reglab/statecodes huggingface dataset:
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter A - GENERAL REGULATION OF SURPLUS LINES INSURANCE › Section 15.5 - Minimum Content of Contracts

Current through Reg. 49, No. 28; July 12, 2024
(a) Each
				  new or renewal insurance contract, policy, certificate, cover note, or other
				  confirmation of insurance purchased and delivered as surplus lines coverage
				  under the Insurance Code must contain, at a minimum:
(1) the information required by Insurance
				  Code §
											981.101;
(2) a statement designating the name and
				  address of the individual to whom the Commissioner will mail service of process
				  in accordance with the Insurance Code; and
(3) a stamping fee.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter A - GENERAL REGULATION OF SURPLUS LINES INSURANCE › Section 15.6 - Forms

Current through Reg. 49, No. 28; July 12, 2024
Applications, reports, and memorandums, required under the
					 Insurance Code and by this chapter relating to surplus lines insurance must
					 include all required information.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter A - GENERAL REGULATION OF SURPLUS LINES INSURANCE › Section 15.7 - Submission of Applications, Notices, and Correspondence

Current through Reg. 49, No. 28; July 12, 2024
(a) All submissions to the Commissioner or
				  TDI required in this chapter must be sent to the appropriate physical, mailing,
				  or electronic address:
(1) specified on the
				  applicable TDI form being used; or
(2) listed on the TDI website for a
				  particular submission.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter A - GENERAL REGULATION OF SURPLUS LINES INSURANCE › Section 15.8 - Filing Requirements

Current through Reg. 49, No. 28; July 12, 2024
(a) No report
				  required to be filed under the Insurance Code or this chapter relating to
				  surplus lines insurance will be deemed filed with TDI or the stamping office
				  unless the documents submitted are correctly completed and signed on forms
				  complying with §
										15.6
				  of this title.
(b) A correct
				  surplus lines policy filing submitted to the stamping office will be deemed
				  correctly executed and filed the day the transaction is posted by the stamping
				  office.
(c) The surplus lines agent
				  responsible for a filing must maintain the subject contract file, as specified
				  in § 15.110 of this title, at the agent's place of business in accordance
				  with § 15.108 of this title and must promptly submit the contract file to
				  the stamping office on request. On mutual agreement, a representative of the
				  stamping office may view the requested contract file at the agent's place of
				  business.
(d) Nothing in this
				  section limits TDI's ability to require the agent to submit information or
				  reports as required by the Insurance Code or this chapter.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter A - GENERAL REGULATION OF SURPLUS LINES INSURANCE › Section 15.9 - Becoming an Eligible Insurer

Current through Reg. 49, No. 28; July 12, 2024
(a) The
				  stamping office must evaluate surplus lines insurance policies, contracts, or
				  other evidences of coverage for eligibility and compliance with filing
				  requirements. The stamping office may request additional information from the
				  surplus lines agent responsible for the filing if the information filed is not
				  sufficient to make an evaluation in accordance with this section.
(b) Following its evaluation of filings under
				  this section, the stamping office must provide the following written reports to
				  TDI:
(1) Within 60 days of discovery, a
				  report documenting any surplus lines insurance policy issued by an insurer that
				  is not an eligible surplus lines insurer, any surplus lines insurance policy
				  and contract that is of a type that is not compliant with the Insurance Code,
				  and any act that requires a license that is performed by an unlicensed
				  person.
(2) Promptly upon
				  discovery, a report documenting any surplus lines insurance policy or contract
				  that has uncorrected administrative or technical errors that the stamping
				  office has asked the surplus lines agent to correct.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter B - SURPLUS LINES AGENTS › Section 15.101 - Licensing of Surplus Lines Agents

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Persons performing any of the following surplus lines insurance activities are
				  required to have a surplus lines agent license:
(1) supervising unlicensed staff engaged in
				  activities described in subsection (b) of this section, although unlicensed
				  intermediary supervisors may supervise unlicensed staff engaging in these
				  activities if the ultimate supervisor is licensed;
(2) negotiating, soliciting, effecting,
				  procuring, or binding surplus lines insurance contracts for clients or offering
				  advice, counsel, opinions, or explanations of surplus lines insurance products
				  to agents or clients beyond the scope of underwriting policies or contracts,
				  except for a general lines property and casualty agent making a referral of
				  surplus lines business to a surplus lines agent that then completes the surplus
				  lines transaction; or
(3) receiving
				  any direct commission or variance in compensation based on the volume of
				  surplus lines premiums taken and received from, or as a result of, another
				  person selling, soliciting, binding, effecting, or procuring surplus lines
				  insurance policies, contracts, or coverages, except for a general lines
				  property and casualty agent making a referral of surplus lines business to a
				  surplus lines agent that then completes the surplus lines
				  transaction.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter B - SURPLUS LINES AGENTS › Section 15.103 - Surplus Lines Stamping Fee

