Texas Register, Volume 37, Number 30, Pages 5519-5676, July 27, 2012 Page: 5,579
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amendments clarify that this obligation is placed upon insurance
companies as opposed to insurance carriers in general. These
adopted amendments are also necessary to update and harmo-
nize terminology in this rule with the statutory language in Labor
Code 406.008.
The adopted amendments in 110.1(f) are necessary to clarify
that these provisions apply in situations involving an insurance
company's cancellation or non-renewal of a policy. Similar pro-
visions regarding effective date of a termination of a policy are
recodified in 110.105(c), which applies in situations involving
an employer's termination of a policy. There may be situations
where both of these provisions are implicated; and in such cases,
the party that terminates or cancels the policy first controls.
The adopted amendments in 110.1(g) replace the term "in-
surance carrier" with "insurance company, certified self-insurer,
workers' compensation self-insurance group under Labor Code
Chapter 407A, or political subdivision." This adopted amend-
ment sets out the specific types of entities that are subject the
notice of claim administration contact information requirements
in this subsection. These adopted amendments are necessary
in order to update and harmonize the terminology in this rule
with statutory language in Labor Code 406.006.
The adopted amendments in 110.1(h) replace the term "in-
surance carrier" with "insurance company, certified self-insurer,
workers' compensation self-insurance group under Labor Code
Chapter 407A, or political subdivision." These adopted amend-
ments are necessary in order to clarify the types of insurance
carrier entities that may utilize a servicing agent when process-
ing and filing coverage information under this rule.
Adopted 110.1(j) provides a January 1, 2013 effective date for
this rule. This adopted amendment is necessary in order to pro-
vide additional time to those affected by the changes to imple-
ment these changes.
110.7.
Adopted new 110.7 delineates specific reporting requirements
for a self-insured political subdivision to notify the Division when
it elects, in accordance with Labor Code 504.053(b)(2), to pro-
vide medical benefits to its injured employees or the injured em-
ployees of the members of the pool by directly contracting with
health care providers or by contracting through a health benefits
pool established under Local Government Code Chapter 172.
Section 110.7(a) adds a definition of health plan for clarity of
term usage in this rule. Section 110.7(b) provides applicability of
this rule to self-insured political subdivisions electing to provide
medical benefits pursuant to Labor Code 504.053(b)(2). Sec-
tion 110.7(c) states the notice of method of providing employee
benefits required by subsection (b) of the section shall be filed
in writing or electronically, in the form and manner prescribed by
the Division, and lists relevant data elements that the notice shall
include. Section 110.7(d) provides a December 31, 2012 report-
ing deadline for self-insured political subdivisions that provide
medical benefits in accordance with Labor Code 504.053(b)(2)
as of the effective date of this rule. Section 110.7(e) provides a
reporting deadline of not later than the 30th day after the date
the political subdivision begins to provide medical benefits for
political subdivisions providing medical benefits in the manner
described by Labor Code 504.053(b)(2) after the effective date
of this rule. Section 110.7(f) provides a self-insured political sub-
division shall notify the Division of any change in the information
required by this section not later than the 30th day after the date
of the change.This new rule is necessary in order to provide a process that will
allow the Division to effectively gather information concerning the
method by which self-insured political subdivisions provide med-
ical benefits in accordance with Labor Code 504.053(b)(2). La-
bor Code 504.018(a) requires a political subdivision to notify the
Division of the method by which its employees will receive ben-
efits, the approximate number of employees covered, and the
estimated amount of payroll. Much of the information required
under Labor Code 504.053(b)(2) is already reported to the Di-
vision. This new rule requires only the information required by
504.018(a) that is not already reported to the Division.
110.101.
The adopted amendments to 110.101 relate to employer
notice requirements under Labor Code 406.005. Labor Code
406.005 requires an employer to notify each employee as re-
quired by that section whether or not the employer has workers'
compensation insurance coverage. This statute requires the
employer to notify a new employee of the existence or absence
of workers' compensation insurance coverage at the time the
employee is hired. This statute also requires an employer to
post a notice in the workplace of whether the employer has
workers' compensation insurance coverage. The Commissioner
is authorized by this section to adopt rules relating to the form
and content of the notice.
The adopted amendments to 110.101(a) are necessary to track
statutory language, eliminating the terms "covered" and "non-
covered" from the text of the rule and replacing the terms with a
directional pointer to the definition of an employer in Labor Code
406.001 as it applies to this chapter.
The adopted amendments to 110.101(a)(2) - (3) are neces-
sary to conform the time deadlines for employers to provide
notice to employees with the Labor Code requirements under
406.005(d). Specifically, 110.101(a)(2) provides that em-
ployers whose workers' compensation insurance coverage is
terminated or cancelled shall provide notice to employees of
their workers' compensation status not later than the 15th day
after the date on which the termination or cancellation takes
effect. Section 110.101(a)(3) provides that employers who
obtain workers' compensation insurance coverage shall provide
notice to employees of their workers' compensation status not
later than the 15th day after the date on which the coverage
takes effect. These changes to timing requirements are nec-
essary to harmonize rule language and related requirements
with statutory language and timing requirements in Labor Code
406.005(d).
The adopted amendments to 110.101(a)(5) replace "certified
self-insurer" with "self-insurance as provided by the Texas Work-
ers' Compensation Act" to clarify that this rule covers both cer-
tified self-insureds and employers in a self-insurance group; ac-
cordingly these terms are subsequently updated through the re-
mainder of this rule. Labor Code Chapter 407A which allows
for group self-insurance coverage by employers was added to
the Act after the initial adoption of 110.101. Therefore, these
adopted amendments are necessary to update this rule and clar-
ify that employers in a self-insurance group are subject to the re-
quirements of Labor Code 406.005 and this rule. The adopted
amendments to 110.101(a)(5) also insert "workers' compensa-
tion insurance" before "coverage" in order to clarify that coverage
refers to workers' compensation insurance coverage as opposed
to other types of coverage.ADOPTED RULES July 27, 2012 37 TexReg 5579
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Texas. Secretary of State. Texas Register, Volume 37, Number 30, Pages 5519-5676, July 27, 2012, periodical, July 27, 2012; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth243959/m1/59/: accessed May 5, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.