reglab/housing_qa huggingface dataset:
TX Ins Code § 846.002 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 846 - Multiple Employer Welfare Arrangements|Subchapter A. General Provisions|Section 846.002. Applicability of Chapter

Sec. 846.002.  APPLICABILITY OF CHAPTER.  (a)  In this section, "fully insured multiple employer welfare arrangement" means an arrangement that provides to its participating employees and beneficiaries benefits for which 100 percent of the liability has been assumed by an insurance company authorized to do business in this state.(b)  This chapter applies only to a multiple employer welfare arrangement that meets either or both of the following criteria:(1)  one or more of the employer members in the arrangement:(A)  is domiciled in this state;  or(B)  has its principal headquarters or principal administrative office in this state;  or(2)  the arrangement solicits an employer that:(A)  is domiciled in this state;  or(B)  has its principal headquarters or principal administrative office in this state.(c)  This chapter does not apply to a fully insured multiple employer welfare arrangement during the period in which the arrangement is fully insured.  The commissioner periodically may require proof that the arrangement is fully insured.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 846.003 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 846 - Multiple Employer Welfare Arrangements|Subchapter A. General Provisions|Section 846.003. Limited Exemption From Insurance Laws; Applicability of Certain Laws

Sec. 846.003.  LIMITED EXEMPTION FROM INSURANCE LAWS;  APPLICABILITY OF CERTAIN LAWS.  (a)  A multiple employer welfare arrangement is exempt from the operation of all insurance laws of this state, except laws that are made applicable by their specific terms or as specified in this section or chapter.(b)  A multiple employer welfare arrangement is subject to the following laws:(1)  Subchapters C and D, Chapter 36;(2)  Section 38.001;(3)  Section 81.002;(4)  Chapter 82;(5)  Chapter 83;(6)  Chapter 86;(7)  Section 201.003;(8)  Sections 401.051, 401.052, 401.054-401.062, 401.151, 401.152, 401.155, and 401.156;(9)  Chapter 441;(10)  Chapter 443;(11)  Chapter 461;(12)  Section 521.005;(13)  Chapter 541;(14)  Chapter 701;(15)  Chapter 801;(16)  Chapter 803;(17)  Chapter 804;(18)  Subchapter A, Chapter 805; and(19)  Sections 841.259, 841.701-841.702, and 841.704-841.705.(c)  A multiple employer welfare arrangement is only considered an insurer for purposes of the laws described by this section.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.Amended by: Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2E.056, eff. April 1, 2009.|
TX Ins Code § 846.004 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 846 - Multiple Employer Welfare Arrangements|Subchapter A. General Provisions|Section 846.004. Late-Participating Employee or Dependent

Sec. 846.004.  LATE-PARTICIPATING EMPLOYEE OR DEPENDENT.  (a)  For purposes of this chapter, an employee or dependent eligible for enrollment in a participating employer's health benefit plan is a late-participating employee or dependent if the individual requests enrollment after the expiration of:(1)  the initial enrollment period established under the terms of the first health benefit plan for which that employee or dependent was eligible through the participating employer;  or(2)  an open enrollment period under Section 846.257.(b)  An employee or dependent is not a late-participating employee or dependent if the individual:(1)  was covered under another health benefit plan or self-funded employer health benefit plan at the time the individual was eligible to enroll;(2)  declined enrollment in writing, at the time of the initial eligibility for enrollment, stating that coverage under another health benefit plan or self-funded employer health benefit plan was the reason for declining enrollment;(3)  has lost coverage under the other health benefit plan or self-funded employer health benefit plan as a result of:(A)  the termination of employment;(B)  a reduction in the number of hours of employment;(C)  the termination of the other plan's coverage;(D)  the termination of contributions toward the premium made by the employer;  or(E)  the death of a spouse or divorce;  and(4)  requests enrollment not later than the 31st day after the date coverage under the other health benefit plan or self-funded employer health benefit plan terminates.(c)  An employee or dependent is also not a late-participating employee or dependent if the individual is:(1)  employed by an employer that offers multiple health benefit plans and the individual elects a different health benefit plan during an open enrollment period under Section 846.257;(2)  a spouse for whom a court has ordered coverage under a covered employee's plan and the request for enrollment of the spouse is made not later than the 31st day after the date the court order is issued;  or(3)  a child for whom a court has ordered coverage under a covered employee's plan and the request for enrollment is made not later than the 31st day after the date the employer receives the court order.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 846.005 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 846 - Multiple Employer Welfare Arrangements|Subchapter A. General Provisions|Section 846.005. Rules; Orders

