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Texas Statutes (Last Updated: January 4, 2014) |
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INSURANCE CODE |
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Title 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES |
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Subtitle G. HEALTH COVERAGE AVAILABILITY |
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Chapter 1501. HEALTH INSURANCE PORTABILITY AND AVAILABILITY ACT |
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Subchapter E. UNDERWRITING AND RATING OF SMALL EMPLOYER HEALTH BENEFIT PLANS |
Sec. 1501.202. ESTABLISHMENT OF CLASSES OF BUSINESS
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(a) Except as otherwise provided by this subchapter, a small employer health benefit plan issuer may not establish a separate class or classes of business for small employers.
(b) A small employer health benefit plan issuer may establish a separate class of business only to reflect substantial differences in expected claims experience or administrative costs related to the following reasons:
(1) the issuer uses more than one type of system to market and sell small employer health benefit plans to small employers;
(2) the issuer has acquired a class of business from another small employer health benefit plan issuer; or
(3) the issuer provides coverage to one or more employer-based association groups.
(c) Except as provided by Subsection (e), a small employer health benefit plan issuer may not establish more than nine separate classes of business under this section.
(d) The commissioner may adopt rules to provide for a transition period to permit a small employer health benefit plan issuer to comply with Subsection (c) after acquiring an additional class of business from another small employer health benefit plan issuer.
(e) On application to the commissioner, the commissioner may approve the establishment of additional classes of business if the commissioner finds that the establishment of additional classes would enhance the efficiency and fairness of the health coverage market for small employers.