Texas Insurance Code Title 4, Chapter 463 - Texas Life And Health Insurance Guaranty Association

SUBCHAPTER A GENERAL PROVISIONS

• Texas Section 463.001 - Short Title
  This chapter may be cited as the Texas Life and Health Insurance Guaranty Association Act. Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017),...
• Texas Section 463.002 - Purpose
  The purpose of this chapter is to protect, subject to certain limitations, a person specified by Section 463.201 against failure in the performance of a...
• Texas Section 463.003 - General Definitions
  In this chapter: (1) "Association" means the Texas Life and Health Insurance Guaranty Association. (1-a) "Benefit plan" means a specific employee, union, or association of...
• Texas Section 463.0031 - Definition Of Principal Place Of Business Of Plan Sponsor Or Other Person
  (a) Except as otherwise provided by this section, in this chapter, the "principal place of business" of a plan sponsor or a person other than...
• Texas Section 463.004 - Construction
  This chapter shall be liberally construed to implement the purpose of this chapter described by Section 463.002. Section 463.002 shall be used to aid and...
• Texas Section 463.005 - Immunity
  (a) The following persons are not liable, and a cause of action does not arise against any of the following persons, for a good faith...

SUBCHAPTER B GOVERNANCE OF AND PARTICIPATION IN ASSOCIATION

• Texas Section 463.006 - Rules
  The commissioner shall adopt reasonable rules as necessary to carry out and supplement this chapter and the purposes of this chapter. Added by Acts 2005,...
• Texas Section 463.051 - Purpose And Regulation Of Association
  (a) The Texas Life and Health Insurance Guaranty Association is a nonprofit legal entity existing to pay benefits and continue coverage as provided by this...
• Texas Section 463.052 - Required Participation In Association
  (a) As a condition of engaging in the business of insurance in this state, an insurer, including a mutual assessment company, a local mutual aid...
• Texas Section 463.053 - Board Of Directors
  (a) The association's powers are exercised through a board of directors consisting of nine individuals appointed by the commissioner as provided by this section. (b)...
• Texas Section 463.054 - Eligibility To Serve As Public Representative
  To be eligible to serve as a public representative, an individual may not: (1) be an officer, director, or employee of an insurer, insurance agency,...
• Texas Section 463.055 - Term; Vacancy
  (a) Board members serve staggered six-year terms, with the terms of three members expiring each odd-numbered year. A member may be reappointed. (b) A board...
• Texas Section 463.056 - Compensation Of Board Members
  A board member may not receive compensation from the association for the member's services but may be reimbursed from the association's assets for expenses incurred...
• Texas Section 463.057 - Financial Statement Of Board Member
  Each board member shall file with the Texas Ethics Commission a financial statement as provided by Subchapter B, Chapter 572, Government Code. Added by Acts...
• Texas Section 463.058 - Conflict Of Interest
  (a) In this section, "transaction on behalf of an impaired insurer" includes a reinsurance agreement, transaction, merger, purchase, sale, contribution, or exchange of assets, insurance...

