Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 19 - LICENSING AND REGULATION OF INSURANCE PROFESSIONALS › Subchapter Q - DISCOUNT HEALTH CARE PROGRAM REGISTRATION AND RENEWAL REQUIREMENTS › Section 19.1602 - Registration Requirement

Current through Reg. 49, No. 28; July 12, 2024
(a) Registration
				  Requirement. An applicant for registration to offer a discount health care
				  program in this state is required to submit all of the following to the
				  department:
(1) the initial registration fee
				  of $1,000 as provided in Insurance Code §
											7001.006, concerning
				  Fees, and §
											19.802 of this title (relating to
				  Amount of Fees) that is nonrefundable and nontransferable;
(2) a complete application for registration
				  that contains all the information required by Insurance Code §
											7001.005, concerning
				  Application for Registration and Renewal of Registration, and this section,
				  including:
(A) the applicant's full legal name
				  and federal employer identification number or social security number; daytime
				  telephone number with extension; toll free telephone number; website address;
				  physical address, including city, state, and ZIP code; mailing address,
				  including the city, state, and ZIP code; a contact person's name, including the
				  title, telephone number, and email address; the applicant's agent for service
				  of process, including the physical address, city, state, and ZIP
				  code;
(B) identification of whether
				  the applicant is a corporation, association, limited partnership, limited
				  liability company, limited liability partnership, sole proprietorship, or other
				  legal entity;
(C) any and all
				  assumed names to be used by the applicant in operating a discount health care
				  program. If a filing is required under the Assumed Business or Professional
				  Name Act under the Texas Business and Commerce Code, or any similar statute,
				  the discount health care program operator applicant for registration must
				  provide the department with a copy of the assumed name certificate reflecting
				  the registration of each assumed name used by the discount health care program
				  operator applicant;
(D) a statement
				  generally describing the applicant, its facilities, personnel, and the health
				  care services or products for which a discount will be made available under its
				  discount health care programs;
(E)
				  a copy of the form of all contracts made or to be made between the applicant
				  and any providers or provider networks regarding the provision of health care
				  services or products to members;
(F) a copy of the applicant's charter,
				  certificate of authority, or registration obtained from the Texas Secretary of
				  State's office;
(G) if the
				  applicant is an entity subject to the bank or farm credit administration, a
				  copy of the documentation issued by a federal or Texas state agency authorizing
				  the entity to do business in Texas;
(H) an original surety bond payable to the
				  department for the use and benefit of members in the principal amount of
				  $50,000, as required by Insurance Code §
												562.103(f)(1),
				  concerning Program Operator Duties, and §
												19.1603 of this title (relating to
				  Financial Responsibility Requirement), except that an insurer that holds a
				  certificate of authority under Texas Insurance Code Title 6, concerning
				  Organization of Insurers and Related Entities, is not required to maintain the
				  surety bond;
(I) lists of marketers,
				  both entities and individuals, separated as follows:
(i) a list of the marketers, both entities
				  and individuals, authorized to sell or distribute the program operator's
				  programs under the program operator's name; and
(ii) a list of the marketers, both entities
				  and individuals, authorized to private label the program operator's
				  programs;
(J) a
				  certification in writing to the department that its programs comply with the
				  requirements of Insurance Code Chapter 7001, concerning Registration of
				  Discount Health Care Program Operators, and Chapter 562, concerning Unfair
				  Methods of Competition and Unfair or Deceptive Acts or Practices Regarding
				  Discount Health Care Programs;
(K)
				  a list of names, addresses, official positions, and biographical information
				  of:
(i) the individuals responsible for
				  conducting the applicant's affairs;
(ii) each member of the board of directors,
				  board of trustees, executive committee, or other governing board or
				  committee;
(iii) the
				  officers;
(iv) any contracted
				  management company personnel; and
(v) any person owning or having the right to
				  acquire 10% or more of the voting securities of the applicant;
(L) a complete biographical
				  certificate concerning each individual whose biographical information is
				  required under Insurance Code §
												7001.005(a)(2)
				  and this section, including:
(i) the
				  identification of the individual's relationship to the applicant;
(ii) the name of the applicant;
(iii) the full name; title; social security
				  number; date of birth; mailing address, including the city, state, and ZIP
				  code; telephone number; fax number; and email address of the
				  individual;
(iv) excluding traffic
