Insurance

Insurance Code section 843.306 - If a pharmacy benefit manager serves as a delegated entity of a health maintenance organization and thereby terminates contracts with pharmacy providers, the pharmacy benefit manager must comply with the notice and review requirements of section 843.306.|Insurance Code section 1301.057 - With regard to preferred benefit plans, before a contract with a preferred provider is terminated, an insurer must ensure that either itself or the entities with whom it contracts, which could include pharmacy benefit managers, comply with the notice and review process required under section 1301.057.

Automated photographic system to enforce financial responsibility laws, county authority to use

Article 21.52B, Texas Insurance Code ("Any Willing Pharmacy " statute), a court addressing the issue today would likely conclude that, is saved from preemption under the federal Employee Retirement Income Security Act of 1974 ("ERISA"), pursuant to the test set forth by the U.S. Supreme Court in Kentucky Ass'n Of Health Plans, Inc. v. Miller.|Texas Pharmacy Ass'n v. Prudential Insurance Co. of America, the current Fifth Circuit Court of Appeals decision in, holding that article 21.52B, Texas Insurance Code ("Any Willing Pharmacy" statute) is preempted under the federal Employee Retirement Income Security Act of 1974 ("ERISA"), still stands.|Article 21.52B, Texas Insurance Code ("Any Willing Pharmacy" statute), until a court affirmatively concludes that, is saved from preemption, we cannot conclude as a matter of law that the statute is enforceable

Article VI entails preemption of state law by express provision, implication, or conflict between federal and state law|Federal preemption of certain Texas Department of Insurance bulletins regarding health reimbursement arrangements|Federal preemption of certain Department bulletins regarding health reimbursement arrangements

Health wellness plan with increased insurance premium for tobacco users

Board of Examiners of Psychologists rule must not be inconsistent with relevant statute|Submission of bill to third-party payer by licensed psychologist for test conducted by supervisee|Insurance fraud - Penal Code section 35.02 sets out offense of

Civil asset forfeiture funds - use of to purchase property insurance pending appeal|Civil asset forfeiture funds - use of to purchase property pending appeal|Property insurance - Use of civil asset forfeiture funds to purchase for property forfeited by State

Provision of health insurance benefits to surviving spouse of municipal fire fighter under Government Code section 615.073

Indexed life insurance product - investment in by Teacher Retirement System - conditions required for|Indexed life insurance product - conditions required for Teacher Retirement System to invest assets in

Balance billing, whether physician may bill health maintenance organization enrollee for unpaid balance and whether Department of Insurance may enforce provisions of Health Maintenance Organization Act against such physicians|Balance billing, whether physicians who are not under contract with a health maintenance organization may bill HMO enrollee for unpaid balance and whether Department of Insurance may enforce provisions of Health Maintenance Organization Act against such p|Balance billing, authority to enforce provisions of Health Maintenance Organization Act against physicians who are not under contract with an HMO and who bill HMO enrollee for unpaid balance

Reciprocal exchange insurers are exempt from article 21.49-2C of the Insurance Code, and therefore not subject to a moratorium issued by the Commissioner of Insurance|Reciprocal insurance exchanges, such as Farmers Insurance Exchange and Fire Insurance Exchange, are not required to file withdrawal plans in order to withdraw from the homeowners' insurance market|Refusal of reciprocal exchange insurers to renew policies of homeowners would not violate state law provided that the exchanges follow statutory notice procedure|Refusal to renew policies of homeowners, reciprocal exchange insurers would not violate state law by their refusal, provided that the exchanges follow statutory notice procedure|Moratorium issued by the Commissioner of Insurance, reciprocal exchange insurers are exempt from article 21.49-2C of Insurance Code and therefore not subject to

