Chapter
1501
Health Insurance Portability and Availability Act
Sections
1501.001
Short Title
1501.002
Definitions
1501.003
Applicability: Small Employer Health Benefit Plans
1501.004
Applicability: Large Employer Health Benefit Plans
1501.005
Exception: Certain Individually Underwritten Policies
1501.006
Certification
1501.007
Affiliates
1501.008
Late Enrollees
1501.009
School District Election
1501.010
General Rules
1501.011
Determination of Employer Status for Certain Employers
1501.051
Definitions
1501.052
Texas Health Benefits Purchasing Cooperative; Board of Trustees
1501.053
Texas Health Benefits Purchasing Cooperative: Executive Director and Other Employees
1501.054
Regional Subdivisions of Texas Health Benefits Purchasing Cooperative
1501.055
Applicability of Public Information Law to Texas Health Benefits Purchasing Cooperative
1501.056
Private Purchasing Cooperatives and Health Group Cooperatives
1501.057
Immunity
1501.058
Powers and Duties of Cooperatives
1501.059
Self-insured or Self-funded Plan Prohibited
1501.060
Scope of Group Coverage
1501.061
Requirements Applicable to Health Benefit Plan Issuers with Which Cooperative May Contract
1501.062
Cooperative Not Insurer; Agents and Administrators
1501.063
Status as Employer
1501.064
Certain Use of Appropriated Money Prohibited
1501.065
Certain Actions Based on Risk Characteristics or Health Status Prohibited
1501.066
Election to Treat Participating Employers Separately for Rating Purposes
1501.067
Eligible Single-employee Business
1501.0095
School District Employee Election
1501.101
Geographic Service Areas
1501.102
Preexisting Condition Provision
1501.103
Treatment of Certain Conditions as Preexisting Prohibited
1501.104
Affiliation Period
1501.105
Waiting Period Permitted
1501.106
Certain Limitations or Exclusions of Coverage Prohibited
1501.107
Discounts, Rebates, and Reductions
1501.108
Renewability of Coverage; Cancellation
1501.109
Refusal to Renew; Discontinuation of Coverage
1501.110
Notice to Covered Persons
1501.111
Written Statement of Denial, Cancellation, or Refusal to Renew Required
1501.151
Guaranteed Issue
1501.152
Exclusion of Eligible Employee or Dependent Prohibited
1501.153
Employer Contribution
1501.154
Minimum Participation Requirement
1501.155
Exception to Minimum Participation Requirement
1501.156
Employee Enrollment; Waiting Period
1501.157
Coverage for Newborn Children
1501.158
Coverage for Adopted Children
1501.159
Continuation of Coverage for Certain Dependents
1501.201
Definitions
1501.202
Establishment of Classes of Business
1501.203
Establishment of Classes of Business on Certain Bases Prohibited
1501.204
Index Rates
1501.205
Premium Rates: Establishment
1501.206
Premium Rates: Adjustments
1501.207
Premium Rate Adjustment in Closed Plan
1501.208
Premium Rates: Industry Classification
1501.209
Premium Rates: Number of Employees
1501.210
Premium Rates: Nondiscrimination
1501.211
Rules Concerning Premium Rates
1501.212
Restricted Provider Network
1501.213
Premium Rates: Health Maintenance Organization Health Benefit Plan
1501.214
Enforcement
1501.215
Reporting Requirements
1501.216
Premium Rates: Notice of Increase
1501.251
Exception from Certain Mandated Benefit Requirements
1501.252
Health Benefit Plans
1501.254
Alcohol and Substance Abuse Benefits
1501.255
Health Maintenance Organization Plans
1501.256
Coordination with Federal Law
1501.257
Cost Containment
1501.258
Forms
1501.259
Riders; Filing with Commissioner
1501.260
Plain Language Required
1501.301
Definitions
1501.302
Texas Health Reinsurance System
1501.303
System Board of Directors
1501.304
Open Meetings; Public Information
1501.305
Board Member Immunity
1501.306
System Plan of Operation
1501.307
System Powers
1501.308
System Notes as Legal Investment for Small Employer Health Benefit Plan Issuer
1501.309
System Audit
1501.310
Election of Status
1501.311
Change in Status
1501.312
Application to Operate as Risk-assuming Health Benefit Plan Issuer
1501.313
Rescission of Approval to Operate as Risk-assuming Health Benefit Plan Issuer
1501.314
Reinsurance
1501.315
Limits on Reinsurance
1501.316
Termination of Reinsurance
1501.317
Application of Managed Care Procedures
1501.318
Premium Rates for Reinsurance
1501.319
Determination of Net Loss
1501.320
Assessments to Recover Net Losses
1501.321
Limits on Assessments
1501.322
Adjustment to Assessments on Federally Qualified Health Maintenance Organizations
1501.323
Advance Interim Assessments
1501.324
Limit on Total Assessments
1501.325
Estimate of Assessments; Evaluation and Protection of System
1501.326
Deferment of Assessment
1501.351
Marketing Requirements
1501.352
Health Status and Claims Experience; Prohibited Acts
1501.353
Agent Compensation
1501.354
Required Disclosures
1501.355
Rules Concerning Marketing and Availability
1501.356
Reporting Requirements
1501.357
Violations
1501.358
Applicability to Third-party Administrator
1501.0575
Voluntary Participation by Issuer in Cooperative
1501.0581
Special Provisions Relating to Health Group Cooperatives
1501.0582
Health Group Cooperative: Expedited Approval Process
1501.601
Participation Criteria
1501.602
Coverage Requirements
1501.603
Exclusion of Eligible Employee or Dependent Prohibited
1501.604
Declining Coverage
1501.605
Minimum Contribution or Participation Requirements
1501.606
Employee Enrollment; Waiting Period
1501.607
Coverage for Newborn Children
1501.608
Coverage for Adopted Children
1501.609
Coverage for Unmarried Children
1501.610
Premium Rates; Adjustments
1501.611
Marketing Requirements
1501.612
Encouraging Exclusion of Employee Prohibited
1501.613
Agents
1501.615
Additional Reporting Requirements
1501.616
Applicability to Third-party Administrator
1501.2561
Waiver of Certain Federal Requirements
1501.3021
Authorization of Operation
1501.3022
Suspension of Operation
