Reporting period – January 1, 2023, to December 31, 2023
Report due date – May 1, 2024
This page contains the following sections:
Background Information
Each year, TDI collects health care reimbursement rate information under Insurance Code Chapter 38, Subchapter H. This subchapter requires the department to collect health benefit plan reimbursement rate information in a uniform format. This data call applies to issuers of preferred provider benefit plans, exclusive provider plans, health maintenance organization plans, and specified governmental employee plans under Insurance Code Chapters 1551, 1575, 1579, and 1601. The rules that implement this statute are in 28 TAC, Chapter 21, Subchapter KK.
The data call applies to health benefit plan issuers with at least 20,000 covered lives in comprehensive health coverage as reported on Part 1 of the National Association of Insurance Commissioners Supplemental Health Care Exhibit as of the end of 2023.
Only issuers who meet this requirement are required to submit reimbursement rate data. More information on applicability
Instructions and Data Template
IMPORTANT NOTICE:
Please make sure that you are using version 8.0 of the reporting form by checking the version number in the ‘Introduction’ worksheet of the reporting template. Do not submit data on previous versions of the form.
Instructions and Data Template Documents