Law:Title 8. Health Insurance And Other Health Coverages. Subtitle B. Group Health Coverage from Chapter 1254. Notice Of Rate Increase For Group Health And Accident Coverage (Texas)

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Subtitle B. Group Health Coverage

Chapter 1254. Notice Of Rate Increase For Group Health And Accident Coverage

Section  1254.001.  Notice Of Rate Increase.

(a) In this section, "insurer" means:

(1)  a life insurance company;

(2)  a health insurance company;

(3)  an accident insurance company;

(4)  a general casualty company;

(5)  a mutual life insurance company or other mutual insurance company;

(6)  a mutual or natural premium life insurance company;

(7)  a Lloyd's plan;

(8)  a reciprocal or interinsurance exchange;

(9)  a fraternal benefit society;

(10)  a local mutual aid association; or

(11)  a group hospital service corporation.

(b)  Not less than 60 days before the date on which a premium rate increase takes effect on a group policy of health insurance, accident and health insurance, or life, health, and accident insurance delivered or issued for delivery in this state by an insurer, the insurer shall give written notice to the policyholder of:

(1)  the amount of the increase; and

(2)  the date on which the increase is to take effect.

(c)  A health maintenance organization shall give notice of an increase in subscriber charges and service fees under a group contract or coverage in the same manner as is required of an insurer under Subsection (b).

(d)  An insurer that issues a group policy described by Subsection (b) to a multiple employer trust shall give the notice required by that subsection to the trustee or group policyholder.

(e)  The notice required by this section must be based on coverage in effect on the date of the notice.

(f)  This section may not be construed to prevent an insurer or health maintenance organization, at the request of a policyholder or contract holder, from negotiating a change in benefits or rates after delivery of the notice required by this section.

(g)  An insurer may not require a policyholder or trustee 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 (b) is given.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.

Amended by:

Acts 2005, 79th Leg., Ch. 728, Sec. 11.031(a), eff. September 1, 2005.


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