Current through Reg. 49, No. 28; July 12, 2024
For each surplus lines policy, contract, or other detailed
					 evidence of coverage issued on Texas risks, including additions or deletions
					 to, or cancellations of, the surplus lines agent must submit a stamping fee as
					 approved by TDI. The fees are due and payable as provided in § 15.106 of
					 this title.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter B - SURPLUS LINES AGENTS › Section 15.104 - Reasonable Duty in Placing Coverage

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  Before placing insurance with an eligible surplus lines insurer, a surplus
				  lines agent must make a reasonable inquiry into the financial condition and
				  operating history of the insurer.
(b) During the course of placing coverage
				  with an eligible surplus lines insurer, each surplus lines agent will be under
				  a continuous duty to stay informed of the insurer's solvency and the soundness
				  of its financial strength, and of the insurer's ability to process claims and
				  pay losses expeditiously.
(c) A
				  surplus lines agent must immediately inform TDI and the stamping office if the
				  agent has grounds to reasonably doubt the capacity, competence, stability,
				  claim practices, or business practices of an eligible surplus lines
				  insurer.
(d) A surplus lines agent
				  must immediately inform TDI and the stamping office if the agent has reasonable
				  grounds to believe that an insurer that is not an admitted insurer, an alien
				  insurer listed with the NAIC's International Insurer Department, or an eligible
				  surplus lines insurer, is transacting the business of insurance in this
				  state.
(e) A surplus lines agent
				  may place surplus lines insurance on Texas risks with only an eligible insurer
				  that meets the requirements of the Insurance Code and TDI's rules.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter B - SURPLUS LINES AGENTS › Section 15.105 - Evidence of Insurance

Current through Reg. 49, No. 28; July 12, 2024
(a) A surplus
				  lines agent must promptly provide the insured or the client's agent with
				  written evidence of insurance containing complete terms, conditions, and
				  exclusions pertaining to the coverage to protect all parties against
				  misunderstanding. If temporary confirmation of insurance coverage is required
				  by the insured or is given by the surplus lines agent, that temporary
				  confirmation must be replaced as promptly as possible with a policy or
				  certificate stating the complete terms, conditions, and exclusions of the
				  insurance.
(b) If, after delivery
				  to the insured or the insured's agent of any document evidencing insurance
				  coverage, there is any change as to the identity of the insurers or the portion
				  of the direct risk assumed by the insurer as stated in the previously mentioned
				  original documents, or any other material change as to the insurance coverage,
				  the surplus lines agent must promptly send to the insured or the insured's
				  agent a substitute certificate, cover note, confirmation, or endorsement for
				  the original. All substitute documents must accurately show the current status
				  of the coverage and the responsible insurers.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter B - SURPLUS LINES AGENTS › Section 15.106 - Stamping Office Filing and Fees

Current through Reg. 49, No. 28; July 12, 2024
(a)
				  The surplus lines agent must file a true and correct copy of each executed
				  surplus lines policy, contract, or other detailed evidence of coverage,
				  including additions, deletions, or cancellations with the stamping office
				  within 60 days of issuance or the effective date, whichever is later. If
				  evidence of coverage other than the policy is initially filed, a copy of the
				  policy must be filed with the stamping office within 60 days after it becomes
				  available.
(b) For purposes of
				  reporting to the stamping office, the term "true and correct copy of a surplus
				  lines insurance policy" as used in this section, includes:
(1) a declarations page;
(2) a listing of all participating insurers
				  on the policy;
(3) all coverage
				  parts and schedules, including limits;
(4) extended coverage exclusions;
(5) all premium-bearing documents;
(6) risk ZIP code location; and
(7) any other parts as may be required by the
				  stamping office to review and record the policy.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter B - SURPLUS LINES AGENTS › Section 15.107 - Requests for Information

Current through Reg. 49, No. 28; July 12, 2024
(a) In
				  addition to those documents required to be filed under § 15.106 and §
				  15.301 of this title, the stamping office may request a surplus lines agent to
				  submit additional information necessary to evaluate the eligibility of surplus
				  lines policies, contracts, or other detailed evidence of coverage.
(b) The stamping office must issue a written
				  report to TDI if the requested additional information is not timely submitted
				  by the surplus lines agent.
(c) The
				  stamping office and the surplus lines agent may mutually agree for a
				  representative of the stamping office to review the requested information at
				  the surplus lines agent's place of business.
(d) Nothing in this section limits TDI's
				  ability to require the surplus lines agent to submit information or reports as
				  required by the Insurance Code and this chapter.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter B - SURPLUS LINES AGENTS › Section 15.108 - Recordkeeping

