reglab/housing_qa huggingface dataset:
TX Ins Code § 1501.353 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter H. Marketing of Small Employer Health Benefit Plans|Section 1501.353. Agent Compensation

Sec. 1501.353.  AGENT COMPENSATION.  (a)  A small employer health benefit plan issuer shall pay the same commission, percentage of premium, or other amount to an agent for renewal of a small employer health benefit plan as the issuer paid for original placement of the plan, except that the issuer may increase compensation for renewal of a plan to reflect an increase in the cost of living or similar factors.(b)  A small employer health benefit plan issuer may not implement, directly or indirectly, agent commission schedules that vary the level of agent commissions based on the size of the group or otherwise reduce access to small employer health benefit plans.(c)  Notwithstanding Subsection (b), a small employer health benefit plan issuer may:(1)  vary agent commission amounts or percentages based on group size if the variation in the commission amounts or percentages are inversely related to the size of the group;(2)  vary agent commission amounts or percentages based on the cumulative premium paid by a single small employer over a specific period if the variation in the commission amounts or percentages are inversely related to the cumulative premium paid during the period;  or(3)  pay agent commissions as a percentage of premiums charged to a small employer if the commission percentage is based on all premiums paid by the small employer.(d)  A small employer health benefit plan issuer may not use an agent compensation schedule that provides compensation in a specific dollar amount for each individual covered during a specified period or for each group of individuals covered during a specified period.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.Amended by: Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.059(b), eff. September 1, 2005.|
TX Ins Code § 1501.354 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter H. Marketing of Small Employer Health Benefit Plans|Section 1501.354. Required Disclosures

Sec. 1501.354.  REQUIRED DISCLOSURES.  (a)  In connection with offering a small employer health benefit plan for sale, each small employer health benefit plan issuer and agent shall make a reasonable disclosure, as part of its solicitation and sales materials, of:(1)  the extent to which premium rates for a specific small employer are established or adjusted based on the actual or expected variation in:(A)  claim costs;  or(B)  health status of the employer's employees and their dependents;(2)  provisions concerning the issuer's right to change premium rates and factors other than claims experience that affect changes in premium rates;(3)  provisions relating to renewability of policies and contracts;  and(4)  any preexisting condition provisions.(b)  On request by a small employer, each small employer health benefit plan issuer shall disclose the benefits and premiums available under all small employer coverage for which the employer is qualified.(c)  A small employer health benefit plan issuer is not required to disclose information to a small employer that is proprietary or trade secret information under applicable law.(d)  Information provided under this section to a small employer must be provided in a manner that is:(1)  understandable by the average small employer;  and(2)  sufficient to reasonably inform a small employer of its rights and obligations under a small employer health benefit plan.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.355 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter H. Marketing of Small Employer Health Benefit Plans|Section 1501.355. Rules Concerning Marketing and Availability

Sec. 1501.355.  RULES CONCERNING MARKETING AND AVAILABILITY.  Rules adopted under Section 1501.010 may establish additional standards to provide for the fair marketing and broad availability of small employer health benefit plans to small employers in this state.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.356 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter H. Marketing of Small Employer Health Benefit Plans|Section 1501.356. Reporting Requirements

Sec. 1501.356.  REPORTING REQUIREMENTS.  (a)  In this section, "case characteristics" has the meaning assigned by Section 1501.201.(b)  The department may require periodic reports by small employer health benefit plan issuers and agents regarding small employer health benefit plans issued by those issuers and agents.  The reporting requirements must include information regarding:(1)  case characteristics;  and(2)  the number of small employer health benefit plans in various categories that are marketed or issued to small employers.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.357 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter H. Marketing of Small Employer Health Benefit Plans|Section 1501.357. Violations

Sec. 1501.357.  VIOLATIONS.  A violation of Section 1501.352 by a small employer health benefit plan issuer or agent is an unfair method of competition and an unfair or deceptive act or practice under Chapter 541.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.358 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter H. Marketing of Small Employer Health Benefit Plans|Section 1501.358. Applicability to Third-Party Administrator

Sec. 1501.358.  APPLICABILITY TO THIRD-PARTY ADMINISTRATOR.  If a small employer health benefit plan issuer enters into an agreement with a third-party administrator to provide administrative, marketing, or other services related to offering small employer health benefit plans to small employers in this state, the third-party administrator is subject to Sections 1501.111, 1501.351-1501.353, and 1501.355-1501.357.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.601 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter M. Large Employer Health Benefit Plans|Section 1501.601. Participation Criteria

Sec. 1501.601.  PARTICIPATION CRITERIA.  (a)  In this subchapter, "participation criteria" means any criteria or rules established by a large employer to determine the employees who are eligible for enrollment or continued enrollment under the terms of a health benefit plan.(b)  The participation criteria may not be based on health status related factors.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.602 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter M. Large Employer Health Benefit Plans|Section 1501.602. Coverage Requirements

