10817
This form is used for transmittal checklist for Health Care Collaborative (HCC) filings in Texas.
This form is used for changing the name of an administrator (TPA) in Texas.
This form is used for providing payor information in the Health Care Collaborative program in Texas.
This form is used for acknowledging the indemnity agreement for group self-insurance coverage of Workers' Compensation Insurance in Texas.
This form is used for applying for authority to offer continuing care in residence services in Texas under Health and Safety Code Section 246.0025(B).
This document is used for obtaining a biographical certificate for a captive management company in the state of Texas.
This form is used for filing the annual report for insurers and HMOs operating in the state of Texas. It provides information about the financial health and operations of these companies.
This document is a form used for the officers and directors page of the Health Care Collaborative in Texas. It is used to gather information about the individuals serving in leadership roles within the organization.
This Form is used for notifying the Texas Workers' Compensation Self-insurance Group (SIG) about workers' compensation self-insurance.
This form is used for the acknowledgement of mandatory training in the state of Texas.
This form is used for updating the information of Continuing Education (CE) providers in Texas. It is used to provide the latest details and information related to CE providers in the state.
This form is used for registering a captive management company in Texas.
This form is used for small employers in Texas to certify their status as a carrier.
This form is used for large employers in Texas to certify their carrier status.
This form is used for the actuarial certification of annual small employer health benefit plans in Texas. It is specifically for Figure 47 of the certification process.