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§ 124.6. Electronic Transfer Payments Made Through an Access Card

(a) Access card. In this chapter, access card means any card or other payment method that may be used by a claimant to initiate an electric fund transfer from an insurance carrier’s bank account. The term “access card” does not include stored value cards or prepaid cards that store funds directly on the card and that are not linked to an insurance carrier’s bank account.

(b) Mutual agreement. An insurance carrier may pay income or death benefits through an access card to a claimant if there is written mutual agreement signed by the insurance carrier and the claimant. The insurance carrier shall maintain accurate records of the mutual agreement for, at a minimum, 401 weeks from the date of injury. The written mutual agreement shall contain an acknowledgement that the claimant received and agreed to the written disclosure in subsection (f) of this section.

(c) Agent of the insurance carrier. Any person with whom an insurance carrier utilizes or contracts for the purpose of providing service or fulfilling duties under this section is an agent of the insurance carrier under §180.1(3) of this title (relating to Definitions).

(d) Requirements and prohibited fees. An insurance carrier shall:

(1) permit the claimant to withdraw the entire amount of the balance of an access card in one transaction;

(2) not reduce income or death benefits paid to a claimant through an access card for the following fees, surcharges, and adjustments:

(A) overdraft services under which a financial institution pays a transaction (including a check or other item) when the claimant has insufficient or unavailable funds in the account;

(B) ATM withdrawal or a point of sale purchase for more than the card holds and the transaction is denied;

(C) ATM balance inquiries;

(D) withdrawing money from network ATMs;

(E) withdrawing money from a teller;

(F) customer service calls;

(G) activating the card;

(H) fees for card inactivity;

(I) closing account;

(J) access card replacement through standard mail;

(K) withdrawing the entire payment in one transaction;

(L) point of sale purchases; or

(M) any other fees or charges that are not authorized under subsection (e) of this section.

(e) Permitted fees. The claimant may be charged for the following:

(1) access card replacement through an expedited mail service;

(2) international transaction fees; and

(3) out-of-network ATM fees.

(f) Required disclosure. Insurance carriers shall provide a written disclosure to the claimant contemporaneously with the written mutual agreement under subsection (a) of this section. The written disclosure shall include:

(1) a summary of the claimant’s liability for unauthorized electronic fund transfers;

(2) the telephone number and address of the person or office to be notified when the claimant believes that an unauthorized electronic fund transfer has been or may be made;

(3) the type of electronic fund transfers that the claimant may make and any limitations on the frequency of transfers;

(4) any fees imposed for electronic fund transfers or for the right to make transfers including a statement that fees may be imposed by ATM operator that is out-of-network;

(5) fees for expedited card replacement or international transaction fees will be removed from the balance maintained in the bank account linked to the access card;

(6) a summary of the claimant’s right to receipts and periodic statements;

(7) all bank locations and network ATMs in the United States where the claimant may access his or her funds at no cost;

(8) a statement informing the claimant that they have a right to receive payments directly into their personal bank account through direct deposit.

(g) Plain language requirement. An insurance carrier shall provide a written disclosure and notice of term or condition changes under this section that:

(1) are printed in not less than 12-point font;

(2) include the full text in English, Spanish, and any other language common to the claimant population;

(3) are written in a clear and coherent manner and wherever practical, words with common and everyday meaning shall be used to facilitate readability; and

(4) are appropriately divided and captioned in a meaningful sequence such that each section contains an underlined, boldfaced, or otherwise conspicuous title or caption at the beginning of the section that indicates the nature of the subject matter included in or covered by the section.

(h) Access card information. An access card issued to the claimant under the section:

(1) shall not bear any information that could reasonably identify the claimant as a participant in the workers’ compensation system.

(2) shall include on the front or back of the access card a toll-free customer service number and website address. Customer service personnel shall be available by phone Monday through Friday, during normal business hours as outlined in §102.3 of this title (relating to Computation of Time).

(i) Written notice of term or condition changes. The insurance carrier shall provide a written notice to the claimant at least 21 days before the effective date of any change in a term or condition of the mutual agreement or disclosure, including terminating the access card program, increased fees, or liability for unauthorized electronic fund transfers. Any terms or conditions that violate the requirements of this section are null and void and may result in administrative penalties for the insurance carrier. An insurance carrier shall provide a written notice of term or condition changes that:

(1) provides a comparison of the current terms and the changes; and

(2) references the claimant’s ability to request a change in payment outlined in §124.5(i) of this title (relating to Mode of Payment Made by Carriers).

(j) Account closure. An insurance carrier may close the account by issuing a check to the claimant with the remaining balance of the access card if the account has been inactive for 12 months or longer.

(k) Recoupment of payment. The insurance carrier shall not remove money from the claimant’s account or access card except to remove permitted fees under subsection (e) of this section or to close the account for inactivity of a period of 12 months or more. An insurance carrier seeking to recoup overpayments shall follow the procedures outlined in §126.16 of this title (relating to Procedures for Recouping Overpayments of Income Benefits).

(l) Paid date. An insurance carrier is considered to have made an income or death benefit payment the date the payment is available on the claimant’s access card.

(m) No granting of rights. Nothing in the section shall be construed to grant any rights otherwise prohibited under federal law.

(n) Effective date. This section is effective for income or death benefit payments due on or after June 1, 2015.

The provisions of this §124.6 adopted to be effective June 1, 2015, 40 TexReg 332.

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At a Glance:

Title:

§ 124.6. Electronic Transfer Payments Made Through an Access Card

Title:

Title 28. Insurance

Status:

Current

Usage:

New Law Rule

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