reglab/statecodes huggingface dataset:
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter A. General Provisions › Section 463.007. Construction of Long-Term Care Rider

Sec. 463.007.  CONSTRUCTION OF LONG-TERM CARE RIDER.  For purposes of this chapter, benefits provided by a long-term care rider to a life insurance policy or annuity contract are considered to be the same type of benefits as the base life insurance policy or annuity contract.
Added by Acts 2019, 86th Leg., R.S., Ch. 432 (S.B. 1153), Sec. 3, eff. September 1, 2019.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter B. Governance of and Participation in Association › Section 463.051. Purpose and Regulation of Association

Sec. 463.051.  PURPOSE AND REGULATION OF ASSOCIATION.  (a)  The Texas Life and Health Insurance Guaranty Association is a nonprofit legal entity existing to pay benefits and continue coverage as provided by this chapter.
(b)  The association is subject to the applicable provisions of this code and other insurance laws of this state and the immediate supervision of the commissioner.  The commissioner may examine and regulate the association in the same manner as an insurer under this code.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 3B.014(a), eff. September 1, 2007.
Acts 2007, 80th Leg., R.S., Ch. 921 (H.B. 3167), Sec. 9.014(a), eff. September 1, 2007.
Acts 2011, 82nd Leg., R.S., Ch. 14 (S.B. 567), Sec. 4, eff. September 1, 2011.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter B. Governance of and Participation in Association › Section 463.052. Required Participation in Association

Sec. 463.052.  REQUIRED PARTICIPATION IN ASSOCIATION.  (a)  As a condition of engaging in the business of insurance in this state, an insurer, including a mutual assessment company, a local mutual aid association, a statewide mutual assessment company, a stipulated premium company, and a health maintenance organization authorized to engage in business in this state, shall participate as a member of the association if the insurer holds a certificate of authority to engage in a kind of insurance business in this state with respect to which this chapter provides coverage as determined under Subchapter E.  The requirement to participate applies regardless of whether the insurer's certificate of authority in this state is suspended, revoked, not renewed, or voluntarily withdrawn.
(b)  The following do not participate as member insurers:
(1)  a fraternal benefit society;
(2)  a mandatory state pooling plan;
(3)  a reciprocal or interinsurance exchange;
(4)  an organization which has a certificate of authority or license limited to the issuance of charitable gift annuities, as defined by this code or rules adopted by the commissioner; and
(5)  an entity similar to an entity described by Subdivision (1), (2), (3), or (4).
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 3B.013(c), eff. September 1, 2007.
Acts 2007, 80th Leg., R.S., Ch. 921 (H.B. 3167), Sec. 9.013(c), eff. September 1, 2007.
Acts 2019, 86th Leg., R.S., Ch. 432 (S.B. 1153), Sec. 4, eff. September 1, 2019.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter B. Governance of and Participation in Association › Section 463.053. Board of Directors

Sec. 463.053.  BOARD OF DIRECTORS.  (a)  The association's powers are exercised through a board of directors consisting of nine individuals appointed by the commissioner as provided by this section.
(b)  The commissioner shall appoint three board members from officers or employees of the 50 member insurers having the largest total direct premium income according to the most recent financial statement on file on the date of appointment.
(c)  To give fair representation to member insurers, the commissioner shall appoint two board members from member insurers other than insurers described by Subsection (b), considering the varying categories of premium income and geographical location.
(c-1)  The commissioner shall consider, among other things, whether the directors appointed under Subsections (b) and (c) fairly represent the member insurers that are health maintenance organizations and life, health, and annuity insurers.
(d)  The commissioner shall appoint four board members who are public representatives.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
Amended by:
Acts 2019, 86th Leg., R.S., Ch. 432 (S.B. 1153), Sec. 5, eff. September 1, 2019.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter B. Governance of and Participation in Association › Section 463.054. Eligibility to Serve as Public Representative

