1. (a) Purpose. The purpose of this subchapter is to require certain health benefit plan issuers to collect and report data regarding certain mandated health benefits to the commissioner.

2. (b) Scope. This subchapter applies to:

   1. (1) a health benefit plan issuer that reports in its most recently filed annual statement a total of $10 million or more in direct premiums earned in the state of Texas for group accident and health insurance policies;
   2. (2) a health benefit plan issuer that reports in its most recently filed annual statement a total of $2 million or more in direct premiums earned in the state of Texas for individual accident and health insurance policies;
   3. (3) a health benefit plan issuer that is a basic service health maintenance organization and reports in its most recently filed annual statement a total of $10 million or more in direct commercial premiums earned in the state of Texas;
   4. (4) a licensed third party administrator that performs claims payment services for any health benefit plan issuer that meets the requirements of paragraphs (1) - (3) of this subsection.

Source Note:The provisions of this §21.3401 adopted to be effective December 29, 2002, 27 TexReg 11990.