Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES
Subchapter AA - LIMITED EXEMPTION FOR INSURANCE COVERAGE FROM THE REQUIREMENTS OF INSURANCE CODE CHAPTER 1701
Section 3.4103 - Obtaining Exemptions
Universal Citation: 28 TX Admin Code § 3.4103
Current through Reg. 50, No. 13; March 28, 2025
The exemption specified in § 3.4102 of this title (relating to Coverage Which May Be Exempted) is conditioned as follows.
(1) The insurer has an affirmative duty to comply with the following:
(A) the insurer
must file with the Texas Department of Insurance a statement signed by an
officer of the company certifying that each of the conditions specified in
either §
3.4102(1) or (2)
of this title (relating to Coverage Which May Be Exempted) is satisfied, and
stating the name of the insured, the nature and extent of benefits, the date
the parties concluded the agreement respecting insurance coverage, and the
effective date of coverage;
(B) the
insurer must inform the group policyholder in writing that the coverage is
exempted from review by the Texas Department of Insurance for a limited
time;
(C) the insurer must file the
statement required by subparagraph (A) of this paragraph and a copy of the
communication required by subparagraph (B) of this paragraph with the Texas
Department of Insurance by the later of:
(i)
10 days from the date the parties concluded the agreement respecting the
insurance coverage; or
(ii) 10 days
from the effective date of coverage; and
(D) the insurer must submit the exempted
forms for review with the Texas Department of Insurance in the usual manner
prescribed by Insurance Code Chapter 1701, as soon as possible after:
(i) the effective date of coverage;
or
(ii) the date the parties
concluded the agreement respecting the insurance coverage. In no event may the
insurer delay submission of the forms for review more than 45 days from the
later of:
(I) the effective date of coverage;
or
(II) the date the parties
concluded the agreement respecting the insurance coverage.
(2) The insurance coverage must be authorized by and comply with the laws of this state.
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