Sec. 463.054.  ELIGIBILITY TO SERVE AS PUBLIC REPRESENTATIVE.  To be eligible to serve as a public representative, an individual may not:
(1)  be an officer, director, or employee of an insurer, insurance agency, agent, broker, solicitor, adjuster, or other business entity regulated by the department;
(2)  be a person required to register under Chapter 305, Government Code; or
(3)  be related within the second degree by affinity or consanguinity to a person described by Subdivision (1) or (2).
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter B. Governance of and Participation in Association › Section 463.055. Term; Vacancy

Sec. 463.055.  TERM; VACANCY.  (a)  Board members serve staggered six-year terms, with the terms of three members expiring each odd-numbered year.  A member may be reappointed.
(b)  A board member shall serve until a successor is appointed.
(c)  If a board member who is an officer or employee of a member insurer ceases to be an officer or employee of the insurer, the member's office becomes vacant.
(d)  The commissioner shall appoint an individual to fill a vacancy on the board for the unexpired term.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter B. Governance of and Participation in Association › Section 463.056. Compensation of Board Members

Sec. 463.056.  COMPENSATION OF BOARD MEMBERS.  A board member may not receive compensation from the association for the member's services but may be reimbursed from the association's assets for expenses incurred as a board member.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter B. Governance of and Participation in Association › Section 463.057. Financial Statement of Board Member

Sec. 463.057.  FINANCIAL STATEMENT OF BOARD MEMBER.  Each board member shall file with the Texas Ethics Commission a financial statement as provided by Subchapter B, Chapter 572, Government Code.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter B. Governance of and Participation in Association › Section 463.058. Conflict of Interest

Sec. 463.058.  CONFLICT OF INTEREST.  (a)  In this section, "transaction on behalf of an impaired insurer" includes a reinsurance agreement, transaction, merger, purchase, sale, contribution, or exchange of assets, insurance policies, or property made by the association or a supervisor, conservator, or receiver on behalf of an impaired insurer.
(b)  A board member may not:
(1)  receive money or another thing of value for negotiating, procuring, participating in, recommending, or aiding  a transaction on behalf of an impaired insurer; or
(2)  as a principal, coprincipal, agent, or beneficiary, have a pecuniary interest in a transaction on behalf of an impaired insurer.
(c)  For the purposes of this section, a board member is considered to receive a thing of value or have a pecuniary interest in a transaction on behalf of an impaired insurer regardless of whether the receipt or interest is direct, indirect, or through a substantial interest in a corporation, firm, or other business unit.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter B. Governance of and Participation in Association › Section 463.059. Meetings by Telephone and Videoconference

Sec. 463.059.  MEETINGS BY TELEPHONE AND VIDEOCONFERENCE.  (a)  Notwithstanding Chapter 551, Government Code, or any other law, the board or a committee of the board may meet by telephone conference call, videoconference, or other similar telecommunication method.  The board may use telephone conference call, videoconference, or other similar telecommunication method for establishing a quorum, voting, or any other meeting purpose in accordance with this section regardless of the subject matter discussed or considered by the board at the meeting.
(b)  A meeting authorized by this section is subject to the notice requirements that apply to other meetings.
(c)  The notice of a meeting authorized by this section must specify the location of the meeting.
(d)  Each part of a meeting authorized by this section that must be open to the public must be audible to the public at the location specified by Subsection (c).
(e)  Two-way audio communication must be available during the entire meeting between all members of the board or committee attending a meeting authorized by this section, and if the two-way audio communication is disrupted so that a quorum of the board or committee is no longer participating in the meeting, the meeting may not continue until the two-way audio communication is reestablished.
(f)  An audio or digital recording of a meeting authorized by this section must be made in accordance with the association's bylaws.  The recording of the open portion of the meeting must be posted on the association's Internet website.
(g)  A vote during a meeting authorized by this section must be taken in such a manner that the vote of each member is audible and may be verified as the vote of the member.
Added by Acts 2011, 82nd Leg., R.S., Ch. 14 (S.B. 567), Sec. 5, eff. September 1, 2011.
Amended by:
Acts 2019, 86th Leg., R.S., Ch. 432 (S.B. 1153), Sec. 6, eff. September 1, 2019.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter C. General Powers and Duties of Association › Section 463.101. General Powers and Duties