Mental health parity, applicability of Insurance Code provisions requiring municipal risk pool|Pregnancy as preexisting condition, applicability of Insurance Code provisions requiring to municipal risk pool|Immunizations required for children through age six, municipality may not charge deductible of covered children even if received from non-network provider|Municipal risk pool, applicability of statutes requiring mental health parity, prohibiting treating pregnancy as preexisting condition, and prohibiting risk pool from charging deductible for covered child's required immunizations|Immunizations, municipal risk pool may not charge deductible for those required for children through age six even if received from non-network provider|Municipal risk pool, Department's jurisdiction over with respect to mental health parity requirements, use of pregnancy as preexisting condition, and charging deductible for covered child's required immunizations|Risk pool, applicability of Insurance Code provisions requiring mental health parity, prohibiting treating pregnancy as a preexisting condition, and prohibiting charging deductible for covered child's required immunizations|Deductible

Holocaust registry established by article 21.74, Insurance Code, interferes with the President's conduct of foreign affairs, and is thus preempted by the United States Constitution|Article 21.74 of the Insurance Code, which establishes a Holocaust registry, interferes with the President's conduct of foreign affairs, and is thus preempted by the United States Constitution

Retired employees receiving group health care coverage under Texas Public School Retired Employees Group Insurance plan who have returned to work, school district not participating in Texas Public School Employees Group Insurance plan required to provide |Retired employees who have waived coverage under Texas Public School Retired Employees Group Insurance plan, school district not participating in Texas Public School Employees Group Insurance plan obliged to subsidize health care coverage of

Public Information Act exception relating to criminal investigations does not preclude county commissioners from accessing county records they are otherwise entitled to review|Employee insurance records, subject to privacy constraints imposed by state and federal law an individual county commissioner is entitled to access|Health Insurance Portability and Accountability Act of 1996 Privacy Rule, whether Privacy Rule under HIPAA permits disclosure of medical insurance coverage information regarding a former commissioner and his wife is a question of fact and beyond scope of |Medical Practice Act makes confidential patient-physician communications and records and limits their disclosure and subsequent redisclosure|Health Insurance Portability and Accountability Act of 1996 Privacy Rule, whether Privacy Rule under HIPAA permits disclosure of medical insurance coverage information regarding a former commissioner and his wife is a question of fact and beyond the scope

Military leave-time account, municipal fire fighters and police officers are entitled to donate any amount of leave to their department's military leave-time account that they would be entitled to for themselves|Delete time from military leave-time account, a municipality may not|Insurance and benefits coverage, municipality must maintain when a municipal fire fighter or police officer is called for military duty, but only on the terms in effect when the employee received the call which may include the employees' obligations to pa|Military leave-time account, municipal fire fighters are entitled to donate any amount of leave to their department's military leave-time account that they would be entitled to use for themselves|Delete time from the military leave-time account, a municipality may not|Insurance and benefits coverage, when a municipal fire fighter is called for military duty a municipality must maintain, but only on the terms in effect when the employee received the call which may include the employees' obligations to pay their portion |Military leave-time account, municipal fire fighters and police officers are entitled to donate any amount of leave to their department's military leave-time account that they would be entitled to use for themselves|Insurance and benefits coverage, municipality must maintain when a police officer is called for military duty, but only on the terms in effect when the employee received the call which may include the employees' obligations to pay their portion of any pre|Military leave-time account, municipal police officers are entitled to donate any amount of leave to their department's military leave-time account that they would be entitled to use for themselves

Legislative authorization for provision of employee benefits, chapter 157 of the Local Government Code is, and is not another insurance law of this state|Self-funded benefit plans, by express terms, section 1201.062 of the Texas Insurance Code applies to|Self-funded plan that is not a health benefit plan, provisions of Texas Insurance Code that apply to health benefit plans do not apply to|Health benefit plan, pursuant to chapter 1501 of the Texas Insurance Code a self-funded plan of a political subdivision does not constitute a|Business of insurance, benefit plan established by political subdivision is not engaged in|Self-funded benefit plan is not insurance because it does not involve shifting of risk or loss

Texas coast, Department of Insurance may disclose identities of companies writing commercial insurance policies along|Texas coast, Department may disclose identities of companies writing commercial insurance policies along

