SECTION 3.4103. Obtaining Exemptions

The exemption specified in §3.4102 of this title (relating to Coverage Which May Be Exempted) is conditioned as follows.

(1) The insurer has an affirmative duty to comply with the following:

(A) the insurer must file with the Texas Department of Insurance a statement signed by an officer of the company certifying that each of the conditions specified in either §3.4102(1) or (2) of this title (relating to Coverage Which May Be Exempted) is satisfied, and stating the name of the insured, the nature and extent of benefits, the date the parties concluded the agreement respecting insurance coverage, and the effective date of coverage;

(B) the insurer must inform the group policyholder in writing that the coverage is exempted from review by the Texas Department of Insurance for a limited time;

(C) the insurer must file the statement required by subparagraph (A) of this paragraph and a copy of the communication required by subparagraph (B) of this paragraph with the Texas Department of Insurance by the later of:

(i) 10 days from the date the parties concluded the agreement respecting the insurance coverage; or

(ii) 10 days from the effective date of coverage; and

(D) the insurer must submit the exempted forms for review with the Texas Department of Insurance in the usual manner prescribed by Insurance Code Chapter 1701, as soon as possible after:

(i) the effective date of coverage; or

(ii) the date the parties concluded the agreement respecting the insurance coverage. In no event may the insurer delay submission of the forms for review more than 45 days from the later of:

(I) the effective date of coverage; or

(II) the date the parties concluded the agreement respecting the insurance coverage.

(2) The insurance coverage must be authorized by and comply with the laws of this state.

Source Note: The provisions of this §3.4103 adopted to be effective September 13, 1982, 7 TexReg 3145; amended to be effective May 11, 2022, 47 TexReg 2758