Current through Reg. 49, No. 28; July 12, 2024
(a) In order to provide for basic uniformity
				  in recordkeeping requirements, and to make it possible for TDI to make a
				  complete and accurate examination of the surplus lines agent's records, the
				  following insurance and accounting records must be established and maintained
				  by each surplus lines agent:
(1) a policy
				  register;
(2) a contract
				  file;
(3) general books of
				  account;
(4) a list of all
				  agreements entered into with a managing underwriter under Insurance Code §
											225.006(c)
				  and copies of the agreements; and
(5) any other insurance and accounting
				  records as are necessary to properly and promptly service Texas policyholders
				  and provide required information to TDI.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter B - SURPLUS LINES AGENTS › Section 15.109 - Policy Number

Current through Reg. 49, No. 28; July 12, 2024
(a) All surplus
				  lines agents must, immediately on procuring insurance from an eligible surplus
				  lines insurer, record the policy number and the name of the insured. The
				  surplus lines agent must inscribe with the same policy number all records and
				  files maintained by the surplus lines agent that are pertinent to a specific
				  risk.
(b) For agents having
				  authority to issue policies on behalf of an eligible surplus lines insurer, and
				  in the instance of voided or unused policy numbers, the agent must record an
				  explanation in the policy number register.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter B - SURPLUS LINES AGENTS › Section 15.110 - Contract File

Current through Reg. 49, No. 28; July 12, 2024
Each surplus lines agent must maintain a contract file
					 containing a complete and true record for each individual surplus lines
					 contract including the items described under Insurance Code §
										981.215(a)
					 and the following, as applicable:
(1)
				  a copy of the daily report or other evidence of insurance;
(2) amount of insurance and perils insured
				  against;
(3) brief general
				  description of the property insured and its location, including ZIP
				  code;
(4) gross premium;
(5) name and mailing address of the
				  insured;
(6) name and home office
				  address of the insurer, underwriting syndicate or other risk-bearing
				  entity;
(7) record of losses or
				  claims filed and payments made;
(8)
				  a true and correct copy of the insurance policy, contract, and other detailed
				  evidences of coverage, as issued to the insured;
(9) all correspondence relating to the
				  specific insurance coverage of that contract file;
(10) support for exempt commercial purchaser
				  status complying with Insurance Code § 981.215(a)(12)(A) and § 15.111
				  of this title; and
(11) support for
				  the industrial insured status complying with Insurance Code §
				  981.215(a)(12)(B) and § 15.112 of this title.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter B - SURPLUS LINES AGENTS › Section 15.111 - Exempt Commercial Purchaser Documentation

Current through Reg. 49, No. 28; July 12, 2024
Support for exempt commercial purchaser status must include
					 documentation of the following:
(1) a
				  copy of the document described in Insurance Code §
										981.004(c)(2);
				  and
(2) a signed statement from the
				  insured identifying which provisions of Insurance Code §
										981.0031(a)(3)
				  and §
										981.0032(3)
				  are applicable to the insured.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter B - SURPLUS LINES AGENTS › Section 15.112 - Industrial Insured Documentation

Current through Reg. 49, No. 28; July 12, 2024
Support for industrial insured status must include
					 documentation of the following:
(1)
				  compliance with Insurance Code §
										981.004(d)(2)
				  and (3); and
(2) a signed statement from the insured
				  identifying which provisions of Insurance Code and §981.0032(3) and
				  §981.0033(2) are applicable to the insured.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter B - SURPLUS LINES AGENTS › Section 15.113 - Agent Accounting Records

Current through Reg. 49, No. 28; July 12, 2024
(a) Each
				  surplus lines agent must maintain general accounting records, which must
				  include a general ledger, a general journal, cash records, and other items
				  necessary to reflect the financial solvency of the agent.
(b) The surplus lines agent's general
				  accounting records must show a month-end summary of operations and fiscal or
				  calendar-year-to-date summary of operations, and must be maintained in
				  accordance with generally accepted accounting principles.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter B - SURPLUS LINES AGENTS › Section 15.114 - Untimely Filed Policies