Amusement Ride Safety Insurance and Inspection Act, to the extent a municipality that operates a pool slide is a person operating an amusement ride, the municipality is subject to the \r\n|Pool slide, to the extent a municipality that operates is subject to the Amusement Ride Safety Insurance and Inspection Act but must purchase insurance only in amounts sufficient to satisfy the municipality’s potential liability under the Tort Claims Act\r\n

Insurance services to a state university, a member of the Legislature not not provide unless authorized by the Texas Constitution and statutes|Insurance services to a state university, a legislator may not provide unless authorized by the Texas Constitution and statutes|Member of the Legislature does not include person yet to be elected to the Legislature|Member of the Legislature, an interest under Texas Constitution article III, section 18 must be more than the general interest shared by the public; it must be one that involves gain or loss specific to the|Member of the Legislature, interest under Texas Constitution article III, section 18 must be more than the general interest shared by the public; it must be one that involves gain or loss specific to the |Individuals not yet elected to the Legislature, the constitutional prohibition in article III, section 18 does not bar contracts with|Provide insurance services to a state university, a legislator may not provide unless authorized under the Texas Constitution and statutes|Legislator's business or employment activities, questions about the propriety of such activities under chapter 572 of the Government Code are generally not appropriate for the opinion process

Insurance policies are contracts|Liability insurance that real estate inspectors are required to carry|General liability insurance|Incompetence|Professional liability insurance

Open-enrollment charter school is an entity for which the state may enter into an agreement with the Social Security Administration|Political subdivision|Instrumentality of a State

Certain health benefit plans offered by employers, applicability of chapter 1501 of the Insurance Code to

Serious mental illness, group health plans that provides more than 60 outpatient visits for physical illnesses must provide the same number of outpatient visits for

Discretion to provide medical insurance for juvenile board, county commissioners have|Eligibility for county medical insurance, juvenile board members|Compensation|Medical insurance, included within the term "compensation"

Premiums paid on group health, accident, and life insurance policies by a single nonprofit trust established to provide coverage for employees of municipalities, counties or hospital districts, subsection 222.002(c)(5) of the Insurance Code excludes from the imposition of insurance premium taxes|Comptroller’s interpretation of single nonprofit trust to mean that the trust can be used only for the purpose of paying insurance premiums is reasonable; however, limiting use of the funds to only paying premiums and prohibiting trust funds from being used to cover other expenses in furtherance of the trust’s purpose is contrary to the statute

A prescription drug, medicine, or other remedy at a fee-rate that is negotiated by contract, a workers’ compensation insurance carrier may pay for|A prescription drug, medicine, or other remedy at negotiated fee rates, a workers’ compensation health care network may contract to pay for|A prescription drug, medicine, or other remedy at a fee-rate that is negotiated by contract, a workers’ compensation insurance carriers may pay for

Liability insurance to cover tort claims arising from a college district’s operation of a child- care center, whether purchase would violate article III, section 52(a) of the Texas Constitution|Liability insurance required to cover tort claims arising from a college district’s operation of a child-care center, whether purchase would violate article III, section 52(a) of the Texas Constitution

Applicant for a real estate inspector’s license must carry liability insurance, and the Texas Real Estate Commission lacks authority to waive that requirement

Texas Windstorm Insurance Association, Legislature did not establish a legal obligation on behalf of the State to pay unfunded losses that cannot be paid by the|Texas Constitution article III, section 49, any statutory provision that converted significant uncovered losses into state debt without voter approval could violate

Chapter 2210, Insurance Code, no provision prohibits the Texas Windstorm Insurance Association from using current and future premiums to pay prior obligations under

To the extent institutions of higher education are state agencies subject to Labor Code chapter 501, they must have State Office of Risk Management approval to purchase property, casualty, or liability insurance|Property, casualty, or liability insurance; except for those otherwise excluded, state agencies subject to Labor Code chapter 501 must have State office of Risk Management approval to purchase for itself

Funding and provision of health care services covered by Medicaid; 2 models, the traditional model and the managed care model|The Health and Human Services Commission is responsible for administering the state\\'s Medicaid Program, which is a federal-state program providing health-care services for low-income individuals|Reimbursement for behavioral health services under Texas Medicaid Reimbursement Methodology|The Texas Health and Human Services Commission does not operate under the Insurance Code. It is the state agency that administers the state\\'s Medicaid program for individuals who cannot afford insurance.