Sec. 846.005.  RULES;  ORDERS.  (a)  The commissioner may, on notice and opportunity for all interested persons to be heard, adopt rules and issue orders reasonably necessary to augment and implement this chapter.(b)  The commissioner shall adopt rules necessary to meet the minimum requirements of federal law and regulations.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 846.006 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 846 - Multiple Employer Welfare Arrangements|Subchapter A. General Provisions|Section 846.006. Appeal of Orders

Sec. 846.006.  APPEAL OF ORDERS.  A person affected by an order of the commissioner issued under this chapter may appeal that order by filing suit in a district court in Travis County under Subchapter D, Chapter 36.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 846.007 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 846 - Multiple Employer Welfare Arrangements|Subchapter A. General Provisions|Section 846.007. Premium Rates; Adjustments

Sec. 846.007.  PREMIUM RATES;  ADJUSTMENTS.  (a)  A multiple employer welfare arrangement may charge premiums in accordance with this section to the group of employees or dependents who meet the participation criteria and who do not decline coverage.(b)  A multiple employer welfare arrangement 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 participating employees and dependents of participating employees of the employer.(c)  Subsection (b) does not restrict the amount that an employer may be charged for coverage.(d)  A multiple employer welfare arrangement may establish premium discounts, rebates, or a reduction in otherwise applicable copayments or deductibles in return for adherence to programs of health promotion and disease prevention.  A discount, rebate, or reduction established under this subsection does not violate Section 541.056(a).|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.Amended by: Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2E.057, eff. April 1, 2009.|
TX Ins Code § 846.051 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 846 - Multiple Employer Welfare Arrangements|Subchapter B. Formation and Structure of Multiple Employer Welfare Arrangements|Section 846.051. Certificate of Authority Required

Sec. 846.051.  CERTIFICATE OF AUTHORITY REQUIRED.  A person may not establish or maintain an employee welfare benefit plan that is a multiple employer welfare arrangement in this state unless the arrangement obtains and maintains a certificate of authority issued under this chapter.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 846.052 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 846 - Multiple Employer Welfare Arrangements|Subchapter B. Formation and Structure of Multiple Employer Welfare Arrangements|Section 846.052. Application for Initial Certificate of Authority

Sec. 846.052.  APPLICATION FOR INITIAL CERTIFICATE OF AUTHORITY.  (a)  A person who wants to establish an employee welfare benefit plan that is a multiple employer welfare arrangement must apply for an initial certificate of authority on an application form prescribed by the commissioner.(b)  The application form must be completed and submitted along with all information required by the commissioner, including:(1)  a copy of each organizational document;(2)  current financial statements of the arrangement;(3)  a fully detailed statement indicating the plan under which the arrangement proposes to transact business;(4)  an initial actuarial opinion in compliance with the requirements of Section 846.153(a)(2) and subject to Section 846.157(b);  and(5)  a statement by the applicant certifying that the arrangement is in compliance with all applicable provisions of the Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.).(c)  The application must be accompanied by proof of a fidelity bond that:(1)  protects against acts of fraud or dishonesty in servicing the multiple employer welfare arrangement;(2)  covers each person responsible for servicing the employee welfare benefit plan;  and(3)  is in an amount equal to the greater of 10 percent of the premiums and contributions received by the arrangement or 10 percent of the benefits paid, during the preceding calendar year, with a minimum of $10,000 and a maximum of $500,000.(d)  A third-party administrator licensed to engage in business in this state is not required to submit a fidelity bond under Subsection (c).(e)  The commissioner shall promptly examine the application and documents submitted by the applicant and may:(1)  conduct any investigation that the commissioner considers necessary;  and(2)  examine under oath any person interested in or connected with the multiple employer welfare arrangement.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 846.054 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 846 - Multiple Employer Welfare Arrangements|Subchapter B. Formation and Structure of Multiple Employer Welfare Arrangements|Section 846.054. Issuance of Initial Certificate of Authority

