SECTION 13.545. Representations to Clients and Participants

(a) Pricing and billing. An approved PEO must be fair and accurate in its pricing and billings with respect to the plan, and may not make any materially inaccurate, knowingly or recklessly misleading, or fraudulent misrepresentations of the projected contributions to be assessed for plan coverage for a client's covered employees or participants.

(b) Notice of increased contribution. An approved PEO may not increase a client's contribution amount without giving the client at least 60 days' advance notice of the amount of the increase.

(c) PEO solely responsible if trust assets insufficient. An approved PEO's professional employer services agreement must provide that the PEO, and not the client, will be responsible for funding any additional asset amount needed to equal the liabilities owed by the plan. An approved PEO may not contractually obligate its clients to make up any shortfall in trust assets.

(d) Agreement in conflict with this subchapter. An approved PEO's professional employer services agreement is unenforceable to the extent that it conflicts with the requirements of this subchapter.

(e) Summary plan description. An approved PEO must provide each participant an evidence of coverage and a summary plan description specific to the participant's plan. The summary plan description must contain the following statement: "The benefits and coverages described in this document are provided through a self-funded health benefit plan and trust fund established and funded by your employers, {insert the name of the covered employer and the approved PEO}. The plan and trust are established in compliance with Chapter 91 of the Texas Labor Code and the Employee Retirement Income Security Act of 1974, 29 U.S.C. §§1001-1191c. This is not an insurance contract, and you are not protected by an insurance guarantee fund or other protective governmental program."

Source Note: The provisions of this §13.545 adopted to be effective May 17, 2016, 41 TexReg 3479