Current through Reg. 49, No. 28; July 12, 2024
(a) On or
				  before the 15th day of each month, the stamping office must either directly
				  provide or make easily obtainable to surplus lines agents a report listing any
				  surplus lines policies the agent filed in the previous month that were untimely
				  filed. The surplus lines agent is responsible for confirming the accuracy of
				  the report.
(b) For any policy
				  listed in the report described in subsection (a) of this section that the
				  surplus lines agent believes was timely filed, the agent must, on or before the
				  earlier of 90 days from the date of the report or February 15 of each year
				  following the year in which the policies were filed, either:
(1) correct any errors in the record using
				  electronic procedures established by the stamping office, or
(2) if the error in the record cannot be
				  corrected using electronic procedures established by the stamping office, the
				  agent must notify the stamping office that the agent believes the policy was
				  timely filed. The notification must identify the filing at issue, describe any
				  special factors or unique circumstances that apply, and provide all necessary
				  documentation to support the agent's position that it was timely
				  filed.
(3) Following receipt of
				  notification described in paragraph (2) of this subsection, on or before the
				  earlier of either 30 days after receipt or March 1, the stamping office must
				  review and research the notification and then provide TDI with a summary as
				  well as the stamping office's opinion as to whether the policy should be
				  considered timely filed. On receiving the summary from the stamping office, TDI
				  will decide by the earlier of either 45 days after receiving the stamping
				  office's analysis or March 15 whether the policy should be considered timely
				  filed and notify the agent and stamping office. If TDI determines that the
				  policy should be considered timely filed, the stamping office must make any
				  necessary changes to its records so that the policy is considered timely
				  filed.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter B - SURPLUS LINES AGENTS › Section 15.115 - Surplus Lines Policies for Purchasing Groups

Current through Reg. 49, No. 28; July 12, 2024
(a) A purchasing group is any group that:
(1) has as one of its purposes the purchase
				  of liability insurance on a group basis;
(2) purchases liability insurance only for
				  its group members and only to cover their similar or related liability
				  exposure;
(3) is composed of
				  members whose businesses or activities are similar or related with respect to
				  the liability to which members are exposed by any related, similar, or common
				  business, trade, product, service, premise, or operation; and
(4) is domiciled in any state.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter C - SURPLUS LINES STAMPING OFFICE PLAN OF OPERATION › Section 15.201 - Commissioner Approval

Current through Reg. 49, No. 28; July 12, 2024
(a) The stamping
				  office's plan of operation (plan of operation) and any amendment to it become
				  effective on written approval by Commissioner order, and constitute the manner
				  in which the stamping office must operate and discharge its responsibilities in
				  accordance with the Insurance Code and TDI's rules.
(b) The stamping office must submit proposed
				  amendments to the plan of operation to the Commissioner for consideration and
				  approval.
(1) The Commissioner may accept or
				  reject some or all of the proposed amendments.
(2) TDI will provide public notice and an
				  opportunity to comment on some or all of the proposed amendments.
(3) The Commissioner will approve amendments
				  to the plan of operation by Commissioner order.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 15 - SURPLUS LINES INSURANCE › Subchapter D - TEXAS CERTIFIED SELF-INSURER GUARANTY ASSOCIATION › Section 15.301 - Evaluation Requirements of Surplus Lines Insurance Coverage

Current through Reg. 49, No. 28; July 12, 2024
(a) Surplus lines insurers not designated as
				  a domestic surplus lines insurer by TDI must provide to TDI and to the stamping
				  office information relating to the insurer's eligibility to write surplus lines
				  insurance.
(1) For insurers domiciled in
				  another state, this information must include documents evidencing authorization
				  from the insurer's domiciliary jurisdiction to write the same kind and class of
				  business that it proposes to write in Texas and documentation that the insurer
				  has capital and surplus required by Insurance Code §
											981.057.
				  Documentation must include:
(A) insurer
				  information, including the insurer's:
(i)
				  full name;
(ii) physical address
				  for its principal place of business;
(iii) mailing address;
(iv) NAIC number; and
(v) contact individual's name, phone number,
				  and email;
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter A - DISCIPLINARY HEARINGS IN RESPECT OF INSURANCE AGENTS › Section 19.1 - Purpose

Current through Reg. 49, No. 28; July 12, 2024
It is the purpose of these sections, in the event a public
					 hearing is set by the commissioner of insurance to consider disciplinary action
					 in respect of an insurance agent and notice of such hearing is deposited in the
					 United States mail, to cause such hearing to be held, evidence to be presented,
					 and an order to be entered by the commissioner of insurance. It is also a
					 purpose of these sections to prevent the defeat of any provision of the
					 Insurance Code relating to disciplinary action including proceedings
					 contemplated pursuant thereto. As used in these sections, the term
					 "disciplinary action" includes actions by which a license is denied, revoked,
					 suspended, or any other sanction imposed.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter A - DISCIPLINARY HEARINGS IN RESPECT OF INSURANCE AGENTS › Section 19.2 - Effect of Surrendering or Attempting To Surrender Agent's License