Sec. 463.101.  GENERAL POWERS AND DUTIES.  (a)  The association may:
(1)  enter into contracts as necessary or proper to carry out this chapter and the purposes of this chapter;
(2)  sue or be sued, including taking:
(A)  necessary or proper legal action to:
(i)  recover an unpaid assessment under Subchapter D; or
(ii)  settle a claim or potential claim against the association; or
(B)  necessary legal action to avoid payment of an improper claim;
(3)  borrow money to effect the purposes of this chapter;
(4)  exercise, for the purposes of this chapter and to the extent approved by the commissioner, the powers of a domestic life, accident, or health insurance company, a health maintenance organization, or a group hospital service corporation, except that the association may not issue an insurance policy or annuity contract other than to perform the association's obligations under this chapter;
(5)  unless prohibited by other law, implement or file for an actuarially justified rate or premium increase in accordance with the terms and conditions of a covered policy or contract;
(6)  to further the association's purposes, exercise the association's powers, and perform the association's duties, join an organization of one or more state associations that have similar purposes;
(7)  request information from a person seeking coverage from the association in determining its obligations under this chapter with respect to the person, and the person shall promptly comply with the request; and
(8)  take any other necessary or appropriate action to discharge the association's duties and obligations under this chapter or to exercise the association's powers under this chapter.
(b)  If not in default, a note or other evidence of indebtedness of the association is a legal investment for a domestic insurer and may be carried as an admitted asset.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 3B.015(a), eff. September 1, 2007.
Acts 2007, 80th Leg., R.S., Ch. 921 (H.B. 3167), Sec. 9.015(a), eff. September 1, 2007.
Acts 2019, 86th Leg., R.S., Ch. 432 (S.B. 1153), Sec. 7, eff. September 1, 2019.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter C. General Powers and Duties of Association › Section 463.102. Plan of Operation; Amendments

Sec. 463.102.  PLAN OF OPERATION; AMENDMENTS.  (a)  The association shall perform the association's functions under a plan of operation approved by the commissioner.  The plan of operation must:
(1)  establish:
(A)  procedures for handling the assets of the association;
(B)  the amount and method of reimbursing board members under Section 463.056;
(C)  regular places and times for board meetings, including telephone conference calls;
(D)  procedures for maintaining records of all financial transactions of the association, the association's agents, and the board; and
(E)  additional procedures for assessments under Subchapter D; and
(2)  contain additional provisions necessary or proper for the execution of the association's powers and duties.
(b)  The association may amend the plan of operation.  An amendment must be approved by the commissioner and takes effect on:
(1)  the date the commissioner approves the amendment; or
(2)  the 60th day after the date the amendment is submitted to the commissioner for approval, if the commissioner does not approve or disapprove the amendment before the 60th day.
(c)  Each member insurer shall comply with the plan of operation.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
Amended by:
Acts 2019, 86th Leg., R.S., Ch. 432 (S.B. 1153), Sec. 8, eff. September 1, 2019.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter C. General Powers and Duties of Association › Section 463.103. Personnel

Sec. 463.103.  PERSONNEL.  The association may employ or retain employees or contractors to handle the association's financial transactions and to perform other functions under this chapter.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter C. General Powers and Duties of Association › Section 463.104. Association Records

Sec. 463.104.  ASSOCIATION RECORDS.  (a)  The association shall maintain a record of each negotiation or meeting in which the association or the association's representative discusses the association's activities in carrying out the powers and duties under Section 463.101, 463.103, 463.109, or 463.111(c) or Subchapter F.
(b)  A record under Subsection (a) may be made public only on:
(1)  termination of a liquidation, rehabilitation, or conservation proceeding involving the impaired or insolvent insurer;
(2)  termination of the impairment or insolvency of the insurer; or
(3)  order of a court.
(c)  This section does not limit the association's duty to report on the association's activities as required by Section 463.110.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter C. General Powers and Duties of Association › Section 463.105. Accounts

Sec. 463.105.  ACCOUNTS.  For the purposes of administration and assessment, the association shall maintain:
(1)  an accident, health, and hospital services insurance account;
(2)  a life insurance account;
(3)  an annuity account; and
(4)  an administrative account.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter C. General Powers and Duties of Association › Section 463.106. Delegation of Powers and Duties

