| INSURANCE |
| A prescription drug, medicine, or other remedy at a fee-rate that is negotiated by contract, a workers’ compensation insurance carriers may pay for | GA-0828 |
| Adjutant General, as chief of Texas National Guard, has authority to purchase liability insurance with federal funds to cover officers and employees who operate mobile shooting range | DM-0148 |
| Applicant for a real estate inspector’s license must carry liability insurance, and the Texas Real Estate Commission lacks authority to waive that requirement | GA-0932 |
| Automobile club may not contract to reimburse members for expenses incurred in obtaining automobile-related services | DM-0445 |
| Cancellation of prepaid funeral benefits contracts, amendatory language of section 154.155 of Finance Code which entitles purchaser to refund of half the earnings generated by payments made applies only to trust-funded prepaid funeral benefits contracts a | JC-0477 |
| Chapter 2210, Insurance Code, no provision prohibits the Texas Windstorm Insurance Association from using current and future premiums to pay prior obligations under | GA-1033 |
| Comptroller’s interpretation of single nonprofit trust to mean that the trust can be used only for the purpose of paying insurance premiums is reasonable; however, limiting use of the funds to only paying premiums and prohibiting trust funds from being used to cover other expenses in furtherance of the trust’s purpose is contrary to the statute | GA-0739 |
| Corporate surety, unincorporated association insurance carrier may not serve as | DM-0254 |
| Deductible, seller of goods or services does not violate criminal law if he does not seek payment from insured of amount equal to | JM-1154 |
| Excursion train operators, owners of trackage may require to purchase liability insurance in amount greater than $5,000,000 | DM-0403 |
| Experience ratings, effect of 1991 amendments to Insurance Code on State Board of Insurance's authority to use in rating insurers | DM-0033 |
| Holocaust registry established by article 21.74, Insurance Code, interferes with the President's conduct of foreign affairs, and is thus preempted by the United States Constitution | GA-0116 |
| Indexed life insurance product - investment in by Teacher Retirement System - conditions required for | KP-0220 |
| Insurance fraud - Penal Code section 35.02 sets out offense of | KP-0198 |
| Insurance policies are contracts | GA-0581 |
| Insurance services to a state university, a legislator may not provide unless authorized by the Texas Constitution and statutes | GA-0567 |
| Life insurance proceeds and policy cash value are exempt from seizure of process | DM-0125 |
| Lloyd's plans or interinsurance exchanges, 1991 amendments to Insurance Code apply to | DM-0033 |
| Manufactured home, creditor may require purchaser of to purchase physical damage insurance policy but may not require consumer to purchase policy from particular vendor | DM-0117 |
| Mortgage insurance on new or rehabilitated hospital or long-term care facility, Texas Department of Health may conduct or commission study necessary for Secretary of Housing and Urban Development to issue | LO97-035 |
| Mortgage insurance, federal law requiring service annually to notify mortgagor of right to cancel is consistent with state law | JC-0045 |
| Municipality must use competitive bidding to purchase excess or surplus insurance coverage and to select "sole broker of record" | DM-0070 |
| Non-resident licensed property and casualty insurance agent may not solicit business in Texas except through local recording agent, prohibition includes solicitation of person located in state by mail or telephone | JM-1163 |
| Pesticide applicator license, determination of what exclusions from coverage are acceptable in bonds or insurance policies for requires determination of fact questions by Department of Agriculture | LO90-017 |
| Physician and health provider claims for payment, Department of Insurance may construe prompt payment provisions requiring preferred provider organizations and health maintenance organizations to disclose to physicians and other health care providers util | JC-0502 |
| Premiums paid on group health, accident, and life insurance policies by a single nonprofit trust established to provide coverage for employees of municipalities, counties or hospital districts, subsection 222.002(c)(5) of the Insurance Code excludes from the imposition of insurance premium taxes | GA-0739 |
| Property insurance - Use of civil asset forfeiture funds to purchase for property forfeited by State | KP-0200 |
| Reciprocal exchange insurers are exempt from article 21.49-2C of the Insurance Code, and therefore not subject to a moratorium issued by the Commissioner of Insurance | GA-0045 |
| Reciprocal insurance exchanges, such as Farmers Insurance Exchange and Fire Insurance Exchange, are not required to file withdrawal plans in order to withdraw from the homeowners' insurance market | GA-0045 |
| Refusal of reciprocal exchange insurers to renew policies of homeowners would not violate state law provided that the exchanges follow statutory notice procedure | GA-0045 |
| Substitution fee, insurance agent may not charge lender if lender sells mortgage and requests endorsement from agent reflecting change | LO92-076 |
