Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 7 - CORPORATE AND FINANCIAL REGULATION
Subchapter R - WITHDRAWAL PLAN REQUIREMENTS AND PROCEDURES
Section 7.1802 - Definitions

Universal Citation: 28 TX Admin Code § 7.1802

Current through Reg. 50, No. 13; March 28, 2025

The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise.

(1) Annual Statement--Annual statement most recently filed by the insurer or HMO with the Texas Department of Insurance.

(2) Association coverage--Coverage under a health benefit plan issued to an association or bona fide association as those terms are defined in § 21.2702 of this title (relating to Association Plans).

(3) Commissioner--Commissioner of Insurance.

(4) Department--Texas Department of Insurance.

(5) Individual coverage--Coverage issued by an HMO that provides an individual health care plan as defined in Insurance Code § 1271.004.

(6) Large employer coverage--Coverage under a health benefit plan issued to a large employer as those terms are defined in § 26.4 of this title (relating to Definitions).

(7) Line of insurance--Each line of business as specified in § 7.1803 of this title (relating to What Constitutes a Line of Insurance).

(8) HMO--A health maintenance organization licensed under Insurance Code Chapter 843.

(9) Medicaid--The Medicaid program under Title XIX of the Social Security Act of 1965.

(10) Medicare--Has the same meaning as specified in § 3.3303 of this title (relating to Definitions).

(11) Medicare+Choice plan--Has the same meaning as specified in § 3.3303 of this title.

(12) Small employer coverage--Coverage under a health benefit plan issued to a small employer as those terms are defined in § 26.4 of this title.

(13) Enrollees of special circumstances--As described in Insurance Code §§ 1301.152 - 1301.154 and § 843.362.

(14) CHIP--The Texas Children's Health Insurance Program under Texas Health and Safety Code Chapter 62.

(15) Withdrawal--The event that occurs when the actions of an insurer or HMO meets the criteria under Insurance Code § 827.003.

(16) Rating territory--A county in Texas.

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