Sec. 1501.602.  COVERAGE REQUIREMENTS.  (a)  A large employer health benefit plan issuer:(1)  may refuse to provide coverage to a large employer in accordance with the issuer's underwriting standards and criteria;(2)  shall accept or reject the entire group of individuals who meet the participation criteria and choose coverage;  and(3)  may exclude only those employees or dependents who decline coverage.(b)  On issuance of a health benefit plan to a large employer, a large employer health benefit plan issuer shall provide coverage to the employees who meet the participation criteria without regard to an individual's health status related factors.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.603 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter M. Large Employer Health Benefit Plans|Section 1501.603. Exclusion of Eligible Employee or Dependent Prohibited

Sec. 1501.603.  EXCLUSION OF ELIGIBLE EMPLOYEE OR DEPENDENT PROHIBITED.  A large employer health benefit plan issuer may not exclude an employee who meets the participation criteria or an eligible dependent, including a late enrollee, who would otherwise be covered under a large employer group.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.604 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter M. Large Employer Health Benefit Plans|Section 1501.604. Declining Coverage

Sec. 1501.604.  DECLINING COVERAGE.  (a)  A large employer health benefit plan issuer shall obtain a written waiver from each employee who meets the participation criteria and declines coverage under a health benefit plan offered to a large employer.  The waiver must ensure that the employee was not induced or pressured to decline coverage because of the employee's health status related factors.(b)  A large employer health benefit plan issuer may not provide coverage to a large employer or the employer's employees if the issuer or an agent for the issuer knows that the employer has induced or pressured an employee who meets the participation criteria or a dependent of the employee to decline coverage because of the individual's health status related factors.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.605 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter M. Large Employer Health Benefit Plans|Section 1501.605. Minimum Contribution or Participation Requirements

Sec. 1501.605.  MINIMUM CONTRIBUTION OR PARTICIPATION REQUIREMENTS.  (a)  A large employer health benefit plan issuer may require a large employer to meet a minimum contribution or participation requirement as a condition of issuance or renewal in accordance with the issuer's usual and customary practices for all the issuer's employer health benefit plans in this state.(b)  A participation requirement may determine the percentage of eligible employees who meet the participation criteria and who must be enrolled in the health benefit plan.(c)  A large employer health benefit plan issuer may apply a participation requirement to a large employer's eligible employees, but may not apply the requirement to eligible dependents of those employees.(d)  A participation requirement must be stated in the health benefit plan contract and must be applied uniformly to each large employer offered or issued coverage by a large employer health benefit plan issuer in this state.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.606 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter M. Large Employer Health Benefit Plans|Section 1501.606. Employee Enrollment; Waiting Period

Sec. 1501.606.  EMPLOYEE ENROLLMENT;  WAITING PERIOD.  (a)  The initial enrollment period for employees meeting the participation criteria under a large employer health benefit plan must be at least 31 days, with a 31-day annual open enrollment period.(b)  A large employer may establish a waiting period.  The employer shall determine the duration of the waiting period.(c)  A new employee who meets the participation criteria may not be denied coverage if the application for coverage is received by the large employer not later than the 31st day after the later of:(1)  the date employment begins;  or(2)  the date the waiting period established under Subsection (b) expires.(d)  If dependent coverage is offered to the enrollees under a large employer health benefit plan:(1)  the initial enrollment period for the dependents must be at least 31 days, with a 31-day annual open enrollment period;  and(2)  a dependent of a new employee who meets the participation criteria may not be denied coverage if the application for coverage is received by the large employer not later than the 31st day after the latest of:(A)  the date on which the employment begins;(B)  the date the waiting period established under Subsection (b) expires;  or(C)  the date the dependent becomes eligible for enrollment.(e)  A late enrollee may be excluded from coverage until the next annual open enrollment period and may be subject to a one-year preexisting condition provision as described by Section 1501.102.  The period during which a preexisting condition provision applies may not exceed 18 months from the date of the initial application.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.607 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter M. Large Employer Health Benefit Plans|Section 1501.607. Coverage for Newborn Children

Sec. 1501.607.  COVERAGE FOR NEWBORN CHILDREN.  (a)  A large employer health benefit plan may not limit or exclude initial coverage of a newborn child of a covered employee.(b)  Coverage of a newborn child of a covered employee under this section ends on the 32nd day after the date of the child's birth unless:(1)  children are eligible for coverage under the large employer health benefit plan;  and(2)  not later than the 31st day after the date of birth, the large employer health benefit plan issuer receives:(A)  notice of the birth;  and(B)  any required additional premium.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.608 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter M. Large Employer Health Benefit Plans|Section 1501.608. Coverage for Adopted Children