SUBCHAPTER C GENERAL POWERS AND DUTIES OF ASSOCIATION

• Texas Section 463.059 - Meetings By Telephone And Videoconference
  (a) Notwithstanding Chapter 551, Government Code, or any other law, the board or a committee of the board may meet by telephone conference call, videoconference,...
• Texas Section 463.101 - General Powers And Duties
  (a) The association may: (1) enter into contracts as necessary or proper to carry out this chapter and the purposes of this chapter; (2) sue...
• Texas Section 463.102 - Plan Of Operation; Amendments
  (a) The association shall perform the association's functions under a plan of operation approved by the commissioner. The plan of operation must: (1) establish: (A)...
• Texas Section 463.103 - Personnel
  The association may employ or retain employees or contractors to handle the association's financial transactions and to perform other functions under this chapter. Added by...
• Texas Section 463.104 - Association Records
  (a) The association shall maintain a record of each negotiation or meeting in which the association or the association's representative discusses the association's activities in...
• Texas Section 463.105 - Accounts
  For the purposes of administration and assessment, the association shall maintain: (1) an accident, health, and hospital services insurance account; (2) a life insurance account;...
• Texas Section 463.106 - Delegation Of Powers And Duties
  (a) The plan of operation may provide that, on approval of the board and the commissioner, a power or duty of the association is delegated...
• Texas Section 463.107 - Exemption From Taxation
  The association is exempt from payment of all fees and all taxes levied by this state or a subdivision of this state, except taxes levied...
• Texas Section 463.108 - Detection And Prevention Of Impairment And Insolvency
  On a majority vote, the board: (1) may make recommendations to the commissioner for detecting and preventing insurer insolvencies; and (2) shall notify the commissioner...
• Texas Section 463.109 - Association Appearance Before Court; Intervention
  (a) The association may appear before a court in this state with jurisdiction over an impaired or insolvent insurer concerning which the association is or...
• Texas Section 463.110 - Annual Report
  Not later than the 120th day after the last day of each association fiscal year, the board shall submit to the commissioner: (1) a financial...
• Texas Section 463.111 - Board And Association Advice And Assistance
  (a) On a majority vote, the board may report and make recommendations to the commissioner on any matter germane to: (1) the solvency, liquidation, rehabilitation,...
• Texas Section 463.112 - Board Access To Records
  The receiver or statutory successor of an impaired insurer shall give the board or a representative of the board: (1) access to the insurer's records...
• Texas Section 463.113 - Board Report At Conclusion Of Insolvency
  (a) At the conclusion of an insurer insolvency in which the association was obligated to pay a covered claim, the board shall prepare and submit...

SUBCHAPTER D ASSESSMENTS

• Texas Section 463.114 - Summary Document; Disclaimer
  (a) The association shall prepare a summary document describing the general purposes and limitations of this chapter and amend the document as necessary to comply...
• Texas Section 463.151 - Making And Payment Of Assessment
  (a) The association shall assess member insurers, separately for each account under Section 463.105, in the amounts and at the times the board determines necessary...
• Texas Section 463.152 - Classes Of Assessments
  (a) Assessments are classified as Class A or Class B assessments. (b) Class A assessments are authorized and called to pay: (1) the association's administrative...
• Texas Section 463.153 - Amount Of Assessments
  (a) The board shall determine the amount of a Class A assessment for each account under Section 463.105, considering with respect to member insurers one...
• Texas Section 463.154 - Deferment
  The association may wholly or partly defer an assessment of a member insurer if the association believes payment of the assessment would endanger the ability...
• Texas Section 463.155 - Deposit Of Assessments
  The association may deposit assessments into the Texas Treasury Safekeeping Trust Company in accordance with procedures established by the comptroller. The comptroller shall account to...
• Texas Section 463.156 - Certificate Of Contribution
  The association shall issue to each member insurer that pays a Class B assessment a certificate of contribution, in a form the commissioner prescribes, for...
• Texas Section 463.157 - Refunds
  (a) The board may refund to member insurers the amount by which the association's assets, including any net realized gains and income from investments, exceed...
• Texas Section 463.158 - Use Of Assessments
  Money from assessments supplements the marshalling of an impaired insurer's assets to make payments on the insurer's behalf. Added by Acts 2005, 79th Leg., Ch....
• Texas Section 463.159 - Failure To Pay; Collection By Commissioner
  On failure of a member insurer to pay an assessment when due, the commissioner may either: (1) suspend or revoke, after notice and hearing, the...
• Texas Section 463.160 - Premium Tax Credit For Class A Assessment
  The amount of a Class A assessment paid by a member insurer in each taxable year shall be allowed as a credit on the amount...
• Texas Section 463.161 - Premium Tax Credit For Class B Assessment
  (a) A member insurer is entitled to show as an admitted asset a certificate of contribution in the form the commissioner approves under Section 463.156....
• Texas Section 463.162 - Assignment Or Transfer Of Credit
  (a) A member insurer may assign or transfer a credit against premium tax to another member insurer if: (1) an acquisition, merger, or total assumption...

