28 Tex. Admin. Code § 26.426

Current through Reg. 49, No. 44; November 1, 2024
Section 26.426 - Rescission of Election
(a) A health group cooperative may rescind its election to admit eligible single-employee business members only if the:
(1) election has been effective for at least two years, except as provided by subsection (b) of this section;
(2) health group cooperative files notice of the rescission with the commissioner not later than the 180th day before the effective date of the rescission; and
(3) health group cooperative provides written notice of termination of coverage to all eligible single-employee business members of the cooperative not later than the 180th day before the effective date of the termination.
(b) A health group cooperative may rescind its election to admit eligible single-employee business members before the second anniversary of the effective date of the election by showing good cause in a written request to TDI that includes the:
(1) description of the specific circumstance requiring early rescission of the election, supported by any evidence of the cooperative's undue financial or operational hardship;
(2) geographical area in which the cooperative operates;
(3) total number of lives covered through the cooperative and the number of lives covered by enrollment of single-employer business members that will be affected by the rescission; and
(4) a signature by an authorized officer of the cooperative.
(c) A health group cooperative that rescinds its election under this division may choose to permit existing single-employee business members to maintain their membership and coverage but only if all single-employee business members are provided the same opportunity.
(d) A health group cooperative that has rescinded an election under this division may not reelect to accept eligible single-employee businesses to join the cooperative before the fifth anniversary of the effective date of the rescission.

28 Tex. Admin. Code § 26.426

Adopted by Texas Register, Volume 42, Number 19, May 12, 2017, TexReg 2562, eff. 5/17/2017