Small Employer Participation
26.522 - Verification of Income
26.531 - Purpose
26.532 - Applicability and Scope
26.533 - Submission of Election to Participate in Healthy Texas
26.534 - Participation Through Direct Purchase of Health Benefit Plan
26.535 - Participation Through Eligible Regional or Local Health Care Program Implementation
26.536 - Withdrawal from Participation
26.537 - Program Certification
26.538 - Applicability of Other Subchapter Provisions
26.551 - Rating of Plans Eligible for Claims Reimbursements
26.552 - Reinsurance Permitted
26.553 - Required Policy Form and Rate Filings
26.561 - Definitions
26.562 - Eligibility of Claims Paid for Reimbursement from the Fund
26.563 - Fund Administration
26.564 - Data Filing Requirements

Chapter 28 - SUPERVISION AND CONSERVATION

Subchapter A - GENERAL PROVISIONS REGARDING SUPERVISION AND CONSERVATION

28.1 - Stay of Time Periods
28.2 - Decisions and Orders
28.3 - The Encouragement of the Merger of Insurers in Weak Financial Condition with Insurers in a Stronger Financial Condition

Chapter 29 - GUARANTY ACTS

Subchapter A - GUARANTY ASSOCIATIONS' PUBLIC INTEREST INFORMATION

29.1 - Guaranty Associations' Public Interest Information

Chapter 31 - LIQUIDATION

Subchapter C - AUDIT COVERAGES REQUIRED FOR GUARANTY ASSOCIATIONS

31.201 - Purpose
31.202 - Applicability
31.203 - Qualification of Accountant
31.204 - Nature of Audits
31.205 - Scope and Frequency of Audits
31.206 - Audit Reporting Requirements
31.207 - Cost of Audits

Chapter 33 - CONTINUING CARE PROVIDERS

Subchapter A - GENERAL PROVISIONS

33.1 - Purpose
33.2 - Definitions
33.3 - Scope
33.4 - Severability
33.5 - Violation of Rules
33.6 - Fees for Filing Application for Certificate of Authority
33.7 - Fiscal Year
33.8 - Forms
33.9 - Address for Filings
33.10 - Unauthorized Providers Required to Respond to Inquiries

Subchapter B - CONTINUING CARE IN RESIDENCE

33.101 - Scope
33.102 - Adding Authority for Continuing Care in Residence
33.103 - Disclosure Statement Requirements
33.104 - Entrance Fee Escrow Account Requirements
33.105 - Contract Requirements for Continuing Care in Residence

Subchapter C - APPLICATION BY CONTINUING CARE PROVIDER FOR CERTIFICATE OF AUTHORITY

33.201 - Scope
33.202 - Incorporated Entities Only
33.203 - Filing Requirements for Application for Certificate of Authority
33.204 - Contents of Application for Certificate of Authority
33.205 - Deficient Application
33.206 - Hearing on Application

Subchapter D - DISCLOSURE STATEMENT

33.301 - Filing and Preparation of Disclosure Statement
33.302 - Annual Disclosure Statement Revision
33.303 - Other Revisions of Disclosure Statement
33.304 - Disclosure Statement Preparation and Filing
33.305 - Date of Disclosure Statement
33.306 - Financial Statement, Studies, and Forecasts
33.307 - Delivery of Disclosure Statement
33.308 - Violation of Requirements Concerning Disclosure Statements

Subchapter E - ESCROW ACCOUNTS

33.401 - Entrance Fee Escrow Accounts
33.402 - Refund of Entrance Fees or Reservation Agreement Deposit to Resident or Prospective Resident from the Entrance Fee Escrow Account
33.403 - Release of Funds from the Entrance Fee Escrow Account to Provider
33.404 - Loan Reserve Fund Escrow Account
33.405 - Release of Funds from Loan Reserve Fund Escrow Account
33.406 - Repayment of Funds Released from Reserve Fund Escrow Account

Subchapter F - ONGOING REGULATORY REQUIREMENTS

33.501 - Books and Records
33.502 - Inquiries
33.503 - Investigations and Examinations by the Department
33.504 - Advertising
33.505 - Financial Condition
33.506 - Actuarial Review Requirements
33.507 - Supervision, Rehabilitation, Liquidation
33.508 - Transfer of Certificate of Authority
33.509 - Management Contract
33.510 - Change of Fiscal Year
33.511 - Changes in Responsible Person

Chapter 34 - STATE FIRE MARSHAL

Subchapter A - FLAMMABLE LIQUIDS

34.1 - Purpose
34.2 - Title
34.3 - Applicability of Sections
34.4 - Definitions
34.5 - Adopted Standards
34.6 - Retroactivity
34.7 - Severability

Subchapter B - FIRE SUPPRESSION RATINGS OVERSIGHT

34.201 - Applicability
34.202 - Definitions
34.203 - Review of Community Fire Ratings
34.204 - Appeal of Community Fire Rating Determination

Subchapter C - STANDARDS AND FEES FOR STATE FIRE MARSHAL INSPECTIONS

34.301 - Purpose
34.302 - Definitions
34.303 - Adopted Standards
34.304 - Severability
34.320 - Guidelines For Assigning Potential Fire Safety Risk
34.340 - Inspection Fees for Requested Inspections

Subchapter D - TESTING LABORATORY RULES

34.401 - Purpose
34.402 - Title
34.403 - Applicability and Scope
34.407 - Approved Testing Laboratories
34.408 - Severability