Sec. 463.106.  DELEGATION OF POWERS AND DUTIES.  (a)  The plan of operation may provide that, on approval of the board and the commissioner, a power or duty of the association is delegated to a corporation or other organization that:
(1)  performs in two or more states functions similar to those of the association or the association's equivalent; and
(2)  provides protection not substantially less favorable and effective than that provided by this chapter.
(b)  A power or duty under Section 463.261(c) or Subchapter D, other than a duty under Section 463.161(c), may not be delegated under this section.
(c)  The corporation or other organization to which a power or duty is delegated shall be:
(1)  reimbursed for a payment made on behalf of the association; and
(2)  paid for performing any other function of the association.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter C. General Powers and Duties of Association › Section 463.107. Exemption From Taxation

Sec. 463.107.  EXEMPTION FROM TAXATION.  The association is exempt from payment of all fees and all taxes levied by this state or a subdivision of this state, except taxes levied on property.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter C. General Powers and Duties of Association › Section 463.108. Detection and Prevention of Impairment and Insolvency

Sec. 463.108.  DETECTION AND PREVENTION OF IMPAIRMENT AND INSOLVENCY.  On a majority vote, the board:
(1)  may make recommendations to the commissioner for detecting and preventing insurer insolvencies; and
(2)  shall notify the commissioner of information indicating that a member insurer may be impaired or insolvent.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter C. General Powers and Duties of Association › Section 463.109. Association Appearance Before Court; Intervention

Sec. 463.109.  ASSOCIATION APPEARANCE BEFORE COURT; INTERVENTION.  (a)  The association may appear before a court in this state with jurisdiction over an impaired or insolvent insurer concerning which the association is or may become obligated under this chapter.  The association's right to appear applies to:
(1)  a proposal for reinsuring, reissuing, modifying, or guaranteeing the insurer's policies or contracts;
(2)  the determination of the insurer's policies or contracts and contractual obligations; and
(3)  any other matter germane to the association's powers and duties.
(b)  The association may appear or intervene before a court in another state with jurisdiction over:
(1)  an impaired or insolvent insurer concerning which the association is or may become obligated; or
(2)  a third party against whom the association may have rights through subrogation of the insurer's policyholders or enrollees.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
Amended by:
Acts 2019, 86th Leg., R.S., Ch. 432 (S.B. 1153), Sec. 9, eff. September 1, 2019.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter C. General Powers and Duties of Association › Section 463.110. Annual Report

Sec. 463.110.  ANNUAL REPORT.  Not later than the 120th day after the last day of each association fiscal year, the board shall submit to the commissioner:
(1)  a financial report in a form approved by the commissioner; and
(2)  a report of the association's activities during the preceding fiscal year.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter C. General Powers and Duties of Association › Section 463.111. Board and Association Advice and Assistance

Sec. 463.111.  BOARD AND ASSOCIATION ADVICE AND ASSISTANCE.  (a)  On a majority vote, the board may report and make recommendations to the commissioner on any matter germane to:
(1)  the solvency, liquidation, rehabilitation, or conservation of a member insurer; or
(2)  the solvency of an insurer seeking to engage in the business of insurance in this state.
(b)  A report or recommendation under Subsection (a) is not a public document, and Chapter 552, Government Code, does not apply to the report or recommendation until the insurer that is the subject of the report or recommendation is designated as impaired.
(c)  On the commissioner's request, the association may assist and advise the commissioner concerning rehabilitation, payment of claims, continuation of coverage, or the performance of other contractual obligations of an impaired or insolvent insurer.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter C. General Powers and Duties of Association › Section 463.112. Board Access to Records

Sec. 463.112.  BOARD ACCESS TO RECORDS.  The receiver or statutory successor of an impaired insurer shall give the board or a representative of the board:
(1)  access to the insurer's records as necessary for the board to carry out the board's functions under this chapter relating to covered claims; and
(2)  copies of those records on the board's request and at the board's expense.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter C. General Powers and Duties of Association › Section 463.113. Board Report at Conclusion of Insolvency