| Texas coast, Department of Insurance may disclose identities of companies writing commercial insurance policies along | GA-0495 |
| Underwriting guidelines, confidentiality provisions for | LO94-061 |
| Automobile |
| Automated photographic system to enforce financial responsibility laws, county authority to use | KP-0076 |
| Forged proof of automobile liability insurance, whether person who produces in court may be prosecuted as third-degree felon under section 37.09(a) of the Penal Code | LO93-075 |
| Single interest policies, Automobile Theft Prevention Authority may not by rule exempt from statutory fee | JC-0166 |
| Texas Automobile Insurance Plan, rule vesting amendment power over in group of private insurers is unconstitutional delegation of legislative authority | DM-0135 |
| Health |
| Application of prompt payment provisions and deadline provisions in Insurance Code sections 843.338 and 1301.103 to out-of-network emergency care providers | KP-0250 |
| Article 21.52B, Texas Insurance Code ("Any Willing Pharmacy " statute), a court addressing the issue today would likely conclude that, is saved from preemption under the federal Employee Retirement Income Security Act of 1974 ("ERISA"), pursuant to the test set forth by the U.S. Supreme Court in Kentucky Ass'n Of Health Plans, Inc. v. Miller. | KP-0103 |
| Article 21.52B, Texas Insurance Code ("Any Willing Pharmacy" statute), until a court affirmatively concludes that, is saved from preemption, we cannot conclude as a matter of law that the statute is enforceable | KP-0103 |
| Balance billing, whether physicians who are not under contract with a health maintenance organization may bill HMO enrollee for unpaid balance and whether Department of Insurance may enforce provisions of Health Maintenance Organization Act against such p | GA-0040 |
| Benefits under policy, assignment of to health care provider does not waive deductible or copayments | DM-0215 |
| Business of insurance, benefit plan established by political subdivision is not engaged in | GA-0327 |
| Certain health benefit plans offered by employers, applicability of chapter 1501 of the Insurance Code to | GA-0640 |
| Chemical dependency benefits, duty to provide under certain group health insurance contracts | JM-1270 |
| Chiropractors, insurance company may not discriminate against services of in payment of claims (LO-90-008 was modified and was renumbered as LO-98-008A) | LO90-008 |
| Department of Insurance not authorized to impose additional penalties beyond legislative parameters | KP-0250 |
| Employee insurance records, subject to privacy constraints imposed by state and federal law an individual county commissioner is entitled to access | GA-0138 |
| Exclusive health provider contract, whether it violates state antitrust laws and insurance code | JC-0447 |
| Federal preemption of certain Texas Department of Insurance bulletins regarding health reimbursement arrangements | KP-0179 |
| Health insurance coverage, county may not pay $200 per month to employee who chooses to forego | LO92-085 |
| Health Insurance Portability and Accountability Act of 1996 Privacy Rule, whether Privacy Rule under HIPAA permits disclosure of medical insurance coverage information regarding a former commissioner and his wife is a question of fact and beyond the scope | GA-0138 |
| Health-maintenance organization, referral program in which enrollees receive services of single health-care service providers at a discount in exchange for fee is not | JM-1167 |
| Insurance and benefits coverage, municipality must maintain when a municipal fire fighter or police officer is called for military duty, but only on the terms in effect when the employee received the call which may include the employees' obligations to pa | GA-0174 |
| Insurance Code section 1301.057 - With regard to preferred benefit plans, before a contract with a preferred provider is terminated, an insurer must ensure that either itself or the entities with whom it contracts, which could include pharmacy benefit managers, comply with the notice and review process required under section 1301.057. | KP-0036 |
| Insurance Code section 843.306 - If a pharmacy benefit manager serves as a delegated entity of a health maintenance organization and thereby terminates contracts with pharmacy providers, the pharmacy benefit manager must comply with the notice and review requirements of section 843.306. | KP-0036 |
| Medical coverage provided by county to employees through single-employer, self-funded plan; subject to certain Insurance Code provisions but not to Federal Employee Retirement Income Security Act | DM-0276 |
| Medical Practice Act makes confidential patient-physician communications and records and limits their disclosure and subsequent redisclosure | GA-0138 |
| Nonprofit health corporations certified by Texas State Board of Medical Examiners, authority of Department of Insurance to examine | JC-0559 |
| Provision of health insurance benefits to surviving spouse of municipal fire fighter under Government Code section 615.073 | KP-0214 |