Subchapter E - FIRE EXTINGUISHER RULES

34.501 - Purpose
34.502 - Title
34.503 - Applicability of Subchapter
34.504 - Exceptions
34.505 - Notices
34.506 - Definitions
34.507 - Adopted Standards
34.508 - Approved Testing Laboratories
34.509 - Approved Certification Organization
34.510 - Certificates of Registration
34.511 - Fire Extinguisher Licenses
34.512 - Apprentice Permit
34.513 - Alteration of Certificates, Licenses, or Permits
34.514 - Applications
34.515 - Fees
34.516 - Tests
34.517 - Installation and Service
34.518 - Fire Extinguisher Fixed System Plans for Other Than Pre-engineered Systems
34.519 - Installation Labels for Fixed Extinguisher Systems
34.520 - Service Tags
34.521 - Red Tags
34.522 - Severability
34.523 - Savings Clause

Subchapter F - FIRE ALARM RULES

34.601 - Purpose
34.602 - Title
34.603 - Applicability of Sections
34.604 - Exceptions
34.605 - Notices
34.606 - Definitions
34.607 - Adopted Standards
34.608 - Approved Testing Laboratories
34.609 - Approved Testing Organization
34.610 - Certificate of Registration
34.611 - Licenses and Approvals
34.612 - Alteration of Certificates, Licenses, or Approvals
34.613 - Applications
34.614 - Fees
34.615 - Test
34.616 - Sales, Installation, and Service
34.617 - Certification
34.618 - Installation Inspections
34.619 - Fire Alarm and Detection System Plans and Record Drawings
34.620 - Installation Labels
34.621 - Service Labels
34.622 - Inspection/Test Labels
34.623 - Yellow Labels
34.624 - Red Labels
34.625 - Enforcement
34.626 - Severability
34.627 - Requirements for Instructors and Training Schools
34.628 - Requirements for Residential Fire Alarm Technician Training Course
34.630 - Application and Renewal Forms

Subchapter G - FIRE SPRINKLER RULES

34.701 - Purpose
34.702 - Title
34.703 - Applicability of Subchapter
34.704 - Exceptions
34.705 - Notices
34.706 - Definitions
34.707 - Adopted Standards
34.708 - Approved Testing Laboratories
34.709 - Approved Certification Organization
34.710 - Certificates of Registration
34.711 - Responsible Managing Employee (RME) License
34.712 - Alteration of Certificates or Licenses
34.713 - Applications
34.714 - Fees
34.715 - Tests
34.716 - Installation, Maintenance, and Service
34.717 - Sprinkler System Plans
34.718 - Installation Tags
34.719 - Service Tags
34.720 - Inspection, Test and Maintenance Service (ITM) Tag
34.721 - Yellow Tags
34.722 - Red Tags
34.723 - Enforcement
34.724 - Administrative Actions
34.725 - Severability

Subchapter H - STORAGE AND SALE OF FIREWORKS

34.801 - Purpose
34.802 - Title
34.803 - Applicability of Rules
34.804 - Exceptions
34.805 - Notices
34.806 - Restrictive Use
34.807 - Administration
34.808 - Definitions
34.809 - General Requirements, Licenses and Permits
34.810 - Requirements, Licensees
34.811 - Requirements, Pyrotechnic Operator License, Pyrotechnic Special Effects Operator License, and Flame Effects Operator License
34.812 - Expiration, License, and Permit
34.813 - Applications for Licenses and Permits
34.814 - Fees
34.815 - Retail Permits
34.816 - Agricultural, Industrial, and Wildlife Control Permits
34.817 - Retail Sales General Requirements
34.818 - Specific Requirements for Retail Fireworks Stands
34.819 - Records and Reports
34.820 - Requirements for Manufacturing, Bulk Storage, and Magazine Facilities
34.821 - Manufacturing Operations
34.822 - Storage of Black Powder and Fireworks 1.3G at Other Than Display Sites
34.823 - Bulk Storage of Fireworks 1.4G
34.824 - Distance Tables
34.825 - Distribution and Transportation
34.826 - Preparing and Conducting Public Pyrotechnic Displays and Flame Effects
34.827 - Qualifications for Persons Assisting at Public Displays
34.828 - Existing Facilities and Conditions
34.829 - Severability
34.830 - Savings Clause
34.832 - Specific Requirements for Retail Fireworks Sites Other Than Stands

Subchapter I - SECURITY BARS

34.901 - Purpose and Application
34.902 - Definitions
34.903 - Labeling and Notice Requirements
34.904 - Recommended Release Mechanism

Subchapter K - GIFTS, GRANTS AND DONATIONS

34.1101 - Purpose
34.1102 - General Authority to Accept Gifts, Grants, and Donations
34.1103 - Definitions
34.1104 - Acceptance of Gifts, Grants, and Donations
34.1105 - Prohibition against Solicitation
34.1106 - Standards of Conduct between Commissioner and Donors or Grantors
34.1107 - Procedures for Acceptance of Gifts, Grants, and Donations

Subchapter L - FIRE STANDARD COMPLIANT CIGARETTES

34.1201 - Purpose, Applicability, and Title
34.1202 - Definitions
34.1203 - General Provisions Regarding Required and Voluntary Submissions
34.1204 - Existing Inventory
34.1205 - Testing
34.1206 - Alternative Testing Methods
34.1207 - Certification
34.1208 - Changes to Cigarette Variety
34.1209 - Records Maintenance
34.1210 - Marking of Package
34.1211 - Certification Filing Fees
34.1212 - Promulgated and Alternate Certification Forms and Marking Applications
34.1213 - Penalties
34.1214 - Forfeiture Authority

Subchapter M - SCHEDULED ADMINISTRATIVE PENALTIES

34.1301 - Imposition of Penalty
34.1302 - Schedule of Administrative Penalties
34.1303 - Combined Sanctions
34.1304 - Notice of Violation and Penalty
34.1305 - Penalty to be Paid or Hearing Requested
34.1306 - Request for Hearing
34.1307 - Failure to Pay Penalty
34.1308 - Dispute of Penalty