82R20428 PMO-F
By: Walle H.B. No. 2723
Substitute the following for H.B. No. 2723:
By: Walle C.S.H.B. No. 2723
A BILL TO BE ENTITLED
AN ACT
relating to notice of premium increase for certain health benefit
plans.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter F, Chapter 843, Insurance Code, is
amended by adding Section 843.2071 to read as follows:
Sec. 843.2071. NOTICE OF INCREASE IN CHARGE FOR COVERAGE.
(a) Not less than 60 days before the date on which an increase in a
charge for coverage under this chapter takes effect, a health
maintenance organization shall:
(1) give to each enrollee under an individual evidence
of coverage written notice of the effective date of the increase;
and
(2) provide the enrollee a table that clearly lists:
(A) the actual dollar amount of the charge for
coverage on the date of the notice;
(B) the actual dollar amount of the charge for
coverage after the charge increase; and
(C) the percentage change between the amounts
described by Paragraphs (A) and (B).
(b) The notice required by this section must be based on
coverage in effect on the date of the notice.
(c) This section may not be construed to prevent a health
maintenance organization, at the request of an enrollee, from
negotiating a change in benefits or rates after delivery of the
notice required by this section.
(d) A health maintenance organization may not require an
enrollee entitled to notice under this section to respond to the
health maintenance organization to renew the coverage or take other
action relating to the renewal or extension of the coverage before
the 45th day after the date the notice described by Subsection (a)
is given.
(e) The notice required by this section must include:
(1) contact information for the department, including
information concerning how to file a complaint with the department;
(2) contact information for the Texas Consumer Health
Assistance Program, including information concerning how to
request from the program consumer protection information or
assistance with filing a complaint; and
(3) the addresses of Internet websites that provide
consumer information related to rate increase justifications,
including the websites of the department and the United States
Department of Health and Human Services.
SECTION 2. Subchapter C, Chapter 1201, Insurance Code, is
amended by adding Section 1201.109 to read as follows:
Sec. 1201.109. NOTICE OF RATE INCREASE. (a) Not less than
60 days before the date on which a premium rate increase takes
effect on an individual accident and health insurance policy
delivered or issued for delivery in this state by an insurer, the
insurer shall:
(1) give written notice to the insured of the
effective date of the increase; and
(2) provide the insured a table that clearly lists:
(A) the actual dollar amount of the premium on
the date of the notice;
(B) the actual dollar amount of the premium after
the premium rate increase; and
(C) the percentage change between the amounts
described by Paragraphs (A) and (B).
(b) The notice required by this section must be based on
coverage in effect on the date of the notice.
(c) This section may not be construed to prevent an insurer,
at the request of an insured, from negotiating a change in benefits
or rates after delivery of the notice required by this section.
(d) An insurer may not require an insured entitled to notice
under this section to respond to the insurer to renew the policy or
take other action relating to the renewal or extension of the policy
before the 45th day after the date the notice described by
Subsection (a) is given.
(e) The notice required by this section must include:
(1) contact information for the department, including
information concerning how to file a complaint with the department;
(2) contact information for the Texas Consumer Health
Assistance Program, including information concerning how to
request from the program consumer protection information or
assistance with filing a complaint; and
(3) the addresses of Internet websites that provide
consumer information related to rate increase justifications,
including the websites of the department and the United States
Department of Health and Human Services.
SECTION 3. Subchapter E, Chapter 1501, Insurance Code, is
amended by adding Section 1501.216 to read as follows:
Sec. 1501.216. PREMIUM RATES: NOTICE OF INCREASE. (a) Not
less than 60 days before the date on which a premium rate increase
takes effect on a small employer health benefit plan delivered or
issued for delivery in this state by an insurer, the insurer shall:
(1) give written notice to the small employer of the
effective date of the increase; and
(2) provide the small employer a table that clearly
lists:
(A) the actual dollar amount of the premium on
the date of the notice;
(B) the actual dollar amount of the premium after
the premium rate increase; and
(C) the percentage change between the amounts
described by Paragraphs (A) and (B).
(b) The notice required by this section must be based on
coverage in effect on the date of the notice.
(c) This section may not be construed to prevent an insurer,
at the request of a small employer, from negotiating a change in
benefits or rates after delivery of the notice required by this
section.
(d) An insurer may not require a small employer entitled to
notice under this section to respond to the insurer to renew the
policy or take other action relating to the renewal or extension of
the policy before the 45th day after the date the notice described
by Subsection (a) is given.
(e) The notice required by this section must include:
(1) contact information for the department, including
information concerning how to file a complaint with the department;
(2) contact information for the Texas Consumer Health
Assistance Program, including information concerning how to
request from the program consumer protection information or
assistance with filing a complaint; and
(3) the addresses of Internet websites that provide
consumer information related to rate increase justifications,
including the websites of the department and the United States
Department of Health and Human Services.
SECTION 4. This Act applies to a health maintenance
organization individual evidence of coverage, an individual
accident and health insurance policy, or a small employer health
benefit plan that is delivered, issued for delivery, or renewed on
or after the effective date of this Act. An evidence of coverage,
policy, or plan delivered, issued for delivery, or renewed before
the effective date of this Act is governed by the law as it existed
immediately before the effective date of this Act, and that law is
continued in effect for that purpose.
SECTION 5. This Act takes effect September 1, 2011.