Sec. 1352.005. NOTICE TO INSUREDS AND ENROLLEES. (a) A health benefit plan issuer subject to this chapter, other than a small employer health benefit plan issuer, must annually notify each insured or enrollee under the plan in writing about the coverages described by Section 1352.003.
(b) The commissioner shall prescribe by rule the specific contents and wording of the notice required under this section.
(c) The notice required under this section must include:
(1) a description of the benefits listed under Section 1352.003;
(2) a statement that the fact that an acquired brain injury does not result in hospitalization or receipt of a specific treatment or service described by Section 1352.003 for acute care treatment does not affect the right of the insured or enrollee to receive benefits described by Section 1352.003 commensurate with the condition of the insured or enrollee; and
(3) a statement of the fact that benefits described by Section 1352.003 may be provided in a facility listed in Section 1352.007.
Added by Acts 2007, 80th Leg., R.S., Ch. 877 (H.B. 1919), Sec. 5, eff. September 1, 2007.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 837 (S.B. 200), Sec. 3.39, eff. January 1, 2016.
Acts 2015, 84th Leg., R.S., Ch. 946 (S.B. 277), Sec. 2.36, eff. January 1, 2016.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Subtitle E - Benefits Payable Under Health Coverages
Section 1352.001. Applicability of Chapter
Section 1352.002. Exception; Application to Qualified Health Plan
Section 1352.0035. Required Coverages--Small Employer Health Benefit Plans
Section 1352.004. Training for Certain Personnel Required
Section 1352.005. Notice to Insureds and Enrollees
Section 1352.006. Determination of Medical Necessity; Extension of Coverage