Sec. 463.113.  BOARD REPORT AT CONCLUSION OF INSOLVENCY.  (a)  At the conclusion of an insurer insolvency in which the association was obligated to pay a covered claim, the board shall prepare and submit to the commissioner a report containing any information the board possesses concerning the history and causes of the insolvency.
(b)  The board:
(1)  shall cooperate with the boards of directors of guaranty associations in other states to prepare a report on the history and causes of the insolvency of a particular insurer; and
(2)  may adopt by reference a report prepared by any of those associations.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter C. General Powers and Duties of Association › Section 463.114. Summary Document; Disclaimer

Sec. 463.114.  SUMMARY DOCUMENT; DISCLAIMER.  (a)  The association shall prepare a summary document describing the general purposes and limitations of this chapter and amend the document as necessary to comply with this chapter.  The document must clearly and conspicuously contain on the document's face a disclaimer that:
(1)  states the name and address of the association and department;
(2)  warns the policy or contract holder that:
(A)  the association may not cover the policy; or
(B)  coverage, if available, is subject to substantial limitations and exclusions and requires continuous residence in this state;
(3)  states that an insurer and the insurer's agent are prohibited by law from using the association's existence to sell, solicit, or induce the purchase of any kind of insurance;
(4)  warns the policy or contract holder not to rely on association coverage in selecting an insurer; and
(5)  provides other information the commissioner prescribes.
(b)  The association shall submit the document to the commissioner for approval.
(c)  At the expiration of the 60th day after approval of the document, a member insurer may not deliver a policy or contract with respect to which this chapter provides coverage as determined under Subchapter E to a policy, contract, or certificate holder or enrollee before a copy of the summary document is delivered to the policy, contract, or certificate holder or enrollee.  The document must also be available on request of a policy, contract, or certificate holder or enrollee.
(d)  The distribution, delivery, content, or interpretation of a summary document does not guarantee that a policy or contract or a policy, contract, or certificate holder or enrollee is provided coverage by this chapter if a member insurer becomes impaired or insolvent.  Failure to receive the document does not give an insured or policy, contract, or certificate holder or enrollee any rights greater than those provided by this chapter.
(e)  An insurer or agent may not deliver a policy or contract described by Section 463.202 that is excluded from the coverage provided by this chapter by Section 463.203 unless the insurer or agent, either before or in conjunction with delivery, gives the policy, contract, or certificate holder or enrollee a separate written notice clearly and conspicuously disclosing that the policy or contract is not covered by the association.
(f)  The commissioner shall specify by rule the form and content of the disclaimer required by Subsection (a) and the notice required by Subsection (e).
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
Amended by:
Acts 2019, 86th Leg., R.S., Ch. 432 (S.B. 1153), Sec. 10, eff. September 1, 2019.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter D. Assessments › Section 463.151. Making and Payment of Assessment

Sec. 463.151.  MAKING AND PAYMENT OF ASSESSMENT.  (a)  The association shall assess member insurers, separately for each account under Section 463.105, in the amounts and at the times the board determines necessary to provide money for the association to exercise the association's powers, perform the association's duties, and carry out the purposes of this chapter.  The association may not authorize and call an assessment to meet the requirements of the association with respect to an impaired or insolvent insurer until the assessment is necessary to carry out the purposes of this chapter.  The board shall classify assessments under Section 463.152 and determine the amount of assessments with reasonable accuracy, recognizing that exact determinations may not always be possible.
(a-1)  The association shall notify each member insurer of its anticipated pro rata share of an authorized assessment not yet called not later than the 180th day after the date the assessment is authorized.
(b)  An assessment is due on the date the association specifies, which may not be earlier than the 30th day after the date the association gives written notice of the assessment to member insurers.  Interest accrues on an unpaid amount at a rate of 10 percent beginning on the due date.
(c)  An insurer whose certificate of authority to engage in business in this state is revoked or surrendered remains liable for any unpaid assessment made before the date of the revocation or surrender.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 3B.016(a), eff. September 1, 2007.
Acts 2007, 80th Leg., R.S., Ch. 921 (H.B. 3167), Sec. 9.016(a), eff. September 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter D. Assessments › Section 463.152. Classes of Assessments

