SECTION 13.403. Filing and Required Forms; How to Obtain Forms

(a) All HCC filings for original or renewal application as required by this subchapter must be made to Company Licensing & Registration, Mail Code 305-2C, Texas Department of Insurance, P.O. Box 149104, Austin, Texas 78714-9104, and copies of all HCC forms are available through that address. All forms also are available on the department website at www.tdi.texas.gov.

(b) All HCC forms for an original or renewal application filing may be submitted electronically in a format permitted by the department.

(c) Paragraphs (1) - (7) of this subsection identify the forms specified for use with the rules adopted under this subchapter. Forms identified in paragraphs (1) and (4) - (7) have a June 2012 revision date. Forms identified in paragraphs (2) and (3) have a March 2013 revision date. Each HCC or other individual or entity must use the form(s) as required by this title in accord with the form's instructions and content requirements and as appropriate to particular activities. The commissioner adopts by reference the following forms:

(1) Original/Renewal Application for Certificate of Authority to do the Business of a Health Care Collaborative (HCC) in the State of Texas;

(2) Health Care Collaborative Officers and Directors Page;

(3) Biographical Affidavit;

(4) Request to Convert to Renewal of Certificate of Authority to do the Business of a Health Care Collaborative (HCC) in the State of Texas;

(5) Financial Authorization and Release Form;

(6) Health Care Collaborative Payor Information Form; and

(7) Health Care Collaborative (HCC) Acquisition Form.

Source Note: The provisions of this §13.403 adopted to be effective March 31, 2013, 38 TexReg 2100