This version of the form is not currently in use and is provided for reference only. Download this version of Form LHL715 for the current year.
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.
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.
Form Details:
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.