Sec. 463.152.  CLASSES OF ASSESSMENTS.  (a)  Assessments are classified as Class A or Class B assessments.
(b)  Class A assessments are authorized and called to pay:
(1)  the association's administrative costs;
(2)  administrative expenses that:
(A)  are properly incurred under this chapter; and
(B)  relate to an unauthorized insurer or to an entity that is not a member insurer; and
(3)  other general expenses not related to a particular impaired or insolvent insurer.
(c)  Class B assessments are authorized and called to the extent necessary for the association to carry out the association's powers and duties under Sections 463.101, 463.103, 463.109, and 463.111(c) and Subchapter F with regard to an impaired or insolvent insurer.
(d)  For purposes of this section, an assessment is authorized at the time a resolution by the board is passed under which an assessment will be called immediately or in the future from member insurers for a specified amount and an assessment is called at the time a notice has been issued by the association to member insurers requiring that an authorized assessment be paid within a period stated in the notice.  An authorized assessment becomes a called assessment at the time notice is mailed by the association to member insurers.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 3B.016(b), eff. September 1, 2007.
Acts 2007, 80th Leg., R.S., Ch. 921 (H.B. 3167), Sec. 9.016(b), eff. September 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter D. Assessments › Section 463.154. Deferment

Sec. 463.154.  DEFERMENT.  The association may wholly or partly defer an assessment on a member insurer if the association believes payment of the assessment would endanger the ability of the insurer to fulfill the insurer's contractual obligations.  The amount of the assessment that is deferred may be assessed against the other member insurers in a manner consistent with this subchapter.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
Amended by:
Acts 2019, 86th Leg., R.S., Ch. 432 (S.B. 1153), Sec. 12, eff. September 1, 2019.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter D. Assessments › Section 463.155. Deposit of Assessments

Sec. 463.155.  DEPOSIT OF ASSESSMENTS.  The association may deposit assessments into the Texas Treasury Safekeeping Trust Company in accordance with procedures established by the comptroller.  The comptroller shall account to the association for the deposited money separately from all other money.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter D. Assessments › Section 463.156. Certificate of Contribution

Sec. 463.156.  CERTIFICATE OF CONTRIBUTION.  The association shall issue to each member insurer that pays a Class B assessment a certificate of contribution, in a form the commissioner prescribes, for the amount paid.  All outstanding certificates are of equal priority regardless of the amount of the assessment paid or the date the certificate is issued.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter D. Assessments › Section 463.157. Refunds

Sec. 463.157.  REFUNDS.  (a)  The board may refund to member insurers the amount by which the association's assets, including any net realized gains and income from investments, exceed the amount the board determines is necessary to carry out the association's obligations regarding that amount during the next year.
(b)  A refund must be made:
(1)  by an equitable method established in the plan of operation; and
(2)  in proportion to the contribution of each member insurer.
(c)  The board may retain a reasonable amount to provide for the association's continuing expenses and for future losses if refunds are impractical.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter D. Assessments › Section 463.158. Use of Assessments

Sec. 463.158.  USE OF ASSESSMENTS.  Money from assessments supplements the marshalling of an impaired insurer's assets to make payments on the insurer's behalf.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter D. Assessments › Section 463.159. Failure to Pay; Collection by Commissioner

Sec. 463.159.  FAILURE TO PAY; COLLECTION BY COMMISSIONER.  On failure of a member insurer to pay an assessment when due, the commissioner may either:
(1)  suspend or revoke, after notice and hearing, the insurer's certificate of authority to engage in the business of insurance in this state; or
(2)  levy a forfeiture in an amount not less than $100 each month or more than five percent of the unpaid assessment each month.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter D. Assessments › Section 463.160. Premium Tax Credit for Class a Assessment

Sec. 463.160.  PREMIUM TAX CREDIT FOR CLASS A ASSESSMENT.  The amount of a Class A assessment paid by a member insurer in each taxable year shall be allowed as a credit on the amount of premium taxes due.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
Amended by:
Acts 2011, 82nd Leg., 1st C.S., Ch. 4 (S.B. 1), Sec. 2.06, eff. September 28, 2011.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter D. Assessments › Section 463.161. Premium Tax Credit for Class B Assessment

