CHAPTER 1254. NOTICE OF RATE INCREASE FOR GROUP HEALTH AND ACCIDENT COVERAGE
INSURANCE CODE
TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES
SUBTITLE B. GROUP HEALTH COVERAGE
CHAPTER 1254. NOTICE OF RATE INCREASE FOR GROUP HEALTH AND
ACCIDENT COVERAGE
Sec. 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.