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Amend Amendment No. 25 by Rose to CSHB 4 (beginning on page
565, amendment packet), on page 8 of the amendment, between lines 10
and 11, by inserting the following:
Art. 5.166. FILING OF RATE INFORMATION WITH DEPARTMENT;
REPORT TO LEGISLATURE
Sec. 1. PURPOSE. The purpose of this article is to require
insurers writing professional liability insurance for physicians
and health care providers in this state to annually file with the
commissioner of insurance rates and supporting data, including
current rates and estimated rates to be charged in the year
following the filing date for the purpose of the preparation of a
summary report for submission to each legislature and the
determination by the commissioner of equitable rate reductions
under Article 5.163 of this code. Information submitted under this
article must be sufficient for the commissioner to determine the
extent of equitable rate reductions under Article 5.163 of this
code. The commissioner's report shall contain a review of the
rates, presented in a manner that protects the identity of
individual insurers:
(1) to inform the legislature as to whether the rates
are just, adequate, and reasonable and not excessive or unfairly
discriminatory; and
(2) to assist in the determination of the most
effective and efficient regulatory system for professional
liability insurance for physicians and health care providers in
Texas.
Sec. 2. DEFINITIONS. In this article:
(1) "Insurer" means an insurer described by Article
5.162 of this code.
(2) "Supplementary rating information" means any
manual, rating schedule, plan of rules, rating rules,
classification systems, territory codes and descriptions, rating
plans, and other similar information used by the insurer to
determine the applicable premium for an insured. The term includes
factors and relativities, such as increased limits factors,
classification relativities, deductible relativities, premium
discount, and other similar factors and rating plans such as
experience, schedule, and retrospective rating.
(3) "Security" or "securities" has the meaning
assigned by Section 4, The Securities Act (Article 581-4, Vernon's
Texas Civil Statutes).
Sec. 3. RATE INFORMATION. (a) Insurers must file rates for
professional liability insurance for physicians and health care
providers and supporting information with the commissioner in
accordance with the requirements determined by the commissioner
under this article.
(b) Filings made by each insurer must be sufficient to
respond to the commissioner's request for information under this
article and must provide both current rates and estimated rates for
the year following the required filing date of this article based on
information reasonably known to the insurer at the time of filing.
(c) The insurer shall file, in a format specified by the
commissioner, including an electronic format:
(1) all rates for professional liability insurance for
physicians and health care providers, supplementary rating
information, underwriting guidelines, reasonable and pertinent
supporting information for risks written in the state, and all
applicable rating manuals;
(2) actuarial support, including all statistics,
data, or other information to support the rates, supplementary
rating information, and underwriting guidelines used by the
insurer;
(3) the policy fees, service fees, and other fees that
are charged under Article 21.35B of this code;
(4) information on the insurer's losses from
investments in securities, whether publicly or privately traded,
including investments in the securities of companies required by
any oversight agency to restate earnings within the 24 months
preceding the filing date, possessed and used by the insurer to
determine premiums or underwriting for professional liability
insurance for physicians and health care providers, as this
information relates to the rates described by Section 1 of this
article;
(5) information on the insurer's costs of reinsurance
possessed and used by the insurer to determine premiums or
underwriting for professional liability insurance for physicians
and health care providers, as this information relates to the rates
described by Section 1 of this article;
(6) a complete explanation, and an electronic copy, of
all computer models used by the insurer not protected by a contract
with a third party; and
(7) a complete explanation of any changes to
underwriting guidelines, rates, and supplementary rating
information since the last filing under this article.
(d) The commissioner shall determine the date on which the
filing is due.
(e) The commissioner may require additional information as
provided by Section 4 of this article.
(f) The commissioner shall issue an order specifying the
information that insurers must file to comply with this article and
the date on which the filing is due.
(g) The commissioner is not required to hold a hearing
before issuing the order required under Subsection (f) of this
section.
(h) The commissioner shall notify an affected insurer of the
order requiring the rate filing information under this section on
the day the order is issued.
Sec. 4. ADDITIONAL INFORMATION. After the initial rate
submission under Section 3 of this article, the commissioner may
require an insurer to provide additional, reasonable information
for purposes of the clarification or completeness of the initial
rate submission.
Sec. 5. USE OF FILED RATE INFORMATION. (a) Information
filed by an insurer with the department under this article that is
confidential under a law that applied to the insurer before the
effective date of this article remains confidential and is not
subject to disclosure under Chapter 552, Government Code, except
that the information may be disclosed as provided by Section
552.008, Government Code, relating to information for legislative
purposes. Information disclosed pursuant to Section 552.008,
Government Code, shall be provided in a commonly used electronic
format, including in spreadsheet or comma-delimited format, if so
requested. The information may not be released to the public except
in summary form in the report required under Section 6 of this
article.
(b) Subsection (a) of this section does not preclude the use
of information filed under this article as evidence in prosecuting
a violation of this code. Confidential information described by
Subsection (a) of this section that is used in prosecuting a
violation is subject to a protective order until all appeals of the
case have been exhausted. If an insurer is found, after the
exhaustion of all appeals, to have violated this code, a copy of the
confidential information used as evidence of the violation is no
longer presumed to be confidential.
Sec. 6. REPORT. (a) The commissioner shall, on a date
determined by the commissioner, submit a report to the governor,
the lieutenant governor, the speaker of the house of
representatives, and the members of the legislature on the
information collected from the filings required under this article.
The report may be created based on a sample of the information
provided under Section 3 of this article.
(b) The report required under this section shall provide a
summary review of the rates currently charged and estimated to be
charged over the year following the date of the report, presented in
a manner that protects the identity of individual insurers:
(1) to inform the legislature as to whether the rates
are just, adequate, and reasonable and not excessive or unfairly
discriminatory; and
(2) to assist the legislature in the determination of
the most effective and efficient regulatory system for professional
liability insurance for physicians and health care providers in
this state.
Sec. 7. NOTIFICATION; NONCOMPLIANCE. The commissioner
shall notify the governor, the lieutenant governor, the speaker of
the house of representatives, and the members of the legislature of
the names of the insurers whom the commissioner requested to make
the rate filings under this article and the names of the insurers
who did not respond in whole or in part to the commissioner's
request. This notification shall be made by separate letter on the
fourth day following the date on which the commissioner determines
the filing is due under Section 3(f) of this article.
Sec. 8. APPLICATION OF CERTAIN LAW. Chapter 40 of this code
does not apply to an action of the commissioner under Section 3(f)
of this article.
Sec. 9. FAILURE TO COMPLY. An insurer that fails to comply
with any request for information issued by the commissioner under
this article is subject, after notice and opportunity for hearing,
to sanctions as provided by Chapters 82 and 84 of this code.