Tex. Ins. Code Section 846.0035
Applicability of Certain Laws to Association Providing Health Benefits

(a)

This section applies only to a multiple employer welfare arrangement:

(1)

that was issued an initial certificate of authority under Section 846.054 (Issuance of Initial Certificate of Authority) on or after January 1, 2024; or

(2)

that elects to be bound by this section in the manner prescribed by the commissioner.

(b)

A multiple employer welfare arrangement that provides a comprehensive health benefit plan, as determined by the commissioner, is subject to the following laws as if the arrangement were an insurer, individuals entitled to coverage under the plan were insureds, and the health benefits were provided through an insurance policy:

(1)

Chapter 421 (Reserves in General);

(2)

Chapter 422 (Asset Protection Act);

(3)

Subchapters C, F, and K, Chapter 1451 (Access to Certain Practitioners and Facilities); and

(4)

Chapter 4201 (Utilization Review Agents).

(c)

A multiple employer welfare arrangement that provides a comprehensive health benefit plan, as determined by the commissioner, that is determined by the commissioner to be structured in the manner of a preferred provider benefit plan or an exclusive provider benefit plan as defined in Section 1301.001 (Definitions) is subject to the following laws as if the arrangement were an insurer, individuals entitled to coverage under the plan were insureds, and the health benefits were provided through an insurance policy:

(1)

Chapter 1301 (Preferred Provider Benefit Plans); and

(2)

Chapter 1467 (Out-of-network Claim Dispute Resolution).
Added by Acts 2023, 88th Leg., R.S., Ch. 117 (H.B. 290), Sec. 1, eff. September 1, 2023.

Source: Section 846.0035 — Applicability of Certain Laws to Association Providing Health Benefits, https://statutes.­capitol.­texas.­gov/Docs/IN/htm/IN.­846.­htm#846.­0035 (accessed Jun. 5, 2024).

846.001
Definitions 846.002
Applicability of Chapter 846.003
Limited Exemption from Insurance Laws 846.004
Late-participating Employee or Dependent 846.005
Rules 846.006
Appeal of Orders 846.007
Premium Rates 846.0035
Applicability of Certain Laws to Association Providing Health Benefits 846.051
Certificate of Authority Required 846.052
Application for Initial Certificate of Authority 846.053
Eligibility Requirements for Initial Certificate of Authority 846.054
Issuance of Initial Certificate of Authority 846.055
Extension of Term of Initial Certificate of Authority 846.056
Final Certificate of Authority 846.057
Denial of Final Certificate of Authority 846.058
Disqualification 846.059
Fees 846.060
Suspension, Revocation, or Limitation of Certificate of Authority 846.061
Action by Attorney General 846.101
Board Members 846.102
Duties of Board Members 846.103
Limitation on Action Against Board Member 846.104
Compensation of Board Members 846.105
Officers 846.106
Compensation of Officers, Agents, and Employees 846.107
Receipt of Thing of Value 846.151
General Powers 846.152
Filing of Organizational Documents 846.153
Required Filings 846.154
Cash Reserve Requirements 846.155
Adjustment of Contributions 846.156
Waiver or Reduction of Required Stop-loss Insurance or Cash Reserves 846.157
Renewal of Certificate 846.158
Examination of Multiple Employer Welfare Arrangements 846.159
Name of Multiple Employer Welfare Arrangement 846.160
Evidence of Existence 846.201
Benefits Allowed 846.202
Preexisting Condition Provision 846.203
Treatment of Certain Conditions as Preexisting Prohibited 846.204
Waiting Period Permitted 846.205
Certain Limitations or Exclusions of Coverage Prohibited 846.206
Renewability of Coverage 846.207
Refusal to Renew 846.208
Notice to Covered Persons 846.209
Written Statement of Denial, Cancellation, or Refusal to Renew 846.251
Participation Criteria 846.252
Coverage Requirements 846.253
Prohibition on Exclusion of Eligible Employee or Dependent 846.254
Written Notice to Employees Covered 846.255
Declining Coverage 846.256
Minimum Contribution or Participation Requirements 846.257
Enrollment 846.258
Coverage for Newborn Children 846.259
Coverage for Adopted Children 846.260
Limiting Age Applicable to Unmarried Child 846.301
Marketing Requirements 846.302
Additional Reporting Requirements 846.303
Applicability to Third-party Administrator
Green check means up to date. Up to date

Accessed:
Jun. 5, 2024

§ 846.0035’s source at texas​.gov