| Retired county employee's health insurance premiums, county may not pay if, at time person retired, the county did not provide for payment of such premiums; county may not seek reimbursement of unconstitutionally paid premiums | JC-0383 |
| Retired county employee, county may invite to participate in county's group health insurance program if retiree pay premiums under chapter 175 of Local Government Code | JC-0383 |
| Self-funded benefit plan is not insurance because it does not involve shifting of risk or loss | GA-0327 |
| Serious mental illness, group health plans that provides more than 60 outpatient visits for physical illnesses must provide the same number of outpatient visits for | GA-0674 |
| Submission of bill to third-party payer by licensed psychologist for test conducted by supervisee | KP-0198 |
| Texas Pharmacy Ass'n v. Prudential Insurance Co. of America, the current Fifth Circuit Court of Appeals decision in, holding that article 21.52B, Texas Insurance Code ("Any Willing Pharmacy" statute) is preempted under the federal Employee Retirement Income Security Act of 1974 ("ERISA"), still stands. | KP-0103 |
| The Texas Health and Human Services Commission does not operate under the Insurance Code. It is the state agency that administers the state's Medicaid program for individuals who cannot afford insurance. | GA-1089 |
| Provision by State and Political Subdivisions |
| Competitive bidding requirements, application to purchase of insurance by school district (Superseded by statute as noted in Tex. Att'y Gen. Op. No. DM-418 (1996)) | DM-0347 |
| Designated broker of record, whether junior college district may purchase insurance through | JC-0205 |
| Discretion to provide medical insurance for juvenile board, county commissioners have | GA-0715 |
| Eligibility for county medical insurance, juvenile board members | GA-0715 |
| Guaranty association for workers' compensation liabilities of certain self-insured political subdivisions and insurance pools, constitutionality of proposal | DM-0326 |
| Health insurance, county is not required to provide it to part-time constable | JC-0414 |
| Health wellness plan with increased insurance premium for tobacco users | KP-0187 |
| Immunizations required for children through age six, municipality may not charge deductible of covered children even if received from non-network provider | GA-0047 |
| Legal services coverage, university board of regents may include in employee benefits if federal law permits and if expenditure serves a public purpose | LO92-041 |
| Liability insurance for state officers and employees, scope of rider regarding and whether purchase constitutes waiver of sovereign immunity (Withdrawn by Letter 7/31/96) | DM-0346 |
| Liability insurance to cover tort claims arising from a college district’s operation of a child- care center, whether purchase would violate article III, section 52(a) of the Texas Constitution | GA-0830 |
| Medical coverage for district officers, authority of county to provide and phase out | DM-0337 |
| Medical coverage provided by county to employees through single-employer, self-funded plan; subject to certain Insurance Code provisions but not to Federal Employee Retirement Income Security Act | DM-0276 |
| Medical insurance benefits under county plan, whether county must provide to district judges whose jurisdiction is limited to county | LO95-056 |
| Mental health parity, applicability of Insurance Code provisions requiring municipal risk pool | GA-0047 |
| Open-enrollment charter school is an entity for which the state may enter into an agreement with the Social Security Administration | GA-0629 |
| Pool slide, to the extent a municipality that operates is subject to the Amusement Ride Safety Insurance and Inspection Act but must purchase insurance only in amounts sufficient to satisfy the municipality’s potential liability under the Tort Claims Act
| GA-0520 |
| Pregnancy as preexisting condition, applicability of Insurance Code provisions requiring to municipal risk pool | GA-0047 |
| Property insurance, state agencies not authorized to purchase without specific legislative authorization | DM-0197 |
| Property, casualty, or liability insurance; except for those otherwise excluded, state agencies subject to Labor Code chapter 501 must have State office of Risk Management approval to purchase for itself | GA-1061 |
| Provision of health insurance benefits to surviving spouse of municipal fire fighter under Government Code section 615.073 | KP-0214 |
| Retired employees receiving group health care coverage under Texas Public School Retired Employees Group Insurance plan who have returned to work, school district not participating in Texas Public School Employees Group Insurance plan required to provide | GA-0119 |
| Retired employees who have waived coverage under Texas Public School Retired Employees Group Insurance plan, school district not participating in Texas Public School Employees Group Insurance plan obliged to subsidize health care coverage of | GA-0119 |
| School district's purchase of, process; length of contract; aggregation; third-party administration | DM-0418 |
| Texas Windstorm Insurance Association, Legislature did not establish a legal obligation on behalf of the State to pay unfunded losses that cannot be paid by the | GA-1012 |