Experience ratings, effect of 1991 amendments to Insurance Code on State Board of Insurance's authority to use in rating insurers | Lloyd's plans or interinsurance exchanges, 1991 amendments to Insurance Code apply to | Experience ratings, effect of 1991 amendments to Insurance Code on Board's authority to use in rating insurers

Excess or surplus insurance coverage, municipality's purchase of is not exempt from competitive bidding requirements|Selection of "sole broker of record," municipality's selection of is not exempt from competitive bidding requirements|Municipality must use competitive bidding to purchase excess or surplus insurance coverage and to select "sole broker of record"

Manufactured home, creditor may require purchaser of to purchase physical damage insurance policy but may not require consumer to purchase policy from particular vendor

Life insurance proceeds and policy cash value are exempt from seizure of process|Seizure under process, life insurance proceeds and life insurance policy cash value are exempt from but individually purchased annuities are not exempt from

Texas Automobile Insurance Plan, rule vesting amendment power over in group of private insurers is unconstitutional delegation of legislative authority|Texas Automobile Insurance Plan, Board has ultimate rule-making authority over

Adjutant General, as chief of Texas National Guard, has authority to purchase liability insurance with federal funds to cover officers and employees who operate mobile shooting range

Property damage, repair or replacement costs funded by special legislative appropriation rather than insurance proceeds or self-insurance and are funded at legislature's discretion|Concurrent resolution may be evidence of legislative intent but is not state law; article III, section 30 requires that laws be passed by bill|Concurrent resolution may be evidence of legislative intent but is not state law; constitution requires that laws be passed by bill|Property insurance, state agencies not authorized to purchase without specific legislative authorization|Property insurance, Agency not authorized to purchase with appropriated funds

Benefits under policy, assignment of to health care provider does not waive deductible or copayments

Corporate surety, unincorporated association insurance carrier may not serve as

Medical coverage provided by county to employees through single-employer, self-funded plan subject to certain Insurance Code provisions but not to Federal Employee Retirement Income Security Act|Medical coverage provided by county to employees through single-employer, self-funded plan; subject to certain Insurance Code provisions but not to Federal Employee Retirement Income Security Act|Employee Retirement Income Security Act does not preempt Insurance Code provisions to the extent they apply to governmental employee benefit plan

Guaranty association for workers' compensation liabilities of certain self-insured political subdivisions and insurance pools, constitutionality of proposal for|Guaranty association for workers' compensation liabilities of certain self-insured political subdivisions and insurance pools, constitutionality of proposal

Medical coverage for district officers, authority of county to provide and phase out|Americans with Disabilities Act, application to county plan to phase out medical coverage for district officers|Medical coverage for district judges, authority of county to provide|Medical coverage for district attorney, authority of county to provide|Medical coverage for district judges, district attorneys, and county extension agents, authority of county to provide|Medical coverage for district officers, county's plan to phase out|Medical coverage for agricultural and home extension agents, authority of county to provide

Liability insurance for state officers and employees, scope of rider regarding and whether purchase constitutes waiver of sovereign immunity (Withdrawn by Letter 7/31/96)|Liability insurance for employees purchased with appropriated funds, constitutionality and scope of rider regarding (Withdrawn by Letter 7/31/96)|Liability insurance, authority of Commission to purchase (Withdrawn by Letter 7/31/96)|Liability insurance for officers and employees, authority of state agency to purchase (Withdrawn by Letter 7/31/96)|Sovereign immunity, whether purchase of liability insurance constitutes waiver of (Withdrawn by Letter 7/31/96)|Liability insurance for employees, whether purchase of constitutes waiver of state's sovereign immunity (Withdrawn by Letter 7/31/96)

