Sec. 1201.109. NOTICE OF RATE INCREASE FOR MAJOR MEDICAL EXPENSE INSURANCE POLICY. (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 that provides major medical expense coverage and that is 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.
(f) For purposes of this section, "major medical expense coverage" means an individual major medical expense insurance policy to which this chapter applies under Section 1201.003 that constitutes creditable coverage under Section 1205.004.
Added by Acts 2011, 82nd Leg., R.S., Ch. 1147 (H.B. 1951), Sec. 3.002, eff. September 1, 2011.
Amended by:
Acts 2013, 83rd Leg., R.S., Ch. 454 (S.B. 853), Sec. 1, eff. June 14, 2013.
Acts 2013, 83rd Leg., R.S., Ch. 454 (S.B. 853), Sec. 2, eff. June 14, 2013.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Subtitle A - Health Coverage in General
Chapter 1201 - Accident and Health Insurance
Subchapter C. General Policy Standards and Provisions
Section 1201.101. Standards for Policy Provisions
Section 1201.102. Prohibition of Policy Provisions
Section 1201.103. Compliance With Minimum Standards for Benefits
Section 1201.104. Minimum Standards for Benefits
Section 1201.106. Identification of Policies According to Coverage Provided
Section 1201.107. Outline of Coverage Required
Section 1201.108. Format and Content of Outline of Coverage
Section 1201.109. Notice of Rate Increase for Major Medical Expense Insurance Policy