Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 7 - CORPORATE AND FINANCIAL REGULATION
Subchapter P - ADMINISTRATORS
Section 7.1614 - Prohibited Acts
Universal Citation: 28 TX Admin Code § 7.1614
Current through Reg. 50, No. 13; March 28, 2025
(a) An administrator is prohibited from:
(1)
misrepresenting the terms or nature of an agreement with an insurer, HMO, plan
sponsor, or group;
(2) making
false, misleading, or incomplete comparisons to the agreements of other
administrators or persons in order to induce any person to enter into,
continue, or discontinue an agreement;
(3) accepting or rejecting risk, other than
under the authority of, and in accordance with, a written agreement with an
insurer, HMO, plan sponsor, or group;
(4) publishing or circulating any advertising
or informational material, benefit descriptions, certificates, booklets, or
brochures pertaining to business underwritten by an insurer, HMO, plan sponsor,
or group without advance written approval of the insurer, HMO, plan sponsor, or
group;
(5) pursuant to the Labor
Code §
415.0036, offering to pay,
paying, soliciting, or receiving an improper inducement relating to the
delivery of benefits to an injured employee, if the administrator performs
administrative services on behalf of a person who is a participant in the
workers' compensation system of this state; and
(6) pursuant to the Labor Code §
415.0036, improperly
attempting to influence the delivery of benefits to an injured employee,
including through the making of improper threats, if the administrator performs
administrative services on behalf of a person who is a participant in the
workers' compensation system of this state.
(b) An administrator may be subject to other prohibitions under the Insurance Code, the Labor Code, and rules adopted thereunder that are not specified in subsection (a) of this section.
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