Form LHL715 Provider Network Contracting Entity Registration or Exemption of Affiliates Form - Texas

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Form LHL715 Provider Network Contracting Entity Registration or Exemption of Affiliates Form - Texas

What Is Form LHL715?

This is a legal form that was released by the Texas Department of Insurance - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the LHL715 form for?A: The LHL715 form is for provider network contracting entity registration or exemption of affiliates in Texas.

Q: Who is required to fill out the LHL715 form?A: Provider network contracting entities in Texas are required to fill out the LHL715 form.

Q: What information is required on the LHL715 form?A: The LHL715 form requires information about the provider network contracting entity and its affiliates.

Q: Is there a fee to submit the LHL715 form?A: Yes, there is a fee associated with submitting the LHL715 form.

Q: What is the purpose of the affiliation information on the LHL715 form?A: The affiliation information on the LHL715 form is used to determine whether the affiliates of the provider network contracting entity are exempt from registration.

Q: Are all affiliates of a provider network contracting entity required to be registered?A: Not all affiliates of a provider network contracting entity are required to be registered. Some affiliates may be exempt from registration.

Q: How often do provider network contracting entities need to update their affiliation information?A: Provider network contracting entities are required to update their affiliation information annually.

Q: What happens if a provider network contracting entity fails to submit the LHL715 form?A: If a provider network contracting entity fails to submit the LHL715 form, they may be subject to penalties and other enforcement actions by the Texas Department of Insurance.

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Form Details:

  • Released on May 1, 2022;
  • The latest edition provided by the Texas Department of Insurance;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form LHL715 by clicking the link below or browse more documents and templates provided by the Texas Department of Insurance.

Download Form LHL715 Provider Network Contracting Entity Registration or Exemption of Affiliates Form - Texas

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