Sec. 463.161.  PREMIUM TAX CREDIT FOR CLASS B ASSESSMENT.  (a)  A member insurer is entitled to show as an admitted asset a certificate of contribution in the form the commissioner approves under Section 463.156.  Unless the commissioner requires a longer period, the certificate may be shown at:
(1)  for the calendar year of issuance, an amount equal to the certificate's original face value approved by the commissioner; and
(2)  beginning with the year following the calendar year of issuance, an amount equal to the certificate's original face value, reduced by 20 percent a year for each year after the year of issuance, for a period of five years.
(b)  An amount written off during a calendar year under Subsection (a) shall be allowed as a credit against the member insurer's premium tax owed for business engaged in during that year.  The insurer is not required to write off in a single year an amount that exceeds the amount of premium tax owed for the business described by this subsection.
(c)  The association shall pay to the commissioner, and the commissioner shall deliver to the comptroller for deposit to the credit of the general revenue fund, any amount owed as a refund from the association under Section 463.157 that was written off and used for a tax credit under this section.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 3B.017(a), eff. September 1, 2007.
Acts 2007, 80th Leg., R.S., Ch. 921 (H.B. 3167), Sec. 9.017(a), eff. September 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter D. Assessments › Section 463.162. Assignment or Transfer of Credit

Sec. 463.162.  ASSIGNMENT OR TRANSFER OF CREDIT.  (a)  A member insurer may assign or transfer a credit against premium tax to another member insurer if:
(1)  an acquisition, merger, or total assumption of reinsurance occurs between the insurers; or
(2)  the commissioner by order approves the assignment or transfer.
(b)  Not later than the later of November 1 or the 60th day after the date of the assignment or transfer, each member insurer shall:
(1)  report the assignment or transfer to the comptroller on a form the comptroller prescribes; and
(2)  include with the report any documents from the commissioner that show approval of the assignment or transfer.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter D. Assessments › Section 463.163. Insured's Liability Under Assessment Plan

Sec. 463.163.  INSURED'S LIABILITY UNDER ASSESSMENT PLAN.  This chapter does not reduce the liability for unpaid assessments of the insureds of an impaired or insolvent insurer operating under a plan with assessment liability.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter E. Coverage Provided by Association › Section 463.202. Policies and Contracts Covered

Sec. 463.202.  POLICIES AND CONTRACTS COVERED.  (a)  Except as limited by this chapter, the coverage provided by this chapter to a person specified by Section 463.201, subject to Sections 463.201(b) and (c), applies with respect to the following policies and contracts issued by a member insurer:
(1)  a direct, nongroup life, health, accident, annuity, or supplemental policy or contract, including a health maintenance organization contract or certificate;
(2)  a certificate under a direct group policy or contract;
(3)  a group hospital service contract; and
(4)  an unallocated annuity contract.
(b)  The coverage provided by this chapter also applies with respect to all other insurance coverage written by the following entities authorized to engage in business in this state:
(1)  a mutual assessment company;
(2)  a local mutual aid association;
(3)  a statewide mutual assessment company; and
(4)  a stipulated premium company.
(c)  For the purposes of this section, an annuity contract or a certificate under a group annuity contract includes:
(1)  a guaranteed investment contract;
(2)  a deposit administration contract;
(3)  an allocated or unallocated funding agreement;
(4)  a structured settlement annuity;
(5)  an annuity issued to or in connection with a government lottery; and
(6)  an immediate or deferred annuity contract.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 3B.018(b), eff. September 1, 2007.
Acts 2007, 80th Leg., R.S., Ch. 921 (H.B. 3167), Sec. 9.018(b), eff. September 1, 2007.
Acts 2019, 86th Leg., R.S., Ch. 432 (S.B. 1153), Sec. 13, eff. September 1, 2019.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter E. Coverage Provided by Association › Section 463.205. Protection Provided by Other Jurisdiction

Sec. 463.205.  PROTECTION PROVIDED BY OTHER JURISDICTION.  This chapter does not provide coverage for a resident with respect to an impaired or insolvent insurer domiciled in another jurisdiction if guaranty protection is provided to the resident by the law of that jurisdiction.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter E. Coverage Provided by Association › Section 463.206. Association Discretion in Manner of Providing Benefits

