(a) Not later than March 1 of each year, an insurer shall file with the commissioner a report relating to the preferred provider benefit plan offered under this chapter and covering the preceding calendar year.
(b) The report shall:
(1) be verified by at least two principal officers;
(2) be in a form prescribed by the commissioner; and
(3) include:
(A) a financial statement of the insurer, including its balance sheet and receipts and disbursements for the preceding calendar year, certified by an independent public accountant;
(B) the number of individuals enrolled during the preceding calendar year, the number of enrollees as of the end of that year, and the number of enrollments terminated during that year; and
(C) a statement of:
(i) an evaluation of enrollee satisfaction;
(ii) an evaluation of quality of care;
(iii) coverage areas;
(iv) accreditation status;
(v) premium costs;
(vi) plan costs;
(vii) premium increases;
(viii) the range of benefits provided;
(ix) copayments and deductibles;
(x) the accuracy and speed of claims payment by the insurer for the plan;
(xi) the credentials of physicians who are preferred providers;
(xii) the number of preferred providers;
(xiii) any waiver requests made and waivers of network adequacy standards granted under § 1301.00565;
(xiv) any material deviation from network adequacy standards reported to the department under § 1301.0055; and
(xv) any corrective actions, sanctions, or penalties assessed against the insurer by the department for deficiencies related to the preferred provider benefit plan.

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Terms Used In Texas Insurance Code 1301.009


(c) The annual report filed by the insurer shall be made publicly available on the department’s website in a user-friendly format that allows consumers to make direct comparisons of the financial and other data reported by insurers under this section.
(d) An insurer providing group coverage of $10 million or less in premiums or individual coverage of $2 million or less in premiums is not required to report the data required under Subsection (b)(3)(C).