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Texas Department of Insurance
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Mandated health benefits

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Fully insured major medical plans – individual and small employer plans, large employer plans, and consumer choice plans – issued in Texas must include certain mandated benefits.

The mandated benefits chart (PDF) lists the mandates and the Texas laws that requires them.

Mandated benefits apply to health benefit plans issued in Texas, and carriers issuing plans under the Affordable Care Act (ACA) need to consider the impact of federal law on those plans.

Learn about the essential health benefits (PDF) required for the benchmark plan for ACA coverage in Texas.

For more information, contact: LifeHealth@tdi.texas.gov

Last updated: 3/6/2024