Current through Reg. 49, No. 28; July 12, 2024
(a) The surrender of any agent's license to
				  the State Board of Insurance will not operate to negate any offense committed
				  prior to the effective date of the surrender.
(b) Transmitting to the State Board of
				  Insurance any or all insurance agent licenses held by an insurance agent for
				  the purpose of surrender and cancellation will in no way affect pending
				  disciplinary proceedings by the commissioner of insurance in respect of such
				  agent.
(c) No communication will
				  issue from the State Board of Insurance designed to effect the surrender of an
				  insurance agent's license to avoid disciplinary proceedings.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter B - MEDICARE ADVANTAGE PLANS, MEDICARE ADVANTAGE PRESCRIPTION DRUG PLANS, AND MEDICARE PART D PLANS › Section 19.101 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
The following words and terms when used in this subchapter
					 shall have the following meanings unless the context clearly indicates
					 otherwise.
(1) CMS--Centers for
				  Medicare and Medicaid Services.
(2)
				  CMS marketing guidelines--CMS' published marketing guidelines for use by
				  Medicare Advantage Plans, Medicare Advantage Prescription Drug Plans,
				  Prescription Drug Plans and 1876 Cost Plans, as revised July 25, 2006, and
				  inclusive of all subsequent revisions.
(3) Department--Texas Department of
				  Insurance.
(4)
				  Marketing--Soliciting and/or selling.
(5) Medicare Plans--Medicare Advantage Plans,
				  Medicare Advantage Prescription Drug Plans, and Prescription Drug Plans as
				  described in the CMS marketing guidelines.
(6) Permanent license--A license issued to a
				  person satisfying all the requirements of the Insurance Code §§
										4001.105,
				  4001.106,
				  4056.052,
				  4056.053,
				  or
				  4056.054.
				  The term does not include a temporary license issued under the Insurance Code
				  §§
										4001.151
				  -
				  4001.154.
(7) Person--An individual, partnership,
				  corporation, or depository institution as defined in the Insurance Code §
										4001.003(8).
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter B - MEDICARE ADVANTAGE PLANS, MEDICARE ADVANTAGE PRESCRIPTION DRUG PLANS, AND MEDICARE PART D PLANS › Section 19.102 - Agent Authority to Market Medicare Advantage Plans, Medicare Advantage Prescription Drug Plans, and Medicare Prescription Drug Plans

Current through Reg. 49, No. 28; July 12, 2024
(a) Persons holding a current permanent
				  general life, accident, and health insurance license under the Insurance Code
				  §
										4054.051 are
				  authorized to act as marketing representatives to market Medicare plans
				  pursuant to federal law, regulations and CMS marketing guidelines.
(b) In accord with the Insurance Code §
										4051.053,
				  persons holding a current permanent general property and casualty insurance
				  agent license under the Insurance Code §
										4051.051 are
				  qualified to act as marketing representatives to market Medicare plans pursuant
				  to federal law, regulations and CMS marketing guidelines, only to the extent
				  that the Medicare plans are offered by a property and casualty insurer
				  authorized to sell those products in this state.
(c) Unless qualifying under subsection (a) or
				  (b) of this section, department licensees, including individuals holding a
				  temporary general life, accident and health insurance agent license or a
				  temporary general property and casualty insurance agent license, are not
				  qualified to act and are prohibited from acting as marketing representatives to
				  market Medicare plans.
(d) Except
				  for activities that are specifically authorized under federal law and CMS
				  marketing guidelines to be performed by unlicensed persons, an insurer, health
				  maintenance organization, or insurance agent is prohibited from assisting or
				  participating in enrolling any individual in a Medicare plan contract marketed
				  by an:
(1) agent that does not hold either:
(A) a current permanent general life,
				  accident, and health insurance agent license; or
(B) a current permanent general property and
				  casualty insurance agent's license, if the agent is acting for a property and
				  casualty insurer engaged in selling Medicare plans; or
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter B - MEDICARE ADVANTAGE PLANS, MEDICARE ADVANTAGE PRESCRIPTION DRUG PLANS, AND MEDICARE PART D PLANS › Section 19.103 - Reporting Requirements

Current through Reg. 49, No. 28; July 12, 2024
An insurer, health maintenance organization, or insurance
					 agent is required to report in writing any violation of §
										19.102 of this title (relating to
					 Agent Authority to Market Medicare Advantage Plans, Medicare Advantage
					 Prescription Drug Plans, and Medicare Prescription Drug Plans) within four
					 calendar days of discovering the violation to the Fraud and Enforcement
					 Division at the contact information provided on the department's
					 website.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter G - LICENSING OF INSURANCE ADJUSTERS › Section 19.601 - Fees for Examination

