2005 Texas Insurance Code CHAPTER 1505. GROUP HEALTH INSURANCE PLANS FOR PERSONS 65 YEARS OF AGE OR OLDER

INSURANCE CODE

CHAPTER 1505. GROUP HEALTH INSURANCE PLANS FOR PERSONS 65 YEARS OF 
AGE OR OLDER


	§ 1505.001. DEFINITION.  In this chapter, "health 
insurer" means an insurance company authorized to provide a 
hospital, surgical, and medical expense insurance plan in this 
state, including:
		(1)  a stock insurance company;                                               
		(2)  a reciprocal or interinsurance exchange;                                 
		(3)  a Lloyd's plan;                                                          
		(4)  a fraternal benefit society;                                             
		(5)  a stipulated premium company;  and                                       
		(6)  a mutual insurance company, including a statewide 
mutual assessment company or a local mutual aid association.

Added by Acts 2003, 78th Leg., ch. 1274, § 3, eff. April 1, 2005.          


	§ 1505.002. PLANS FOR CERTAIN PERSONS 65 YEARS OF AGE OR 
OLDER.  (a) Two or more health insurers may provide a hospital, 
surgical, and medical expense insurance plan under a group 
insurance policy that covers residents of this state who are at 
least 65 years of age and the spouses of those residents.
	(b)  The participating health insurers may enter into 
agreements regarding matters within the scope of this chapter, 
including:
		(1)  premium rates;                                                           
		(2)  policy provisions;  and                                                  
		(3)  sales, administrative, technical, and accounting 
procedures.           
	(c)  Each participating health insurer is subject to 
regulation under the laws of this state and is severally liable on a 
group insurance policy issued under this chapter.

Added by Acts 2003, 78th Leg., ch. 1274, § 3, eff. April 1, 2005.          


	§ 1505.003. APPLICATION AND OTHER EVIDENCE OF INSURANCE 
FORMS.  An application, policy, certificate, or other evidence of 
insurance form for an insurance plan under this chapter is subject 
to Chapter 1701.

Added by Acts 2003, 78th Leg., ch. 1274, § 3, eff. April 1, 2005.          


	§ 1505.004. EXECUTION OF POLICY.  An authorized person 
may execute an insurance policy subject to this chapter on behalf of 
the participating health insurers.

Added by Acts 2003, 78th Leg., ch. 1274, § 3, eff. April 1, 2005.          


	§ 1505.005. USE OF UNINCORPORATED ENTITY.  (a) The 
participating health insurers may issue the group insurance policy 
in their own names or in the name of an unincorporated association, 
trust, or other organization formed for the sole purposes of this 
chapter and evidenced by a written contract executed by the 
insurers.  An unincorporated association, trust, or other 
organization formed under this subsection may sue and be sued in the 
name of the association, trust, or organization.
	(b)  A person licensed as a general life, accident, and 
health agent or as a general property and casualty agent under 
Chapter 4051 or 4054 may act in the licensed capacity in connection 
with an insurance policy or a certificate of insurance issued by an 
unincorporated association, trust, or other organization formed 
under Subsection (a).  The agent is not required to notify the 
department that the person has been appointed to act for that 
purpose.

Added by Acts 2003, 78th Leg., ch. 1274, § 3, eff. April 1, 2005.          


	§ 1505.006. REQUIRED FILINGS;  DEPARTMENT APPROVAL.  (a) 
The participating health insurers shall provide for the filing with 
the department on behalf of the insurers of:
		(1)  a copy of any contract of association or 
organization or trust agreement entered into by the insurers under 
this chapter;
		(2)  the schedule of premium rates to be charged for the 
insurance coverage;  and
		(3)  the plan for operating and marketing the 
insurance.                    
	(b)  Except as provided by Subsection (c), a contract, 
schedule, or plan described by Subsection (a) may not be effective 
until approved by the commissioner.
	(c)  A contract, schedule, or plan described by Subsection 
(a) that is not approved or disapproved in a written order of the 
commissioner on or before the 30th day after the date on which the 
document is filed with the department is considered approved on the 
31st day after the date of filing.

Added by Acts 2003, 78th Leg., ch. 1274, § 3, eff. April 1, 2005.          


	§ 1505.007. EFFECT OF COMMISSIONER DISAPPROVAL.  If, 
after notice and public hearing, the commissioner determines under 
reasonable assumptions that a premium rate charged for the 
insurance coverage offered under this chapter or the plan for 
operating and marketing that insurance is excessive, inadequate, or 
contrary to the public interest or that any activity or practice 
performed in connection with the insurance is unfair, unreasonable, 
or contrary to the public interest, the commissioner shall:
		(1)  enter an order containing the commissioner's 
determination and disapproving the premium rate or plan or the 
activity or practice;  and
		(2)  require the discontinuance of the premium rate, 
plan, activity, or practice within a period that is not less than 30 
days after the date of the commissioner's order containing the 
determination.

Added by Acts 2003, 78th Leg., ch. 1274, § 3, eff. April 1, 2005.          


	§ 1505.008. EXEMPTION FROM PREMIUM TAXES.  Each premium 
received for group insurance coverage authorized by this chapter is 
exempt from any premium tax imposed by any other law of this state.

Added by Acts 2003, 78th Leg., ch. 1274, § 3, eff. April 1, 2005.          


	§ 1505.009. EXEMPTION FROM CERTAIN ANTITRUST 
REQUIREMENTS.  An association, trust, or other organization formed 
and operated in accordance with this chapter or an insurance 
business conducted in accordance with this chapter is not 
considered a combination in restraint of trade, an illegal 
monopoly, or an attempt to lessen competition or fix prices 
arbitrarily and does not otherwise violate the antitrust laws of 
this state.

Added by Acts 2003, 78th Leg., ch. 1274, § 3, eff. April 1, 2005.