Tex. Ins. Code § 1501.061 · Subchapter B. COALITIONS AND COOPERATIVES

REQUIREMENTS APPLICABLE TO HEALTH BENEFIT PLAN ISSUERS WITH WHICH COOPERATIVE MAY CONTRACT.

Verbatim from the official edition

Text — Current through the 89th 2nd Called Legislative Session, 2025

A cooperative may contract only with a small or large employer health benefit plan issuer that demonstrates that the issuer:

(1) is in good standing with the department;

(2) has the capacity to administer health benefit plans;

(3) is able to monitor and evaluate the quality and cost-effectiveness of care and applicable procedures;

(4) is able to conduct utilization management and establish applicable procedures and policies;

(5) is able to ensure that enrollees have adequate access to health care providers, including adequate numbers and types of providers;

(6) has a satisfactory grievance procedure and is able to respond to enrollees' calls, questions, and complaints; and

(7) has financial capacity, either through satisfying financial solvency standards, as applied by the commissioner, or through appropriate reinsurance or other risk-sharing mechanisms.

Notes and commentary — not statutory text

History

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.

Amended by:

Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.053(b), eff. September 1, 2005.

Source of truth

Edition: Current through the 89th 2nd Called Legislative Session, 2025
Official file: https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1501.htm
Text hash: sha256 2e6ddf1878c0d2b51de0dd5c5fe10abb12cf218d6786572bb5a6593a8a931707
Composed by: compose_tx.py 2026-10-05: the Legislative Council's chapter files read in document order; verify_tx.py's independent reading (lxml DOM walk) agrees character for character

Cited by 1 provision

Provisions in this library whose text cites Tex. Ins. Code § 1501.061. Each shows the citation as that text prints it.

Insurance Code

Tex. Ins. Code § 1501.058POWERS AND DUTIES OF COOPERATIVES.Printed as Section 1501.061

Procedural information only. Not legal advice and not a substitute for the advice of an attorney. Confirm the current text with the official publisher before relying on it.

Text — Current through the 89th 2nd Called Legislative Session, 2025

A cooperative may contract only with a small or large employer health benefit plan issuer that demonstrates that the issuer:

(1) is in good standing with the department;

(2) has the capacity to administer health benefit plans;

(3) is able to monitor and evaluate the quality and cost-effectiveness of care and applicable procedures;

(4) is able to conduct utilization management and establish applicable procedures and policies;

(5) is able to ensure that enrollees have adequate access to health care providers, including adequate numbers and types of providers;

(6) has a satisfactory grievance procedure and is able to respond to enrollees' calls, questions, and complaints; and

(7) has financial capacity, either through satisfying financial solvency standards, as applied by the commissioner, or through appropriate reinsurance or other risk-sharing mechanisms.

Source of truth

Edition

Current through the 89th 2nd Called Legislative Session, 2025

Official file

https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1501.htm

Text hash

sha256 2e6ddf1878c0d2b51de0dd5c5fe10abb12cf218d6786572bb5a6593a8a931707

Composed by

compose_tx.py 2026-10-05: the Legislative Council's chapter files read in document order; verify_tx.py's independent reading (lxml DOM walk) agrees character for character