Current through Reg. 49, No. 28; July 12, 2024
Any person wishing to take the examination for an insurance
					 adjuster's license must submit the examination fee specified by §
										19.802
					 of this title (relating to Amounts of Fees) with the application in advance of
					 taking the examination. The fee shall not be refunded to any applicant who may
					 for any reason fail to take such examination or to any applicant who may fail
					 to pass the examination.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter G - LICENSING OF INSURANCE ADJUSTERS › Section 19.602 - Types of Adjuster's Licenses

Current through Reg. 49, No. 28; July 12, 2024
(a) Any
				  references to the Act in this subchapter are references to Insurance Code
				  Chapter 4101, concerning Insurance Adjusters. The following types of adjuster's
				  licenses are approved for insurance:
(1) all
				  lines (issuance of "all lines" adjuster's license for those adjusters who
				  qualify in paragraphs (2) and (3) of this subsection);
(2) property, casualty, and surety;
				  and
(3) workers' compensation,
				  employer's liability, USL&H (U.S. Longshoremen's and Harbor Workers'
				  Compensation Insurance).
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter G - LICENSING OF INSURANCE ADJUSTERS › Section 19.603 - Interpretations of the Act

Current through Reg. 49, No. 28; July 12, 2024
(a) For the purpose
				  of administration of the Act:
(1) the phrase
				  "undisputed and/or uncontested losses" as used in the Act, §1(b)(4), means
				  "losses that do not involve negotiations between the parties on issues
				  involving coverage, damage, or liability";
(2) the word "principally" as used in the
				  Act, §10(a)(1), is interpreted to mean "regularly" as used elsewhere in
				  the Act;
(3) the word "regularly"
				  means "acting in the capacity of an adjuster as a routine part of established
				  employment duties."
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter H - LICENSING OF PUBLIC INSURANCE ADJUSTERS › Section 19.701 - Definitions

Current through Reg. 49, No. 28; July 12, 2024
(a) Words and terms defined in Insurance Code
				  Chapter 4001 shall have the same meaning when used in this
				  subchapter.
(b) The following words
				  and terms, when used in this subchapter, shall have the following meanings,
				  unless the context clearly indicates otherwise.
(1) Commission--Any amount received by a
				  public insurance adjuster for service provided under Insurance Code Chapter
				  4102, consisting of an hourly fee, a flat rate, a percentage of the total
				  amount paid by the insurer to resolve a claim, or another method of
				  compensation, not to exceed 10 percent of the amount of the insurance
				  settlement on the claim, including expenses, direct costs, or any other costs
				  accrued by the public insurance adjuster.
(2) Corporation--A legal entity that is
				  organized under the business corporations laws or limited liability company
				  laws of this state, another state, or a territory of the United States. The
				  licensing and regulation of a limited liability company is subject to all
				  provisions of this subchapter that apply to a corporation licensed under this
				  subchapter.
(3) Partnership--An
				  association of two or more persons organized under the partnership laws or
				  limited liability partnership laws of this state, another state, or a territory
				  of the United States. The term includes a general partnership, limited
				  partnership, limited liability partnership, and limited liability limited
				  partnership.
(4) Public Insurance
				  Adjuster--A person licensed under Insurance Code Chapter 4102 or §
											19.704
				  of this subchapter (relating to Public Insurance Adjuster Licensing). A
				  licensed public insurance adjuster may be otherwise referred to as a "license
				  holder" or "licensee" in this subchapter.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter H - LICENSING OF PUBLIC INSURANCE ADJUSTERS › Section 19.702 - Type of Public Insurance Adjuster Licenses

Current through Reg. 49, No. 28; July 12, 2024
The department will issue a single public insurance license
					 under Insurance Code Chapter 4102, concerning Public Insurance Adjustors and
					 the provisions of this subchapter.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter H - LICENSING OF PUBLIC INSURANCE ADJUSTERS › Section 19.704 - Public Insurance Adjuster Licensing

