Texas Insurance Code Title 2, Chapter 38 - Data Collection And Reports

SUBCHAPTER A GENERAL PROVISIONS

• Texas Section 38.001 - Inquiries
  (a) In this section, "authorization" means a permit, certificate of registration, or other authorization issued or existing under this code. (b) The department may address...
• Texas Section 38.002 - Underwriting Guidelines For Personal Automobile And Residential Property Insurance; Filing; Confidentiality
  (a) In this section: (1) "Insurer" means an insurance company, reciprocal or interinsurance exchange, mutual insurance company, capital stock company, county mutual insurance company, Lloyd's...

SUBCHAPTER B HEALTH BENEFIT PLAN PROVIDER REPORTING

• Texas Section 38.003 - Underwriting Guidelines For Other Lines; Confidentiality
  (a) This section applies to all underwriting guidelines that are not subject to Section 38.002. (b) For purposes of this section, "insurer" means a reciprocal...
• Texas Section 38.051 - Definition
  In this subchapter, "health benefit plan provider" means an insurance company, group hospital service corporation, or health maintenance organization that issues: (1) an individual, group,...

SUBCHAPTER E STATISTICAL DATA COLLECTION

• Texas Section 38.052 - Required Information; Rules
  (a) A health benefit plan provider shall submit information required by the department relating to the health benefit plan provider's: (1) loss experience; (2) overhead;...
• Texas Section 38.201 - Definition
  In this subchapter, "designated statistical agent" means an organization designated or contracted with by the commissioner under Section 38.202. Added by Acts 1999, 76th Leg.,...
• Texas Section 38.202 - Statistical Agent
  The commissioner may, for a line or subline of insurance, designate or contract with a qualified organization to serve as the statistical agent for the...
• Texas Section 38.203 - Qualifications Of Statistical Agent
  To qualify as a statistical agent, an organization must demonstrate at least five years of experience in data collection, data maintenance, data quality control, accounting,...
• Texas Section 38.204 - Powers And Duties Of Statistical Agent
  (a) A designated statistical agent shall collect data from reporting insurers under a statistical plan adopted by the commissioner. (b) The statistical agent may provide...
• Texas Section 38.205 - Duty Of Insurer
  An insurer shall provide all premium and loss cost data to the commissioner or the designated statistical agent as the commissioner or agent requires. Added...
• Texas Section 38.206 - Fees
  (a) A designated statistical agent may collect from a reporting insurer any fees necessary for the agent to recover the necessary and reasonable costs of...

SUBCHAPTER F DATA COLLECTING AND REPORTING RELATING TO MANDATED HEALTH BENEFITS AND MANDATED OFFERS OF COVERAGE

• Texas Section 38.207 - Rules
  The commissioner may adopt rules necessary to accomplish the purposes of this subchapter. Added by Acts 1999, 76th Leg., ch. 101, Sec. 1, eff. Sept....
• Texas Section 38.251 - Applicability
  This subchapter applies to any issuer of a health benefit plan that is subject to this code that provides benefits for medical or surgical expenses...
• Texas Section 38.252 - Collection Of Information; Report
  (a) The commissioner shall require a health benefit plan issuer to collect and report cost and utilization data for each mandated health benefit and mandated...
• Texas Section 38.253 - Maintenance Of Information
  Each health benefit plan issuer shall maintain at its principal place of business all data collected pursuant to this subchapter, including information and supporting documentation...

SUBCHAPTER G DATA REPORTING BY CERTAIN LIABILITY INSURERS

• Texas Section 38.254 - Utilization And Cost Data To Commissioner
  (a) Upon request from the commissioner, the Texas Health and Human Services Commission shall provide to the commissioner data, including utilization and cost data, which...
• Texas Section 38.301 - Insurer Data Reporting
  (a) Each insurer that writes professional liability insurance policies for nursing institutions licensed under Chapter 242, Health and Safety Code, including an insurer whose rates...

SUBCHAPTER H HEALTH CARE REIMBURSEMENT RATE INFORMATION

• Texas Section 38.302 - Recommendations To Legislature
  The commissioner shall assemble information and take other appropriate measures to assess and evaluate changes in the marketplace resulting from the implementation of the legislation...
• Texas Section 38.351 - Purpose Of Subchapter
  The purpose of this subchapter is to authorize the department to: (1) collect data concerning health benefit plan reimbursement rates in a uniform format; and...
• Texas Section 38.352 - Definition
  In this subchapter, "group health benefit plan" means a preferred provider benefit plan as defined by Section 1301.001 or an evidence of coverage for a...
• Texas Section 38.353 - Applicability Of Subchapter
  (a) This subchapter applies to the issuer of a group health benefit plan, including: (1) an insurance company; (2) a group hospital service corporation; (3)...
• Texas Section 38.354 - Rules
  The commissioner may adopt rules as provided by Subchapter A, Chapter 36, to implement this subchapter. Added by Acts 2007, 80th Leg., R.S., Ch. 997...
• Texas Section 38.355 - Data Call; Standardized Format
  (a) Each health benefit plan issuer shall submit to the department, at the time and in the form and manner required by the department, aggregate...
• Texas Section 38.356 - Confidentiality Of Data
  Except as provided by Section 38.357, data collected under this subchapter is confidential and not subject to disclosure under Chapter 552, Government Code. Added by...
• Texas Section 38.357 - Publication Of Aggregate Health Care Reimbursement Rate Information
  The department shall provide to the Department of State Health Services for publication, for identified regions of this state, aggregate health care reimbursement rate information...
• Texas Section 38.358 - Penalties
  A health benefit plan issuer that fails to submit data as required in accordance with this subchapter is subject to an administrative penalty under Chapter...

Last modified: September 28, 2016