Insurance, whether school district must competitively bid contract to purchase (Superseded by statute as noted in Tex. Att'y Gen. Op. No. DM-418 (1996))|Competitive bidding requirements, application to purchase of insurance by school district (Superseded by statute as noted in Tex. Att'y Gen. Op. No. DM-418 (1996))

Excursion train operators, owners of trackage may require to purchase liability insurance in amount greater than $5,000,000|Open courts provision, statute that attempts to limit liability of excursion train operators probably violates|Excursion train operators, statute that attempts to limit liability of to $5,000,000 per occurrence probably unconstitutional

Insurance coverage, school district's purchase of; length of contract; aggregation; third-party administration|School district need not competitively bid contract for purchase of insurance, but generally must use one of specified purchasing methods|School district's purchase of, process; length of contract; aggregation; third-party administration

Automobile club not authorized to reimburse members for expenses incurred in obtaining automobile-related services|Automobile club may not contract to reimburse members for expenses incurred in obtaining automobile-related services|Nonsubstantive revision must be construed consistent with statutory predecessor|Legislative deletion of item from bill indicates legislative intent to reject proposal

Homeowners Protection Act of 1998, notification of mortgagor's right to cancel private mortgage insurance under is consistent with state law|Lender, federal law requiring annually to notify mortgagor of right to cancel private mortgage insurance is consistent with state law|Mortgage insurance, federal law requiring service annually to notify mortgagor of right to cancel is consistent with state law|State law, federal law supersedes if the two laws actually conflict

Single interest policies, Automobile Theft Prevention Authority may not by rule exempt from statutory fee|Single interest policies, Authority may not by rule exempt from statutory fee

Purchase of insurance contracts using designated broker of record|Insurance, whether junior college may purchase using designated broker of record|Designated broker of record, whether junior college district may purchase insurance through

Retired county employee, county may invite to participate in county's group health insurance program if retiree pay premiums under chapter 175 of Local Government Code|Retired county employee's health insurance premiums, county may not pay if, at time person retired, the county did not provide for payment of such premiums; county may not seek reimbursement of unconstitutionally paid premiums|Retroactive compensation, county may not pay group health insurance premiums for retired employee absent additional consideration from employee if county did not provide for such coverage nor possibility of such coverage at time of employee's retirement

Health insurance, county is not required to provide it to part-time constable

Exclusive health provider contract, whether it violates state antitrust laws|Exclusive health provider contract, whether it violates state antitrust laws and insurance code

Cancellation of prepaid funeral benefits contracts, amendatory language of section 154.155 of Finance Code which entitles purchaser to refund of half the earnings generated by payments made applies only to trust-funded prepaid funeral benefits contracts a

Physician and health provider claims for payment, Department of Insurance may construe prompt payment provisions requiring preferred provider organizations and health maintenance organizations to disclose to physicians and other health care providers. Physician and health providers claims for payment, Department may construe prompt payment provisions requiring preferred provider organizations and health maintenance organizations to disclose to physicians and other health care providers utilization revi

Nonprofit health corporations certified by Texas State Board of Medical Examiners, authority to examine|Nonprofit health corporations certified by Texas State Board of Medical Examiners, authority of Department of Insurance to examine

Deductible, seller of goods or services does not violate criminal law if he does not seek payment from insured of amount equal to

Non-resident licensed property and casualty insurance agent may not solicit business in Texas except through local recording agent, prohibition includes solicitation of person located in state by mail or telephone

When the Texas Windstorm Insurance Ass'n Board has provided requisite notice to member insurers about an assessment at a regularly-scheduled Board meeting, it is unlikely a court will require the Board to call an additional emergency meeting to provide the same notice.  So long as the Board complies with its quorum requirement, Board vacancies do not impair its ability to take action.

Application of Business and Commerce Code subsection 20.05(a)(5) to a self-funded plan with a reference-based-pricing program that does not utilize a provider network

Texas Windstorm Insurance Association is not a state agency for purposes of Government Code chapter 556 prohibition on using appropriated funds for lobbying activities