Sec. 463.206.  ASSOCIATION DISCRETION IN MANNER OF PROVIDING BENEFITS.  (a)  The board shall have discretion and may exercise reasonable business judgment to determine the means by which the association is to provide the benefits of this chapter in an economical and efficient manner.
(b)  If the association arranges or offers to provide the benefits of this chapter to a covered person under a plan or arrangement that fulfills the association's obligations under this chapter, the person is not entitled to benefits from the association in addition to or other than those provided under the plan or arrangement.
Added by Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 3B.015(b), eff. September 1, 2007.
Added by Acts 2007, 80th Leg., R.S., Ch. 921 (H.B. 3167), Sec. 9.015(b), eff. September 1, 2007.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter F. Powers and Duties of Association Relating › Section 463.251. Impaired Domestic Insurer

Sec. 463.251.  IMPAIRED DOMESTIC INSURER.  (a)  This section applies only to a member insurer that is an impaired domestic insurer.
(b)  With the commissioner's approval, the association may:
(1)  guarantee, assume, reissue, or reinsure, or cause to be guaranteed, assumed, reissued, or reinsured, one or more of the insurer's policies or contracts;
(2)  provide money, pledges, notes, guarantees, or other means proper to:
(A)  implement Subdivision (1); and
(B)  ensure payment of the insurer's contractual obligations until action is taken under Subdivision (1); or
(3)  loan money to the insurer.
(c)  In taking action under Subsection (b), the association may impose any condition that:
(1)  does not impair the insurer's contractual obligations; and
(2)  is approved by:
(A)  the commissioner; and
(B)  the insurer, except in a conservation or rehabilitation ordered by a court.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
Amended by:
Acts 2019, 86th Leg., R.S., Ch. 432 (S.B. 1153), Sec. 16, eff. September 1, 2019.
2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter F. Powers and Duties of Association Relating › Section 463.252. Impaired Domestic, Foreign, or Alien Insurer Not Paying Claims

Sec. 463.252.  IMPAIRED DOMESTIC, FOREIGN, OR ALIEN INSURER NOT PAYING CLAIMS.  (a)  This section applies only to a member insurer that:
(1)  is an impaired domestic, foreign, or alien insurer; and
(2)  is not timely paying claims.
(b)  Subject to Subsection (d), the association shall:
(1)  with respect to the insurer, take one or more actions that the association is authorized to take under Section 463.251 with respect to an impaired domestic insurer, subject to the conditions of that section; or
(2)  provide substitute benefits instead of the insurer's contractual obligations as provided by Subsection (c).
(c)  A policy or contract owner, certificate holder, or enrollee who claims emergency or hardship may petition for substitute benefits under standards the association proposes and the commissioner approves.  Substitute benefits are available only for a health claim, periodic annuity benefit payment, death benefit, supplemental benefit, or cash withdrawal.
(d)  The association is required to take action under this section only if:
(1)  the laws of the insurer's state of domicile provide that, until all payments of or on account of the insurer's contractual obligations are made by all guaranty associations and all expenses of the associations and interest on those payments and expenses have been repaid to the associations or a plan of repayment by the insurer has been approved by the associations:
(A)  the delinquency proceeding may not be dismissed;
(B)  the insurer and the insurer's assets may not be returned to the control of the insurer's shareholders or private management; and
(C)  the insurer may not solicit or accept new business or have any suspended or revoked certificate of authority restored;
(2)  the insurer is a domestic insurer that has been placed under an order of rehabilitation by a court in this state;  or
(3)  the insurer is a foreign or alien insurer and:
(A)  the insurer has been prohibited from soliciting or accepting new business in this state;
(B)  the insurer's certificate of authority has been suspended or revoked in this state;  and
(C)  a petition for rehabilitation or liquidation has been filed in a court in the insurer's state of domicile by the insurance official of that state.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
Amended by:
Acts 2019, 86th Leg., R.S., Ch. 432 (S.B. 1153), Sec. 17, eff. September 1, 2019.