Part 1. TEXAS DEPARTMENT OF INSURANCE
Chapter 13. MISCELLANEOUS INSURERS
Subchapter D. RISK RETENTION GROUPS AND PURCHASING GROUPS
The Texas Department of Insurance proposes an amendment to §13.313, concerning the annual registration filing date for purchasing groups. The proposed amendment is necessary to change the current annual registration filing dates and to establish a single annual registration filing date requirement for purchasing groups of on or before July 1 of each year. The proposed amendment to §13.313(c) requires each purchasing group to file current information on or before July 1 of each year instead of the existing requirement that such current information be filed on or before each purchasing group's policy anniversary date each year. This change to a single annual registration filing date is necessary because the current registration filing requirement, which allows for multiple registration filing dates, results in an inefficient use of Department resources, and this problem can be eliminated by requiring the same annual registration filing date for all purchasing groups. In addition, purchasing group industry representatives have requested that the Department consider adopting a single annual registration filing date for all purchasing groups because the majority of states have already done so. A single annual registration filing date will help standardize the requirements in Texas with those in other states. The proposed amendment also requires each purchasing group to file its current information on Form PG1R instead of Form PG1. This change is necessary because Form PG1R specifically requires only information directly relevant to the renewal of a purchasing group's registration, whereas Form PG1 requires all information relevant to the initial registration of a purchasing group. The proposed amendments also amend §13.313(a) and (b) to replace the reference to the State Board of Insurance with a reference to the Commissioner of Insurance. This change is necessary because the State Board of Insurance was abolished effective September 1, 1994, and the Commissioner of Insurance was granted the authority previously granted to the State Board of Insurance, pursuant to Acts 1993, 73rd Legislature, ch. 685, §1.23. Amendments to §13.313(a) and (b) are also proposed to update statutory references in accordance with the nonsubstantive revised Insurance Code. The proposed amendments also delete §13.313(b)(6) which requires the use of Form PG2, a form no longer used because the collection of premium taxes from purchasing groups is a function of the Texas Comptroller of Public Accounts, and not the Department.
FISCAL NOTE. Kathy Wilcox, Registrations Officer, Company Licensing and Registration Division, has determined that for each year of the first five years the proposed amendments are in effect, there will be no fiscal implications for state or local government as a result of the amendments, and there will be no effect on local employment or the local economy.
PUBLIC BENEFIT/COST NOTE. Ms. Wilcox also has determined that for each year of the first five years the proposed amendments are in effect, the public benefit will be more efficient review of registration statements filed by purchasing groups resulting in more efficient and uniform regulation of purchasing groups subject to the provisions of the Insurance Code Chapter 2201 (formerly Article 21.54), relating to the regulation of purchasing groups and risk retention groups. The proposed amendments will also result in more consistent reporting by domestic and foreign purchasing groups registered to conduct business in Texas. There is no financial cost to persons required to comply as a result of the adoption, enforcement or administration of the proposed amendments. This is because the proposal does not add any new requirements or costs with which businesses, regardless of size, must comply that are not already required. Under the proposal, purchasing groups seeking to maintain their registration to do business in Texas will continue to file annually on a promulgated form.
ECONOMIC IMPACT STATEMENT AND REGULATORY FLEXIBILITY ANALYSIS. As required by the Government Code §2006.002(c), the Department has determined that the proposed amendments to §13.313(c), concerning the establishment of a single annual registration filing date for purchasing groups and the use of Form PG1R will not have an adverse economic effect on small businesses or micro businesses that are required to comply with the proposal. This is because the proposal does not add any new requirements or costs with which businesses, regardless of size, must comply that are not already required. Under the proposal, small or micro business purchasing groups seeking to maintain their registration to do business in Texas will continue to file annually on a promulgated form. In accordance with the Government Code §2006.002(c), the Department has, therefore, determined that a regulatory flexibility analysis is not required because the proposal will not have an adverse impact on small or micro businesses.
TAKINGS IMPACT ASSESSMENT. The Department has determined that no private real property interests are affected by this proposal and that this proposal does not restrict or limit an owner's right to property that would otherwise exist in the absence of government action and, therefore, does not constitute a taking or require a takings impact assessment under the Government Code §2007.043.
