The Texas Department of Insurance is writing rules and creating the consumer disclosure form required by Senate Bill 1852, which passed during the 2019 legislative session.
Although rules implementing this legislation and the disclosure form are not finalized, TDI strongly encourages carriers to include similar disclosure information as soon as possible—particularly for policies being marketed and sold to consumers who may be looking for alternative coverage during the HealthCare.gov open enrollment.
Information required in the disclosure includes:
- The length of time the policy will provide coverage.
- A statement explaining:
- The number of times the policy can be renewed or if it cannot be renewed.
- That expiration of the policy is not a qualifying life event that would make a person eligible for a special enrollment period.
- The policy may expire outside of the open enrollment period.
- The dates of the next three open enrollment periods, if available.
- Any limitations or exclusions to preexisting conditions.
- The maximum amount payable under the policy.
- Deductible amounts under the policy, and for the health care services to which the deductibles apply.
- Whether the following health care services are covered:
- Prescription drugs
- Mental health services
- Substance abuse treatment
- Maternity care
- Hospitalization
- Surgery
- Emergency health care
- Preventive health care.
SB 1852 also requires that:
- The disclosure information be in a font that is easy to read and at least 14-point in size.
- The consumer applying for the policy signs a form acknowledging receipt of this information if the policy will begin on or after January 1, 2020.