Current through Reg. 49, No. 28; July 12, 2024
(a) Any individual that desires a public
				  adjuster license must file with the department a fully completed license
				  application, on a form as required by the commissioner, and otherwise meet the
				  licensing qualification requirements of Insurance Code Chapter 4102, Subchapter
				  B, concerning License Requirements, and this subchapter.
(b) Any corporation or partnership that
				  desires a public insurance adjuster license must file with the department a
				  fully completed license application on a form as required by the
				  commissioner.
(c) The department
				  will issue a license to a resident or nonresident corporation or partnership if
				  the department finds that:
(1) the corporation
				  or partnership is:
(A) organized under the
				  laws of this state or any other state or territory of the United
				  States;
(B) admitted to conduct
				  business in this state by the secretary of state, if required; and
(C) authorized by its articles of
				  incorporation or its partnership agreement to act as a public insurance
				  adjuster;
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter H - LICENSING OF PUBLIC INSURANCE ADJUSTERS › Section 19.705 - Financial Responsibility Requirement

Current through Reg. 49, No. 28; July 12, 2024
Each public insurance adjuster, as a condition for being
					 licensed, must maintain proof of financial responsibility by obtaining a surety
					 bond in the principal sum of not less than $10,000 that covers all the required
					 perils and losses set forth under Insurance Code §
										4102.105, concerning
					 Financial Responsibility.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter H - LICENSING OF PUBLIC INSURANCE ADJUSTERS › Section 19.706 - Demonstrating Financial Responsibility

Current through Reg. 49, No. 28; July 12, 2024
The public insurance adjuster applicant or licensee must
					 demonstrate proof of financial responsibility by providing to the department
					 the original surety bond upon application, renewal, or replacement of the
					 bond.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter H - LICENSING OF PUBLIC INSURANCE ADJUSTERS › Section 19.707 - Type of Financial Responsibility

Current through Reg. 49, No. 28; July 12, 2024
A surety bond used to maintain and demonstrate proof of
					 financial responsibility under §§
										19.705
					 and
					 19.706
					 of this subchapter (relating to Financial Responsibility Requirement and
					 Demonstrating Financial Responsibility) must:
(1) be in the form specified by the
				  department;
(2) be executed by the
				  public insurance adjuster as principal and a surety company authorized to do
				  business in this state as surety;
(3) be payable to the Texas Department of
				  Insurance for the use and benefit of an insured, conditioned that the public
				  insurance adjuster shall pay any final judgment recovered against it by an
				  insured;
(4) provide that the
				  surety will give no less than 30 days written notice of bond termination to the
				  licensee and the department;
(5) be
				  separate from any other financial responsibility obligation; and
(6) not be used to demonstrate professional
				  responsibility for any other license, certification, or person.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter H - LICENSING OF PUBLIC INSURANCE ADJUSTERS › Section 19.709 - Nonresident Applicants and License Holders

Current through Reg. 49, No. 28; July 12, 2024
An applicant for a nonresident public insurance adjuster
					 license or temporary certificate must, through the law enforcement agency of
					 the applicant's state of residence, submit a copy of the applicant's criminal
					 history records to the department. The department will use the criminal history
					 records to determine eligibility for issuance of a license in accordance with
					 this subchapter and other laws of this state.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter H - LICENSING OF PUBLIC INSURANCE ADJUSTERS › Section 19.710 - Nonresidents Required to File Biographical Information

Current through Reg. 49, No. 28; July 12, 2024
A nonresident who is required to file biographical
					 information under §
										19.704
					 of this subchapter (relating to Public Insurance Adjuster Licensing) shall,
					 through the law enforcement agency of the person's state of residence, submit a
					 copy of the applicant's criminal history records to the department. The
					 department shall use the criminal history records to determine eligibility for
					 issuance of a license in accordance with this subchapter and other laws of this
					 state.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter H - LICENSING OF PUBLIC INSURANCE ADJUSTERS › Section 19.711 - Fingerprint Requirement

Current through Reg. 49, No. 28; July 12, 2024
Any individual who submits to the Department a new
					 application to be licensed or registered under Insurance Code Chapter 4102 and
					 any individual from whom biographical information is required under §
										19.704
					 of this subchapter (relating to Public Insurance Adjuster Licensing) shall
					 comply with the requirements of Chapter 1, Subchapter D of this title (relating
					 to Effect of Criminal Conduct).
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter H - LICENSING OF PUBLIC INSURANCE ADJUSTERS › Section 19.712 - Advertisement