Sec. 846.054.  ISSUANCE OF INITIAL CERTIFICATE OF AUTHORITY.  (a)  The commissioner shall approve, deny, or disapprove an application for an initial certificate of authority that meets the requirements of Section 846.053 not later than the 60th day after the date on which the application is filed.(a-1)  On the applicant's request, the commissioner shall hold a hearing on a denial.  Not later than the 30th day after the date of the applicant's request for a hearing, the commissioner shall request a hearing date.(b)  An initial certificate of authority is a temporary certificate issued for a one-year term.(c)  On receipt of the initial certificate of authority, the multiple employer welfare arrangement shall begin business.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.Amended by: Acts 2009, 81st Leg., R.S., Ch. 1022 (H.B. 4291), Sec. 11, eff. June 19, 2009.|
TX Ins Code § 846.055 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 846 - Multiple Employer Welfare Arrangements|Subchapter B. Formation and Structure of Multiple Employer Welfare Arrangements|Section 846.055. Extension of Term of Initial Certificate of Authority

Sec. 846.055.  EXTENSION OF TERM OF INITIAL CERTIFICATE OF AUTHORITY.  The commissioner may extend the term of an initial certificate of authority for a period not to exceed one year if the commissioner determines that the multiple employer welfare arrangement is likely to meet the requirements of this chapter for a final certificate of authority within that period.  The commissioner may not grant more than one extension of the initial certificate of authority regardless of the length of time for which an extension was granted.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 846.056 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 846 - Multiple Employer Welfare Arrangements|Subchapter B. Formation and Structure of Multiple Employer Welfare Arrangements|Section 846.056. Final Certificate of Authority

Sec. 846.056.  FINAL CERTIFICATE OF AUTHORITY.  (a)  A multiple employer welfare arrangement that holds an initial certificate of authority must apply for a final certificate of authority not later than the first anniversary of the date of issuance of the initial certificate.(b)  The multiple employer welfare arrangement must file an application for a final certificate of authority on a form prescribed by the commissioner and furnish the information required by the commissioner.  The application for a final certificate of authority must include only:(1)  the names and addresses of:(A)  the association or group of employers sponsoring the arrangement;(B)  the board members of the arrangement;  and(C)  if the employers in the arrangement are not an association, at least five employers;(2)  proof of compliance with the bonding requirements;(3)  a copy of each plan document and each agreement with service providers;  and(4)  a funding report containing:(A)  a statement certified by the board and an actuarial opinion that all applicable requirements of Section 846.153 have been met;(B)  an actuarial opinion describing the extent to which contributions or premium rates:(i)  are not excessive;(ii)  are not unfairly discriminatory;  and(iii)  are adequate to provide for the payment of all obligations and the maintenance of required cash reserves and surplus by the arrangement;(C)  a statement of the current value of the assets and liabilities accumulated by the arrangement and a projection of the assets, liabilities, income, and expenses of the arrangement for the next 12-month period;  and(D)  a statement of the costs to be charged for coverage, including an itemization of amounts for:(i)  administrative expenses;(ii)  reserves;  and(iii)  other expenses associated with operation of the arrangement.(c)  The reserves described in Section 846.154(a) must have been established or be established before the final certificate of authority is issued.(d)  If, after examination and investigation, the commissioner is satisfied that the multiple employer welfare arrangement meets the requirements of this chapter, the commissioner shall issue a final certificate of authority to the arrangement.(e)  The commissioner shall maintain the information required under Subsection (b)(1)(C) and Subsection (b)(3) as confidential information.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 846.057 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 846 - Multiple Employer Welfare Arrangements|Subchapter B. Formation and Structure of Multiple Employer Welfare Arrangements|Section 846.057. Denial of Final Certificate of Authority

