Texas § 1271.251 APPROVAL OF FORMULA OR METHOD FOR COMPUTING SCHEDULE OF CHARGES.

Texas Statutes

§ 1271.251 — APPROVAL OF FORMULA OR METHOD FOR COMPUTING SCHEDULE OF CHARGES.

Texas § 1271.251

Code INInsurance Code

This text of Texas § 1271.251 (APPROVAL OF FORMULA OR METHOD FOR COMPUTING SCHEDULE OF CHARGES.) is published on Counsel Stack Legal Research, covering Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Tex. Insurance Code Code Ann. § 1271.251 (2026).

Text

Sec. 1271.251. APPROVAL OF FORMULA OR METHOD FOR COMPUTING SCHEDULE OF CHARGES.

(a)The formula or method for computing the schedule of charges for enrollee coverage for health care services must be filed with the commissioner before the formula or method is used in conjunction with a health care plan.

(b)The formula or method must be established in accordance with actuarial principles for the various categories of enrollees. The filing of the method or formula must contain:

(1)a statement by a qualified actuary that certifies that the formula or method is appropriate; and

(2)supporting information that the commissioner considers adequate.

(c)The formula or method must produce charges that are not excessive, inadequate, or unfairly discriminatory. Benefits must be reasonable with respe

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Sec. 1271.251. APPROVAL OF FORMULA OR METHOD FOR COMPUTING SCHEDULE OF CHARGES. (a) The formula or method for computing the schedule of charges for enrollee coverage for health care services must be filed with the commissioner before the formula or method is used in conjunction with a health care plan.
(b) The formula or method must be established in accordance with actuarial principles for the various categories of enrollees. The filing of the method or formula must contain:
(1) a statement by a qualified actuary that certifies that the formula or method is appropriate; and
(2) supporting information that the commissioner considers adequate.
(c) The formula or method must produce charges that are not excessive, inadequate, or unfairly discriminatory. Benefits must be reasonable with respect to the rates produced by the formula or method.