Sec. 1501.608.  COVERAGE FOR ADOPTED CHILDREN.  (a)  This section applies only if children are eligible for coverage under a large employer health benefit plan.(b)  A large employer health benefit plan may not limit or exclude initial coverage of an adopted child of an insured.  A child is considered to be the adopted child of an insured if the insured is a party to a suit in which the insured seeks to adopt the child.(c)  An adopted child of an insured may be enrolled, at the insured's option, not later than the 31st day after:(1)  the date the insured becomes a party to a suit in which the insured seeks to adopt the child;  or(2)  the date the adoption becomes final.(d)  Coverage of an adopted child of an insured under this section ends unless the large employer health benefit plan issuer receives notice of the adoption and any required additional premium not later than the 31st day after:(1)  the date the insured becomes a party to a suit in which the insured seeks to adopt the child;  or(2)  the date the adoption becomes final.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.609 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter M. Large Employer Health Benefit Plans|Section 1501.609. Coverage for Unmarried Children

Sec. 1501.609.  COVERAGE FOR UNMARRIED CHILDREN.  (a)  This section applies only if children are eligible for coverage under a large employer health benefit plan.(b)  Any limiting age applicable under a large employer health benefit plan to an unmarried child of an enrollee is 25 years of age.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.610 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter M. Large Employer Health Benefit Plans|Section 1501.610. Premium Rates; Adjustments

Sec. 1501.610.  PREMIUM RATES;  ADJUSTMENTS.  (a)  A large employer health benefit plan issuer may charge premiums in accordance with this section to the group of employees or dependents who meet the participation criteria and do not decline coverage.(b)  A large employer health benefit plan issuer may not charge an adjustment to premium rates for individual employees or dependents for health status related factors or duration of coverage.  Any adjustment must be applied uniformly to the rates charged for all employees and dependents of employees of a large employer.(c)  Subsection (b) does not restrict the amount that a large employer may be charged for coverage.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.611 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter M. Large Employer Health Benefit Plans|Section 1501.611. Marketing Requirements

Sec. 1501.611.  MARKETING REQUIREMENTS.  On request, each large employer purchasing a health benefit plan shall be given a summary of all plans for which the employer is eligible.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.612 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter M. Large Employer Health Benefit Plans|Section 1501.612. Encouraging Exclusion of Employee Prohibited

Sec. 1501.612.  ENCOURAGING EXCLUSION OF EMPLOYEE PROHIBITED.  A large employer health benefit plan issuer or agent may not encourage a large employer to exclude an employee who meets the participation criteria from health coverage provided in connection with the employee's employment.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.613 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter M. Large Employer Health Benefit Plans|Section 1501.613. Agents

Sec. 1501.613.  AGENTS.  A large employer health benefit plan issuer may not terminate, fail to renew, or limit its contract or agreement of representation with an agent because of health status related factors of a large employer group placed by the agent with the issuer.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.615 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter M. Large Employer Health Benefit Plans|Section 1501.615. Additional Reporting Requirements

Sec. 1501.615.  ADDITIONAL REPORTING REQUIREMENTS.  The department may require periodic reports by large employer health benefit plan issuers and agents regarding the large employer health benefit plans issued by those issuers.  The reporting requirements must:(1)  require information regarding the number of plans in various categories that are marketed or issued to large employers;  and(2)  comply with federal law, including regulations.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.616 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter M. Large Employer Health Benefit Plans|Section 1501.616. Applicability to Third-Party Administrator

Sec. 1501.616.  APPLICABILITY TO THIRD-PARTY ADMINISTRATOR.  If a large employer health benefit plan issuer enters into an agreement with a third-party administrator to provide administrative, marketing, or other services related to offering large employer health benefit plans to large employers in this state, the third-party administrator is subject to this subchapter and Subchapter C.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1502.001 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1502 - Health Benefit Plans for Children|Subchapter A. General Provisions|Section 1502.001. Applicability of Chapter

Sec. 1502.001.  APPLICABILITY OF CHAPTER.  This chapter applies only to the issuer of a health benefit plan that:(1)  provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, including:(A)  an individual, group, blanket, or franchise insurance policy or insurance agreement, a group hospital service contract, or an individual or group evidence of coverage that is offered by:(i)  an insurance company;(ii)  a group hospital service corporation operating under Chapter 842;(iii)  a fraternal benefit society operating under Chapter 885;(iv)  a stipulated premium company operating under Chapter 884;  or(v)  a health maintenance organization operating under Chapter 843;  and(B)  to the extent permitted by the Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.), a health benefit plan that is offered by:(i)  a multiple employer welfare arrangement as defined by Section 3 of that Act or another analogous benefit arrangement;  or(ii)  an entity not authorized under this code or another insurance law of this state that contracts directly for health care services on a risk-sharing basis, including a capitation basis;  or(2)  is offered by an approved nonprofit health corporation that holds a certificate of authority under Chapter 844.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1502.0011 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1502 - Health Benefit Plans for Children|Subchapter A. General Provisions|Section 1502.0011. Exception

Sec. 1502.0011.  EXCEPTION.  This chapter does not apply to a health benefit plan provided under the state Medicaid program or the state child health plan.|Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.061(a), eff. September 1, 2005.|