REQUEST FOR PUBLIC COMMENT. To be considered, written comments on the proposal must be submitted no later than 5:00 p.m. on March 24, 2008, to Gene C. Jarmon, General Counsel and Chief Clerk, Texas Department of Insurance, Mail Code 110-1A, Austin, Texas 78703. An additional copy of the comments must be submitted simultaneously to Kathy Wilcox, Registrations Officer, Company Licensing and Registration Division, Texas Department of Insurance, Mail Code 305-2C, P.O. Box 149104, Austin, Texas 78714-9104. Any request for a public hearing on the proposal should be submitted separately to the Office of the Chief Clerk before the close of the public comment period. If a hearing is held, written and oral comments presented at the hearing will be considered.
STATUTORY AUTHORITY. The amendments are proposed under the Insurance Code Chapter 2201 and §36.001. Insurance Code §2201.008 authorizes the Commissioner to adopt rules that are necessary to carry out Chapter 2201, relating to the regulation of risk retention groups and purchasing groups. Insurance Code §36.001 provides that the Commissioner of Insurance may adopt any rules necessary and appropriate to implement the powers and duties of the Department under the Insurance Code and other laws of this state.
CROSS REFERENCE TO STATUTE. The following statutes are affected by the proposal: Insurance Code Chapter 2201.
§13.313.Forms Required for Risk Retention Groups and Purchasing Groups.
(a) Requirement for use of specific forms. Risk retention
group or purchasing group filings and registrations under the Insurance
Code,
Chapter 2201,
[
Article 21.54,
] must be effected by using forms promulgated by the
commissioner
[
State Board
] of
insurance
[
Insurance
].
(b) Adoption by reference of forms. The
commissioner
[
State Board
] of
insurance
[
Insurance
]
adopts by reference standard forms
as specified in paragraphs
(1) - (6) of this subsection and subsection (c) of this section
for use by risk retention groups and purchasing groups which are subject
to the provisions of this subchapter and the Insurance Code,
Chapter
2201
[
Article 21.54
]. The forms are published by the
Texas Department
[
State Board
] of Insurance, and copies of the forms are available from the
Company Licensing
and Registration Division, Texas Department of Insurance, Mail Code
305-2C, P.O. Box 149104, Austin, Texas 78714-9104
[
Risk
Retention Unit, Mail Code 014-5, State Board of Insurance, 1110 San
Jacinto Boulevard, Austin, Texas 78701
]. The following forms
must be utilized, as applicable, under the provisions of this subchapter
and the Insurance Code,
Chapter 2201
[
Article 21.54
].
(1) Risk retention groups seeking to be chartered in
this state pursuant to the Insurance Code
Chapters 822, 861, and 883,
[
Chapters 2, 8, and 15,
] must utilize Form RRG-A-120.
(2) Risk retention groups seeking to be chartered in
this state pursuant to the Insurance Code,
Chapter 942
[
Chapter
19
] must utilize Form RRG-A-121.
(3) Foreign or alien risk retention groups seeking to do business as a risk retention group in this state must utilize Form RRG-A-122.
(4) All risk retention groups and purchasing groups seeking to do business in this state must utilize Form RRG/PG PC1, for appointing the commissioner as agent for service of process.
(5) Purchasing groups filing a notice of intent and
registering to do business in this state under the Insurance Code,
§§2201.255 and 2201.256,
[
Article 21.54, §7(a),
] must utilize Form PG1.
[
(6)
Purchasing groups filing taxes
not filed by agent or insurer must utilize Form PG2.
]
(6)
[
(7)
] Agents filing annual reports as required by the Insurance Code,
§2201.007,
[
Article 21.54, §10(e),
] must use Form PG3.
(c) Annual filing by purchasing groups. On or before
July 1
[
its policy anniversary date
] each year,
beginning in 2008,
every purchasing group doing business in this state
shall provide the commissioner of insurance with current information on Form
PG1R
[
PG1, referred to in subsection (b) of this section
]; however, there shall be no filing fee for annual filings of Form
PG1R
[
PG1
] after payment of
the initial filing fee described in §13.312 of this title (relating
to Regulatory Fees).
This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of the Secretary of State on February 5, 2008.
TRD-200800702
Gene C. Jarmon
General Counsel and Chief Clerk
Texas Department of Insurance
Earliest possible date of adoption: March 23, 2008
For further information, please call: (512) 463-6327
Chapter 134. BENEFITS--GUIDELINES FOR MEDICAL SERVICES, CHARGES, AND PAYMENTS
Subchapter E. HEALTH FACILITY FEES
(Editor's note: The text of the following section proposed for repeal will not be published. The section may be examined in the offices of the Texas Department of Insurance, Division of Workers' Compensation or in the Texas Register office, Room 245, James Earl Rudder Building, 1019 Brazos Street, Austin.)
