2023 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 G. Reinsurance for Small Employer Health Benefit Plans › Section 1501.3022. Suspension of Operation

Sec. 1501.3022.  SUSPENSION OF OPERATION.  (a)  The commissioner shall hold a hearing if the system is operating or is authorized to operate and:
(1)  the commissioner believes small employer health benefit plan issuers in this state are not threatened with the inability to secure reinsurance coverage in the open market; or
(2)  the commissioner receives a petition requesting the hearing from an association of health benefit plan issuers in this state or a group of at least 15 small employer health benefit plan issuers operating in this state.
(b)  If, after a hearing under Subsection (a), the commissioner finds that suspension of the operation of the system is in the public interest, the commissioner by order shall direct the board to submit to the commissioner for approval, not later than the 60th day after the date of the order, a plan of suspension of operation of the system.
(c)  A plan of suspension under Subsection (b) must:
(1)  specify the date after which a health benefit plan issuer that is a risk-assuming health benefit plan issuer on the effective date of the plan of suspension may not:
(A)  become a reinsured health benefit plan issuer under Sections 1501.310, 1501.311, and 1501.312; and
(B)  reinsure with the system a small employer group, or any risk, covered under any small employer health benefit plan;
(2)  specify the date after which a health benefit plan issuer that is a reinsured health benefit plan issuer on the effective date of the plan of suspension may not:
(A)  reinsure with the system additional small employer groups in accordance with Section 1501.314; or
(B)  cede additional eligible lives to the system in accordance with Section 1501.314;
(3)  provide for:
(A)  the filing, receipt, processing, and payment of all claims against and debts of the system, and extinguishment of all liabilities of the system, including balances on any lines of credit that may have been established by or on behalf of the system;
(B)  the collection and receipt of all assessments made with respect to reinsured health benefit plan issuers, including any deferred assessments and any final assessment made under Subsection (f); and
(C)  a final audit of the system by the state auditor as provided by Subsection (g);
(4)  specify that the transactions required by the plan of suspension and addressed in Subdivisions (1)-(3) must be closed not later than the effective date of the suspension of the operation of the system as specified under Subdivision (5);
(5)  state the effective date of the suspension of the operation of the system; and
(6)  provide for the proportionate distribution of any surplus assets of the system that remain after the date specified under Subdivision (5).
(d)  The effective date of the suspension of the operation of the system as specified under Subsection (c)(5) may not be later than the 270th day after the date the commissioner by order approves the plan of suspension.
(e)  If the board fails to submit a suitable plan of suspension, the commissioner, after notice and hearing, shall adopt a plan in accordance with Subsection (c).
(f)  The board may make a final assessment of the small employer health benefit plan issuers that, for any portion of the last year in which the system operated, were reinsured health benefit plan issuers.  An assessment under this subsection may be made only if the board determines the assessment is necessary to recover net losses of the system, as provided in Sections 1501.319-1501.326, including administrative expenses for transactions essential to complete execution of the plan of suspension, and the cost of the final audit by the state auditor.
(g)  The transactions necessary to complete execution of the plan of suspension are subject to audit by the state auditor under Chapter 321, Government Code.  The state auditor shall report the cost of the final audit conducted under this section to the board and the comptroller, and the board shall remit that amount to the comptroller for deposit to the general revenue fund.
(h)  The board serving immediately before the effective date of the suspension of the operation of the system is discharged on the effective date of the suspension of the operation of the system as specified under Subsection (c)(5).
(i)  After the effective date of the suspension of the operation of the system as specified under Subsection (c)(5), the commissioner shall take any action necessary under Subsection (c)(6) to distribute the surplus assets of the system until all remaining assets are distributed.
(j)  During a period in which the operation of the system is suspended, Sections 1501.307-1501.326 have no effect.
Added by Acts 2017, 85th Leg., R.S., Ch. 105 (S.B. 1171), Sec. 2, eff. May 23, 2017.