SUBCHAPTER E COVERAGE PROVIDED BY ASSOCIATION

• Texas Section 463.163 - Insured's Liability Under Assessment Plan
  This chapter does not reduce the liability for unpaid assessments of the insureds of an impaired or insolvent insurer operating under a plan with assessment...
• Texas Section 463.201 - Insureds Covered
  (a) Subject to Subsections (b) and (c), this chapter provides coverage for a policy or contract described by Section 463.202 to a person who is:...
• Texas Section 463.202 - Policies And Contracts Covered
  (a) Except as limited by this chapter, the coverage provided by this chapter to a person specified by Section 463.201, subject to Sections 463.201(b) and...
• Texas Section 463.203 - Policies And Contracts Excluded
  (a) In this section, "Moody's Corporate Bond Yield Average" means the monthly average corporates as published by Moody's Investors Service, Inc., or any successor to...
• Texas Section 463.204 - Obligations Excluded
  A contractual obligation does not include: (1) death benefits in an amount in excess of $300,000 or a net cash surrender or net cash withdrawal...
• Texas Section 463.205 - Protection Provided By Other Jurisdiction
  This chapter does not provide coverage for a resident with respect to an impaired or insolvent insurer domiciled in another jurisdiction if guaranty protection is...

SUBCHAPTER F POWERS AND DUTIES OF ASSOCIATION RELATING

• Texas Section 463.206 - Association Discretion In Manner Of Providing Benefits
  (a) The board shall have discretion and may exercise reasonable business judgment to determine the means by which the association is to provide the benefits...
• Texas Section 463.251 - Impaired Domestic Insurer
  (a) This section applies only to a member insurer that is an impaired domestic insurer. (b) With the commissioner's approval, the association may: (1) guarantee,...
• Texas Section 463.252 - Impaired Domestic, Foreign, Or Alien Insurer Not Paying Claims
  (a) This section applies only to a member insurer that: (1) is an impaired domestic, foreign, or alien insurer; and (2) is not timely paying...
• Texas Section 463.253 - Insolvent Insurer
  (a) This section applies only to a member insurer that is an insolvent insurer. (b) The association shall provide money, pledges, guarantees, or other means...
• Texas Section 463.254 - Life Or Health Insurance Policies Or Contracts
  (a) This section applies only when the association is taking an action under Section 463.252(b)(2) or 463.253 with respect to a life or health insurance...
• Texas Section 463.255 - Policy Or Contract With Guaranteed Interest Rate
  In taking an action under Section 463.252(b)(2) or 463.253 with respect to a policy or contract with a guaranteed minimum interest rate, the association shall...
• Texas Section 463.256 - Alternative Policy
  (a) An alternative policy issued by the association must: (1) be approved by the commissioner; (2) provide coverage of a kind that the association determines...
• Texas Section 463.257 - Imposition Of Lien Or Moratorium
  To carry out the association's duties under this chapter and with the court's approval, the association may: (1) impose a permanent policy or contract lien...
• Texas Section 463.258 - Premium For Reissuance Of Terminated Coverage
  If the association reissues terminated coverage at a premium different from the terminated policy's premium, the premium must: (1) reflect the amount of insurance provided...
• Texas Section 463.259 - Premium Due During Receivership
  After a court enters an order of receivership with respect to an impaired or insolvent insurer, a premium due for coverage issued by the insurer...
• Texas Section 463.260 - Limits On And Termination Of Association Obligation
  (a) The association is not liable for benefits that exceed the contractual obligations for which the insurer is liable or would have been liable if...
• Texas Section 463.261 - Assignment Of Rights
  (a) A person receiving a benefit under this chapter, including a payment of or on account of a contractual obligation, continuation of coverage, or provision...
• Texas Section 463.262 - Effect Of Subrogation And Assignment Of Rights And Available Assets On Association Obligation
  (a) The limitations set forth in this chapter are limitations on the benefits for which the association is obligated before taking into account either the...
• Texas Section 463.263 - Deposit To Be Paid To Association
  (a) A deposit in this state, held under law or required by the commissioner for the benefit of creditors, including policy owners, that is not...

