Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 13 - MISCELLANEOUS INSURERS AND OTHER REGULATED ENTITIES › Subchapter F - PROFESSIONAL EMPLOYER ORGANIZATIONS SPONSORING SELF-FUNDED EMPLOYEE HEALTH BENEFIT PLANS › Division 2 - APPLICABILITY OF INSURANCE CODE AND ADMINISTRATIVE CODE PROVISIONS › Section 13.522 - Delegation of Functions to a Contracting Regulated Entity

Current through Reg. 49, No. 28; July 12, 2024
(a) Delegation to regulated entity. An
					 approved PEO or the plan trustees may delegate to a contracting regulated
					 entity the responsibility to perform any requirement of this subchapter that
					 the contracting regulated entity is authorized by law to perform.
(b) Joint and several liability. If an
					 approved PEO or the plan trustees delegate responsibility to perform any
					 requirement of this subchapter, TDI in its sole discretion may hold the PEO,
					 the plan trustees, and the contracting regulated entity jointly or severally
					 liable for noncompliance with respect to the responsibilities
					 delegated.
(c) Notice of contract
					 with regulated entities. An approved PEO or the plan trustees must give the
					 commissioner a written notice of intent to enter into a contract with a
					 regulated entity at least 30 days before the effective date of that contract. A
					 notice of intent must include the information about the contracting regulated
					 entity required by §
											13.532(b)(6)
					 of this title (relating to Application Requirements).
(d) Notice of termination of contract with
					 regulated entity. Except as provided in subsection (g) of this section, an
					 approved PEO or the plan trustees must give the commissioner a written notice
					 of intent to terminate a contract with a regulated entity at least 30 days
					 before the effective date of that termination.
(e) Third party administrator. An approved
					 PEO or the plan trustees may not terminate under any circumstances a contract
					 with the plan's third party administrator unless they have contracted with a
					 replacement third party administrator to perform the day-to-day operations of
					 the plan with no lapse in administrative services to the plan.
(f) Notice of replacement contracting
					 regulated entity. Except as provided in subsection (h) of this section, if an
					 approved PEO or the plan trustees intend to enter into a contract with a
					 regulated entity to perform the functions for which a terminating contracting
					 regulated entity was responsible, the approved PEO or the plan trustees must
					 provide the commissioner notice that complies with subsection (c) of this
					 section.
(g) Notice of contract
					 termination for cause. If an approved PEO or the plan trustees terminate a
					 contract with a regulated entity for cause as permitted by the terms of that
					 contract, the approved PEO or the plan trustees must give the commissioner
					 written notice of the contract's termination not later than five days after the
					 effective date of that termination, including a statement explaining whether
					 the functions for which the terminating contracting regulated entity is
					 responsible will be performed by the approved PEO or by another contracting
					 regulated entity.
(h) Notice of
					 intent to contract with replacement regulated entity. After a termination under
					 subsection (g) of this section, if the plan and trust functions will be
					 performed by another contracting regulated entity, the approved PEO or the plan
					 trustees must give the commissioner written notice of intent to enter into a
					 contract with that new regulated entity as soon as is practicable, but not
					 later than 10 days after the effective date of that contract. The notice of
					 intent must include the information about the contracting regulated entity
					 required by §
											13.532(b)(6)
					 of this title.