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Commissioner’s Bulletin # B-0005-18

March 30, 2018


To: All Insurers Licensed to Write Accident and Health Insurance in Texas, All Basic Service Health Maintenance Organizations, and All Other Related Entities, Including Certain Third-Party Administrators


Re: 2017 Mandated Benefits Data Call Relating to Data Collection under Texas Administrative Code, Title 28, §§21.3401 – 21.3409

Reporting Period: January 1, 2017, to December 31, 2017 

Under 28 TAC, Chapter 21, Subchapter Z, certain health benefit plan issuers and health maintenance organizations must annually submit data to TDI relating to mandated health benefits and mandated offers of coverage. Data for the reporting period specified in this data call is due on June 1, 2018.

Be aware that amendments to Subchapter Z adopted in June 2017 are applicable to this data call. Under the amendments, the reporting period has changed from previous years. Instead of calling for data from October to September, the rules require submission of data for the past calendar year. Because of this change to the reporting period, issuers should not include data from October 1, 2016, through December 31, 2016, in their response to the data call. Instead, only data for the calendar year of 2017 is required.

Applicability 

This data call applies to health benefit plan issuers described in Insurance Code §38.251, if they report to the National Association of Insurance Commissioners a total of $10 million or more in direct premiums earned in Texas in 2017 for the following types of coverage:

  • Individual comprehensive health coverage,
  • Small group comprehensive health coverage, or
  • Large group comprehensive health coverage.

Only issuers who meet these applicability requirements must submit data relating to mandated health benefits and mandated offers of coverage.

Submission Requirements 

Respondents must complete the 2017 Mandated Benefits Data Call using interactive PDF form LAH345 located at www.tdi.texas.gov/health/mbindex.html. This link contains instructions, code lists, and other information pertaining to the data call. Submissions are due to TDI by June 1, 2018.

For more information contact: MBSurvey@tdi.texas.gov.


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Last updated: 7/16/2018