SUBCHAPTER G OPERATION OF IMPAIRED OR INSOLVENT INSURER

• Texas Section 463.264 - Reinsurance
  (a) The association may elect to succeed to the rights of an insolvent insurer under a contract of reinsurance to which the insolvent insurer is...
• Texas Section 463.301 - Issuance Or Renewal Of Policies Following Conservatorship Or Receivership
  (a) If an assessment has been made under this chapter for the insurer or guaranty fees have been provided for the insurer, an impaired insurer...
• Texas Section 463.302 - Distributions To Shareholders And Affiliates
  (a) An impaired or insolvent insurer may not make a distribution to shareholders until the association has recovered the total amount of valid claims for...
• Texas Section 463.303 - Assets Attributable To Covered Policies
  (a) For the purposes of this section, assets attributable to covered policies are the proportion of the assets that the reserves that should have been...

SUBCHAPTER H POWERS AND DUTIES OF COMMISSIONER AND DEPARTMENT

• Texas Section 463.304 - Distribution Of Ownership Rights Of Impaired Or Insolvent Insurer
  In making an equitable distribution of the ownership rights of an impaired or insolvent insurer before the termination of a receivership, the court: (1) shall...
• Texas Section 463.351 - Notice Of Commissioner Actions
  (a) The commissioner shall: (1) notify the insurance officials of all the other states, territories of the United States, and the District of Columbia by...
• Texas Section 463.352 - Advice From Board
  The commissioner may seek the board's advice and recommendations on a matter affecting the commissioner's duties regarding the financial condition of: (1) a member insurer;...
• Texas Section 463.353 - Examination
  (a) The board by majority vote may request the commissioner to order an examination of a member insurer that the board in good faith believes...
• Texas Section 463.354 - Demand To Cure Impairment
  (a) When an impairment is declared and the amount of the impairment is determined, the commissioner shall serve a demand on the impaired insurer to...
• Texas Section 463.355 - Failure To Comply With Plan Of Operation
  On failure of a member insurer to comply with the plan of operation, the commissioner may suspend or revoke, after notice and hearing, the insurer's...
• Texas Section 463.356 - Assumption Of Powers And Duties Of Association
  The commissioner may assume the powers and duties of the association under this chapter with respect to impaired or insolvent insurers if the association does...
• Texas Section 463.357 - Notification Of Effect Of Chapter
  The commissioner, as receiver of an impaired insurer, may notify all interested persons of the effect of this chapter. Added by Acts 2005, 79th Leg.,...

SUBCHAPTER I APPEALS AND OTHER ACTIONS

• Texas Section 463.358 - Statement Of Premiums
  On request, the commissioner shall provide the association with a statement of the premiums in this state and any other appropriate state for each member...
• Texas Section 463.401 - Appeal To Commissioner
  (a) Not later than the 60th day after the date of a final action of the association or the board, a member insurer may appeal...
• Texas Section 463.402 - Venue
  Venue for an action against the association under this chapter is in Travis County. Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec....
• Texas Section 463.403 - Appeal Bond
  The association is not required to give an appeal bond in an appeal of a cause of action under this chapter. Added by Acts 2005,...

SUBCHAPTER J PROHIBITED PRACTICES

• Texas Section 463.404 - Stay Of Proceedings; Certain Decisions Not Binding
  (a) To permit the receiver or association to properly defend a pending cause of action, a proceeding in which an impaired insurer is a party...
• Texas Section 463.451 - Prohibited Use Of Protection Provided By Chapter
  (a) A person may not make, publish, disseminate, circulate, or place before the public, or directly or indirectly cause to be made, published, disseminated, circulated,...

Last modified: September 28, 2016