Current through Reg. 49, No. 28; July 12, 2024
(a) As used in Insurance Code Chapter 4102,
				  concerning Public Insurance Adjusters, "advertisement" includes:
(1) printed and published material,
				  audiovisual material and descriptive literature of a public insurance adjuster
				  used in direct mail, newspapers, magazines, radio, telephone and television
				  scripts, websites, billboards, and similar displays;
(2) descriptive literature and promotional
				  aids of all kinds issued by a public insurance adjuster for presentation to
				  members of the public, including circulars, leaflets, booklets, depictions,
				  illustrations, and form letters;
(3) prepared promotional talks, presentations
				  and materials for use by a public insurance adjuster, and those representations
				  made on a recurring basis by a public insurance adjuster to members of the
				  public;
(4) material used to:
(A) solicit contracts from insureds;
				  or
(B) modify existing
				  contracts;
(5) material
				  included with a contract when the contract is delivered and materials used in
				  the solicitation of contract renewals, extensions or reinstatements, except
				  those extensions or reinstatements provided for in the contract;
(6) lead card solicitations, defined as
				  communications distributed to the public which, regardless of form, content, or
				  stated purpose, are intended to result in the compilation or qualification of a
				  list containing names or other personal information regarding insureds who have
				  expressed a specific interest in obtaining assistance with having their claims
				  settled, and which are intended to be used to solicit residents of this state
				  for the execution of a contract for a public insurance adjuster's services;
				  and
(7) any other communication
				  directly or indirectly related to a public insurance adjuster contract, and
				  intended to result in the eventual execution of such a contract.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter H - LICENSING OF PUBLIC INSURANCE ADJUSTERS › Section 19.713 - Public Insurance Adjuster Rules of Professional Conduct and Ethics

Current through Reg. 49, No. 28; July 12, 2024
(a) This section states legal and ethical
				  requirements that are of prime importance for public insurance adjusters'
				  professional conduct. This section does not exhaust the legal or ethical
				  requirements that govern public insurance adjusters. This section details
				  requirements similar to the codes of ethics adopted by local and national
				  public insurance adjusters' professional organizations.
(b) All public insurance adjuster licensees
				  must comply with the following requirements:
(1) Licensees must conduct business fairly
				  with their clients, insurance companies, and the public.
(2) Licensees must not employ any improper
				  solicitation that would violate Insurance Code Chapter 4102 and applicable
				  rules.
(3) Licensees must not make
				  a misrepresentation, in violation of Insurance Code Chapter 4102, to an insured
				  or to an insurance company in the conduct of their actions as public insurance
				  adjusters.
(4) Licensees must
				  charge only commissions that comply with the requirements set forth in
				  Insurance Code Chapter 4102 and applicable rules.
(5) Licensees must complete continuing
				  education as required by Insurance Code Chapter 4102 and this
				  subchapter.
(6) Licensees must have
				  appropriate knowledge and experience for the work they undertake and should
				  obtain competent technical assistance, when necessary, to help handle claims
				  and losses outside their area of expertise.
(7) Licensees must not engage in the
				  unauthorized practice of law.
(8)
				  Licensees must avoid conflicts of interest, including acquiring any interest in
				  salvaged property or participating in any way, directly or indirectly, in the
				  reconstruction, repair, or restoration of damaged property that is the subject
				  of a claim adjusted by the licensee, except as allowed in Insurance Code
				  Chapter 4102 and this subchapter.
(9) Licensees must not disseminate or use any
				  form of agreement, advertising, or other communication, regardless of format or
				  medium, in this state that is harmful to the profession of public insurance
				  adjusting and that does not comply with Insurance Code Chapter 4102, this
				  subchapter, or other provisions of the Insurance Code.
(10) Licensees must use only contracts that
				  comply with Insurance Code Chapter 4102 and this subchapter.
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter I - GENERAL PROVISIONS REGARDING FEES, APPLICATIONS, AND RENEWALS › Section 19.801 - General Provisions

Current through Reg. 49, No. 28; July 12, 2024
(a) Completed
				  application. An applicant must provide all information required of the
				  applicant by statute and TDI rule.
(b) Original application. In this subchapter,
				  an original application is an application for any license type not currently
				  held by the applicant.
(1) Individual
				  application. An original application for an individual license must include the
				  following information:
(A) the individual's:
(i) name;
(ii) date of birth;
(iii) social security number;
(iv) mailing address, physical address, and
				  email address;
(v) phone number;
				  and
(vi) professional background
				  and criminal history information; and
Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter I - GENERAL PROVISIONS REGARDING FEES, APPLICATIONS, AND RENEWALS › Section 19.802 - Amount of Fees

Current through Reg. 49, No. 28; July 12, 2024
(a) With each
				  application for original license or renewal, notice of appointment, request for
				  examination, or registration or renewal of registration, the applicant,
				  licensee, or registrant must submit the amount shown in this section. The fees
				  for examinations and reexaminations only apply if TDI does not contract with a
				  testing service for the provisions of these examinations.
(b) The amounts of fees are as follows:
(1) General life, accident, and health
				  insurance agent:
(A) original
				  application--$50;
(B)
				  renewal--$50;
(C) additional
				  appointment--$10;
(D) qualifying
				  examination--$50;