Insurance Code § 4151.117

Sec. 4151.117. COMPENSATION OF ADMINISTRATOR. (a) An administrator's compensation may be determined: (1) as a percentage of the premiums or charges the administrator collects or the amount of claims the administrator pays or processes; or (2) except as provided by Subsection (b), on another basis as specified in the written agreement. (b) An insurer or plan sponsor may not permit or provide compensation or another thing of value to an administrator that is based on the savings accruing to the insurer or plan sponsor because of adverse determinations regarding claims for benefits, reductions of or limitations on benefits, or other analogous actions inconsistent with this chapter, that are made or taken by the administrator. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 7, eff. April 1, 2005. Amended by: Acts 2007, 80th Leg., R.S., Ch. 1176 (H.B. 472), Sec. 1.15, eff. September 1, 2007. SUBCHAPTER D. PHARMACY BENEFIT PLANS