The Texas Department of Insurance (Department), Division of Workers' Compensation (Division) proposes the repeal of existing §134.401, concerning Acute Care Inpatient Hospital Fee Guideline.
Section 134.401 was adopted in 1997. It provided for per diem reimbursement and a "stop-loss" provision. The stop-loss provision was intended to compensate for unusually costly services. Instead of per diem reimbursement, the stop-loss provision of §134.401(c)(6) provided for a reimbursement of 75% of total audited charges if those charges exceeded $40,000. At the time the rule was adopted, only 4% of hospital bills exceeded $40,000. By 2006, however, 32% of hospital bills exceeded $40,000.
In 2001, the Legislature passed House Bill 2600, which amended Labor Code §413.011 by directing the Texas Workers' Compensation Commission to adopt a reimbursement structure modeled along the lines of the Medicare system.
In accordance with that directive, the Division recently adopted §134.403, concerning Hospital Fee Guideline--Outpatient and §134.404, concerning Hospital Facility Fee Guideline--Inpatient, which will supersede the provisions of §134.401 on and after March 1, 2008. Section 134.403 and §134.404 implemented Labor Code §413.011 by adopting a standardized reimbursement structure using in part the most current methodologies, models, values and weights used by the Centers for Medicare and Medicaid Services (CMS).
Section 134.401 no longer meets the needs of the workers compensation system. Since §134.401 will no longer be needed after March 1, 2008, the Division proposes the repeal of §134.401.
Matt Zurek, Director of Health Care Policy, has determined that, for the first five years after the repeal of the section, there will be no fiscal implications for state or local government as a result of enforcing or administering the repeal, and there will be no effect on local employment or the local economy as result of the proposed repeal.
Mr. Zurek has also determined that, for each year of the first five years after the repeal of the section, the public benefit anticipated as a result of the repeal will be the elimination of unnecessary regulations. There will be no economic cost to any individuals, or insurers or other Division regulated entities, regardless of size, as a result of the proposed repeal.
In accordance with the Government Code §2006.002(c), a Division analysis has determined that this proposed repeal will not have an adverse economic effect on small or micro business carriers because it is simply a repeal of an unnecessary rule. Therefore, in accordance with the Government Code §2006.002(c), the Division is not required to prepare a regulatory flexibility analysis.
The Division has determined that no private real property interests are affected by this proposal and that this proposal does not restrict or limit an owner's right to property that would otherwise exist in the absence of government action and, therefore, does not constitute a taking or require a takings impact assessment under the Government Code §2007.043.
To be considered, written comments on the proposal must be submitted no later than 5:00 p.m. on March 24, 2008. Comments may be submitted via the Internet through the Division's Internet website at http://www.tdi.state.tx.us/rules/proposedrules/toc.html or by mailing or delivering your comments to Victoria Ortega, Legal Services, MS-4D, Division of Workers' Compensation, Texas Department of Insurance, 7551 Metro Center Drive, Suite 100, Austin, Texas 78744.
Any request for a public hearing should be submitted separately to the Office of the General Counsel, MS-1, 7551 Metro Center Drive, Austin, Texas 78744 before the close of the public comment period. If a hearing is held, written and oral comments presented at the hearing will be considered.
The repeal is proposed under the Labor Code §402.00111 and §402.061. Section 402.00111 provides that the Commissioner of Workers' Compensation shall exercise all executive authority, including rulemaking authority, under the Labor Code and other laws of this state. Section 402.061 provides the Commissioner the authority to adopt rules as necessary to implement and enforce the Texas Workers' Compensation Act.
No other codes, statutes or articles are affected by this proposal.
§134.401.Acute Care Inpatient Hospital Fee Guideline.
This agency hereby certifies that the proposal has been reviewed by legal counsel and found to be within the agency's legal authority to adopt.
Filed with the Office of the Secretary of State on February 11, 2008.
TRD-200800798
Norma Garcia
General Counsel
Texas Department of Insurance, Division of Workers' Compensation
Earliest possible date of adoption: March 23, 2008
For further information, please call: (512) 804-4715