Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 13 - MISCELLANEOUS INSURERS AND OTHER REGULATED ENTITIES › Subchapter E - HEALTH CARE COLLABORATIVES › Division 2 - APPLICATION FOR CERTIFICATE OF AUTHORITY › Section 13.413 - Contents of the Application

Current through Reg. 49, No. 28; July 12, 2024
(a) Order of
					 contents. The application must include the items in the order listed in this
					 section.
(b) Original and copies.
					 An applicant filing a nonelectronic application must submit two additional
					 copies of the application along with the original application.
(c) General contents. An application must
					 include:
(1) a declaration executed under
					 oath or affirmation by an officer or other authorized representative of the HCC
					 certifying that the collection of any confidential information for purposes of
					 satisfying filing requirements of this subchapter was made in accord with the
					 confidentiality requirements of §
												13.426
					 of this title (relating to Confidentiality);
(2) a completed application for certificate
					 of authority;
(3) the basic
					 organizational documents and any amendments to them, complete with the original
					 incorporation certificate with charter number and seal indicating certification
					 by the secretary of state, if applicable;
(4) the bylaws, rules, or any similar
					 documents regulating the conduct of the internal affairs of the applicant,
					 certified by an officer or other authorized representative of the applicant
					 HCC;
(5) a plan of operation for
					 the HCC, including an overview, history, types of health care service offered,
					 and operations provisions that include pro-competitive strategies of the
					 HCC;
(6) information about
					 officers, directors, and staff:
(A) a
					 completed officers and directors page; and
(B) biographical data forms for all
					 individuals who are to be responsible for the day-to-day conduct of the affairs
					 of the applicant;
(7)
					 separate organizational charts or lists, as described in subparagraphs (A) -
					 (C) of this paragraph:
(A) charts clearly
					 identifying the contractual relationships involved in the applicant's health
					 care delivery system and between the applicant and any affiliates, and a list
					 of contracts to provide services between the applicant and the
					 affiliates;
(B) a chart showing the
					 internal organizational structure of the applicant's management and
					 administrative staff; and
(C) for
					 the purposes of this paragraph, the information provided must clearly identify
					 any relationship between the HCC and any affiliate or other organization if a
					 common individual or entity directly or indirectly controls 10 percent or more
					 of both the HCC and the affiliate or other organization;
(8) notice of the physical address in Texas
					 of all books and records described in §
												13.415
					 of this title (relating to Documents to be Available for Quality of Care and
					 Financial Examinations); and
(9) a
					 description of the information systems, management structure, and personnel
					 that demonstrates the applicant's capacity to meet the needs of patients and
					 participants and to meet the requirements of regulatory and contracting
					 entities.