				  violations and a first DWI offense, a response to the following questions:
(I) whether the individual has any pending
				  misdemeanor or felony charges by indictment, information, or any other
				  instrument filed in Texas or in any other state or by the federal
				  government;
(II) whether the
				  individual has ever been convicted of any misdemeanor or felony offense in
				  Texas, in any other state, or by the federal government;
(III) whether the individual has ever had
				  deferred adjudication on any misdemeanor or felony charge or offense in Texas,
				  in any other state, or by the federal government; and
(IV) whether the person has ever served any
				  period of probation for any misdemeanor or felony offense in Texas, in any
				  other state, or by the federal government;
(v) if the response is positive to any
				  question under clause (iv)(I) - (IV) of this subparagraph, the applicant for
				  registration as a discount health care program operator is required to provide
				  to the department original certified copies of the charging document,
				  indictment, information, or any other charging document, any judgment of
				  conviction, deferred adjudication order, or probation order, and any order
				  terminating probation, community supervision certificate, or parole certificate
				  for each offense. If the court does not maintain the record, the submission of
				  a letter on the court's letterhead will be required. If the arrest did not
				  result in a prosecution, the submission of a records search from the
				  appropriate jurisdiction indicating a final disposition will be required. A
				  statement describing the circumstances leading to the offense and the
				  individual's age at the time of the offense will be required. Letters of
				  recommendation from any person aware of a particular criminal history may be
				  provided;
(vi) a response to the
				  question whether the individual whose biographical information is required
				  under Insurance Code §
													7001.005(a)(2)
				  and this section, or any entity in which the individual served as a director,
				  officer, shareholder, manager, member, or partner, has ever been the subject of
				  an administrative or legal action filed by the department, or any other
				  insurance department, financial regulatory agency, or of an action filed on
				  behalf of the State of Texas or any other state or by the federal government
				  based on alleged violations of state or federal insurance, securities, or
				  financial regulatory laws that the individual has not previously reported to
				  the department. If the response is positive, the applicant for registration as
				  a discount health care program operator is required to provide to the
				  department a description of the circumstances regarding the administrative or
				  legal action and a copy of any document sent to the individual to commence the
				  administrative or legal action that described the nature of the
				  action;
(vii) a response to the
				  question whether the individual, whose biographical information is required
				  under Insurance Code §
													7001.005(a)(2)
				  and this section, is indebted to any discount health care program operator,
				  policyholder, insurance or reinsurance company, insurance agency, general
				  agent, managing general agency, premium finance company or court-appointed
				  liquidator for membership refunds, premiums collected, or commissions retained,
				  or have any claims or judgments filed against the individual for membership
				  refunds, retaining premiums, or commissions. If the response is positive, the
				  applicant for registration as a discount health care program operator is
				  required to provide to the department a description of the circumstances
				  regarding the indebtedness, including the name and contact information of the
				  person or entity to whom the individual is indebted;
(viii) a response to the question whether the
				  individual whose biographical information is required under Insurance Code
				  §
													7001.005(a)(2)
				  and this section has ever had a discount health care program contract cancelled
				  for cause, such as for misrepresentation or misappropriation. If the response
				  is positive, the applicant for registration as a discount health care program
				  operator is required to provide to the department a description of the
				  circumstances regarding the cancellation including the name and contact
				  information of the individual or entity that cancelled the contract;
(ix) a copy of a fingerprint receipt from the
				  state authorized fingerprint collection vendor for each individual that uses
				  the electronic fingerprint process;
(x) an acknowledgment from each individual
				  whose biographical information is required under Insurance Code §
													7001.005(a)(2)
				  and this section that the fingerprints provided will be used to check criminal
				  history records of the Texas Department of Public Safety and the Federal Bureau
				  of Investigation; and
(xi)
				  compliance with the requirements of Chapter 1, Subchapter D, of this title
				  (relating to Effect of Criminal Conduct) relating to fingerprint requirements
				  for a criminal background check under Insurance Code §
													7001.008, concerning
				  Criminal Background Check.