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Texas Insurance Department Issues Bulletin to TPAs and Agents

The Texas Insurance Department (TDI) recently issued Commissioners’ Bulletin No. B-0007-19 (the “Bulletin”) to Third Party Administrators (“TPAs”) and agents licensed in Texas. Specifically, the Bulletin is a reminder to TPAs and agents that their licenses are potentially at risk if they assist a company engaged in the unauthorized business of insurance in Texas under Texas Insurance Code Chapter 101.

The TDI noted that new types of health insurance-like products are being sold to Texas consumers by unlicensed and unauthorized companies. For example, the Bulletin noted that companies may claim to be exempt from licensing requirements as a healthcare sharing ministry or other innovative business without complying with the requirements of the claimed exemption.

The Bulletin states that any “person who in any manner assists directly or indirectly in the procurement of an unauthorized insurance contract can be held strictly liable to the insured for the full amount of a claim or loss … if the unauthorized insurer fails to pay the claim or loss.”

Additionally, the TDI cautions that it may bring an action against an agent or TPA who assists the unauthorized company; even if the agent or TPA did not know the company was unauthorized. Such actions by the TDI against a TPA or agent for assisting an unauthorized company includes civil penalties up to $10,000 for each act of violation and for each day of violation. Further, the TDI may also suspend or revoke the agent or TPA’s license for engaging in the unauthorized business of insurance.

© Polsinelli PC, Polsinelli LLP in CaliforniaNational Law Review, Volume IX, Number 267

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About this Author

Jonathan Kyle  Lowder Associate Kansas City Insurance Business and Regulatory Law
Associate

Jonathan (Kyle) Lowder has devoted his career to assisting a wide range of insurers and related entities efficiently manage the regulatory system in pursuit of their goals. He relies on a broad experience base, built from several years’ experience with matters arising throughout the insurance business life cycle, to form a comprehensive view of each issue and develop long term solutions for clients. 

Kyle represents both traditional and nontraditional insurers, re-insurers, third-party administrators, producers, adjusters, and other insurance regulated entities. He guides clients on...

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Steven L. Imber, Polsinelli PC, Insurance Regulatory Attorney, Enforcement Actions Lawyer,
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Steve Imber chairs Polsinelli's Insurance Business and Regulatory group.  As a former General Counsel at a state insurance department, Steve Imber has the knowledge and experience to provide quality counsel to insurers, third party administrators, insurance agencies, medical discount plans and other insurance regulated entities. His practice includes representing and assisting clients on multi-state and national licensing projects, research projects, enforcement actions, market conduct examinations, audits and compliance programs and various other regulatory and compliance matters.

913.234.7469
Shareholder

Justin Liby has a talent for organizing and managing large national and multi-state licensure and research projects. This knack provides him with a solid foundation for crafting and implementing sound, efficient strategies that achieve success for his clients. Justin concentrates his efforts on helping the insurance industry navigate the formidable federal and state regulatory maze to achieve the industry’s business needs. He stays current in the insurance industry's evolution, as well as the legislation and regulatory activity impacting the industry.

...
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Counsel

Jennifer Osborn Nix works diligently for insurance companies, third-party administrators, and other regulated entities to further their goals and help them remain compliant within the 50-state regulatory scheme. She focuses on insurance regulatory and compliance issues, with a primary emphasis on life and health insurance matters.

Jennifer works with many regulated entities, including many in the health care sector, who rely on her for research, advice, strategic counsel, and licensing.

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