SECTION 21.4105. Department Monitoring and Analysis of National Accreditation Organization Standards

(a) Analysis of standards. The department will compare statutory and regulatory requirements of the department for health benefit plan issuers with the standards of national accreditation organizations. The standards of national accreditation organizations that are the same as, substantially similar to, or more stringent than the department's statutory and regulatory requirements will be identified and used to determine the presumption of compliance of health benefit plan issuers.

(b) Monitoring schedule. The department will, at least annually, monitor and analyze updates and amendments made to accreditation standards by national accreditation organizations to ensure that those standards remain the same as, substantially similar to, or more stringent than the statutory and regulatory requirements of the department.

(c) Posting of standards. The department will post a table on its website that contains a summary of its comparison of national accreditation organization standards with the statutory and regulatory requirements of the department and indicates which portions of the examination process the department will presume compliance for accredited entities. The presumed compliance table listing the summary of the comparison of national accreditation standards and department statutory and regulatory requirements may be obtained from:

(1) the department's website at www.tdi.texas.gov; or

(2) the Financial Regulation Division, MC-FRD, Texas Department of Insurance, P.O. Box 12030, Austin, Texas 78711-2030.

(d) Updates to standards. The department will update the table of standards posted on its website on at least an annual basis, as necessary, to reflect changes made to national accreditation organization standards.

Source Note: The provisions of this §21.4105 adopted to be effective May 3, 2007, 32 TexReg 2364; amended to be effective November 7, 2021, 46 TexReg 7408