tx-May82026-49: 28 TAC §26.9 (Amendment) — Employer-related Health Benefit Plan Regulations
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STATUTORY AUTHORITY. TDI proposes amendments to §26.9 under Insurance Code §1501.010(1) and §36.001. Insurance Code §1501.010(1) directs the commissioner to adopt rules necessary to implement Insurance Code Chapter 1501. Insurance Code §36.001 provides that the commissioner may adopt any rules necessary and appropriate to implement the powers and duties of TDI under the Insurance Code and other laws of this state. CROSS-REFERENCE TO STATUTE. Section 26.9 implements Insurance Code §1501.157, as amended by SB 896. §26.9. Exclusions, Limitations, Waiting Periods, Affiliation Periods, Preexisting Conditions, and Restrictive Riders. (a) All health benefit plans that provide coverage for small employers and their employees must comply with the following requirements. (1) A small employer carrier may not exclude any eligible employee or dependent (including a late enrollee who would otherwise be covered under a small employer health benefit plan), except to the extent permitted under Insurance Code §1501.156, [(]concerning Employee Enrollment; Waiting Period[)]. (2) A small employer carrier may not limit or exclude (by use of rider, amendment, or other provision of the plan, applicable...
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