1. (a) A small employer carrier that establishes more than one class of business pursuant to the provisions of the Insurance Code, Article 26.31, shall maintain on file for inspection by the commissioner the following information with respect to each class of business so established:

   1. (1) a description of each criterion employed by the health carrier (or any of its agents) for determining membership in the class of business;
   2. (2) a statement describing the justification for establishing the class as a separate class of business and documentation that the establishment of the class of business is intended to reflect substantial differences in expected claims experience or administrative costs related to the reasons set forth in the Insurance Code, Chapter 26, Subchapter D; and
   3. (3) a statement disclosing which, if any, health benefit plans are currently available for purchase in the class and any significant limitations related to the purchase of such plans.
2. (b) A health carrier may not directly or indirectly use group size or the trade or occupation of the employees of a small employer or the industry or type of business of the small employer as criteria for establishing eligibility for a health benefit plan or for a class of business.
3. (c) A health carrier may not establish a separate class of business based on participation requirements or whether the coverage provided to a small employer group is provided on a guaranteed issue basis or is subject to underwriting or proof of insurability.

Source Note:The provisions of this §26.10 adopted to be effective December 30, 1993, 18 TexReg 9375; amended to be effective April 9, 1996, 21 TexReg 2648.