By: Cook, et al. S.B. No. 1307
A BILL TO BE ENTITLED
AN ACT
relating to a biennial health coverage reference guide developed by
the Texas Department of Insurance.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle B, Title 5, Insurance Code, is amended
by adding Chapter 524A to read as follows:
CHAPTER 524A. PUBLIC EDUCATION ON HEALTH COVERAGE
Sec. 524A.001. BIENNIAL HEALTH COVERAGE REFERENCE GUIDE.
(a) The department shall consult with the Health and Human Services
Commission to develop a biennial reference guide designed to
educate the public about health coverage in this state.
(b) The reference guide must include the following
information:
(1) the biennial period covered by the current
edition;
(2) definitions of the term "health insurance" and
terms used to describe other forms of health coverage;
(3) sources from which consumers may obtain health
coverage, including through employers, and an explanation of how
coverage may be obtained from each of those sources;
(4) a guide to consumer rights and resources related
to health coverage;
(5) a health coverage shopping guide that includes:
(A) an explanation of discount cards and other
noninsurance health coverage products and a comparison of those
products to health insurance;
(B) an explanation and comparison of common types
of short-term or disease-specific health coverage;
(C) an explanation and comparison of preferred
provider benefit plans, exclusive provider benefit plans, health
maintenance organizations, and point-of-service plans;
(D) an explanation of provider networks and the
differences between in-network providers and out-of-network
providers;
(E) an explanation of the Affordable Care Act
marketplace plan categories of bronze, silver, gold, and platinum;
(F) an explanation of the out-of-pocket costs of
health coverage, including premiums, deductibles, copayments, and
coinsurance; and
(G) information on how to recognize health
coverage scams;
(6) an explanation of the effect of the Consolidated
Omnibus Budget Reconciliation Act of 1985 (Pub. L. No. 99-272) on
consumers' health coverage;
(7) a basic overview of federal, state, and local
programs that may assist consumers to obtain health care services;
(8) methods for a consumer to resolve disputes with a
health coverage issuer or administrator;
(9) methods to seek assistance from the department for
a complaint regarding a health coverage plan or product; and
(10) the areas of health coverage regulated by the
department and those regulated by federal law, including the
Employee Retirement Income Security Act of 1974 (29 U.S.C. Section
1001 et seq.).
(c) The department shall publish the reference guide
developed under this section on the department's Internet website
and in a printed form available to the public on request.
SECTION 2. The Texas Department of Insurance shall publish
the first biennial reference guide under Section 524A.001,
Insurance Code, as added by this Act, not later than January 1,
2026.
SECTION 3. This Act takes effect September 1, 2025.