Sec. 846.057.  DENIAL OF FINAL CERTIFICATE OF AUTHORITY.  (a)  The commissioner shall deny a final certificate of authority to an applicant that does not comply with this chapter.(b)  If the commissioner denies a final certificate of authority, the commissioner shall issue a written notice of refusal to the applicant.  The notice of refusal must state the basis for the denial.  The notice of refusal constitutes 30 days' advance notice of the revocation of the initial certificate of authority.(c)  If the applicant submits a written request for a hearing not later than the 30th day after the date of mailing of the notice of refusal, revocation of the initial certificate of authority is temporarily stayed, and the commissioner shall promptly conduct a hearing at which the applicant is given an opportunity to show compliance with this chapter.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 846.058 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 846 - Multiple Employer Welfare Arrangements|Subchapter B. Formation and Structure of Multiple Employer Welfare Arrangements|Section 846.058. Disqualification

Sec. 846.058.  DISQUALIFICATION.  (a)  A multiple employer welfare arrangement, each board member and officer of the arrangement, and any agent or other person associated with the arrangement shall be subject to disqualification for eligibility for a certificate of authority if the person:(1)  makes a material misstatement or omission in an application for a certificate of authority under this chapter;(2)  obtains or attempts to obtain at any time a certificate of authority or license for an insurance entity through intentional misrepresentation or fraud;(3)  misappropriates or converts to the person's own use or improperly withholds money under an employee welfare benefit plan or multiple employer welfare arrangement;(4)  is prohibited from serving in any capacity with the arrangement under Section 411, Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1111);(5)  without reasonable cause or excuse, fails to appear in response to a subpoena, examination, warrant, or any other order lawfully issued by the commissioner;  or(6)  has previously been subject to a determination by the commissioner resulting in:(A)  suspension or revocation of a certificate of authority or license;  or(B)  denial of a certificate of authority or license on grounds that would be sufficient for suspension or revocation.(b)  This section does not apply to a participating employer in its capacity as a participating employer and the employer's participating employees.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 846.059 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 846 - Multiple Employer Welfare Arrangements|Subchapter B. Formation and Structure of Multiple Employer Welfare Arrangements|Section 846.059. Fees; Service of Process

Sec. 846.059.  FEES;  SERVICE OF PROCESS.  (a)  Each multiple employer welfare arrangement shall pay to the department in the amount set by the commissioner:(1)  an application fee for an initial certificate of authority;(2)  an application fee for a final certificate of authority;  and(3)  a filing fee for submission of the arrangement's annual statement.(b)  The commissioner shall set the fees described by Subsection (a) in amounts reasonable and necessary to defray the costs of administering this chapter.(c)  Each multiple employer welfare arrangement shall appoint the commissioner as its resident agent for purposes of service of process.  The fee for that service is $50, payable at the time of appointment.(d)  Fees paid under this section shall be deposited to the credit of the Texas Department of Insurance operating fund.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 846.060 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 846 - Multiple Employer Welfare Arrangements|Subchapter B. Formation and Structure of Multiple Employer Welfare Arrangements|Section 846.060. Suspension, Revocation, or Limitation of Certificate of Authority

Sec. 846.060.  SUSPENSION, REVOCATION, OR LIMITATION OF CERTIFICATE OF AUTHORITY.  In addition to any requirement or remedy under a law cited under Section 846.003, the commissioner may suspend, revoke, or limit the certificate of authority of a multiple employer welfare arrangement if the commissioner determines, after notice and hearing, that the agreement does not comply with this chapter.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 846.061 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 846 - Multiple Employer Welfare Arrangements|Subchapter B. Formation and Structure of Multiple Employer Welfare Arrangements|Section 846.061. Action by Attorney General

Sec. 846.061.  ACTION BY ATTORNEY GENERAL.  (a)  The commissioner may notify the attorney general of a violation of this chapter, and the attorney general may apply to a district court in Travis County for leave to file suit in the nature of quo warranto or for injunctive relief or both.(b)  The attorney general may seek and the court may order:(1)  restitution for victims of an act declared to be unlawful under this chapter;(2)  assessment of a fine under this code;  and(3)  recovery of reasonable attorney's fees.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|