CHAPTER 1254. NOTICE OF RATE INCREASE FOR GROUP HEALTH AND ACCIDENT COVERAGE - Texas Statutes

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.