CHAPTER 258. HEALTH MAINTENANCE ORGANIZATIONS - Texas Statutes

INSURANCE CODE

TITLE 3. DEPARTMENT FUNDS, FEES, AND TAXES

SUBTITLE C. INSURANCE MAINTENANCE TAXES

CHAPTER 258. HEALTH MAINTENANCE ORGANIZATIONS

Sec. 258.001. APPLICABILITY OF CERTAIN DEFINITIONS. In this

chapter, a term defined by Section 843.002 has the meaning

assigned by that section.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 1, eff. April 1,

2005.

Sec. 258.002. MAINTENANCE TAX IMPOSED. A per capita maintenance

tax is imposed on each authorized health maintenance organization

with gross revenues subject to taxation under Section 258.004.

The tax required by this chapter is in addition to other taxes

imposed that are not in conflict with this chapter.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 1, eff. April 1,

2005.

Sec. 258.003. MAXIMUM RATE; ANNUAL ADJUSTMENT. (a) The rate of

assessment set by the commissioner may not exceed $2 per

enrollee.

(b) The commissioner shall annually adjust the rate of

assessment of the per capita maintenance tax so that the tax

imposed that year, together with any unexpended funds produced by

the tax, produces the amount the commissioner determines is

necessary to pay the expenses during the succeeding year of

regulating health maintenance organizations.

(c) The rate of assessment may differ between basic health care

plans, limited health care service plans, and single health care

service plans and must equitably reflect any differences in

regulatory resources attributable to each type of plan.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 1, eff. April 1,

2005.

Sec. 258.004. REVENUES SUBJECT TO TAXATION; LIMIT. (a) A

health maintenance organization shall pay per capita maintenance

taxes under this chapter on the correctly reported gross revenues

collected from issuing health maintenance certificates or

contracts in this state.

(b) The amount of maintenance tax assessed may not be computed

based on:

(1) enrollees who as individual certificate holders or their

dependents are covered by a master group policy paid for by

revenues received from the United States for insurance contracted

for by the United States in accordance with or in furtherance of

Title XVIII of the Social Security Act (42 U.S.C. Section 1395c

et seq.) and its subsequent amendments; or

(2) revenues paid on group health, accident, and life

certificates or contracts in which the group covered by the

certificate or contract consists of a single nonprofit trust

established to provide coverage primarily for employees of:

(A) a municipality, county, or hospital district in this state;

or

(B) a county or municipal hospital, without regard to whether

the employees are employees of the county or municipality or of

an entity operating the hospital on behalf of the county or

municipality.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 1, eff. April 1,

2005.

Amended by:

Acts 2005, 79th Leg., Ch.

728, Sec. 11.007(a), eff. September 1, 2005.

Sec. 258.005. MAINTENANCE TAX DUE DATES. (a) The health

maintenance organization shall pay the maintenance tax annually

or semiannually.

(b) The comptroller may require semiannual or other periodic

payment only from a health maintenance organization whose

maintenance tax liability under this chapter for the previous

year was at least $2,000.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 1, eff. April 1,

2005.