Registrations
Registration of Provider Network Contracting Entities (PNCE) – Each person operating as a PNCE must register with the Texas Department of Insurance. Please refer to the PNCE Registration or Exemption of Affiliates form and information about PNCE registration is located at www.tdi.texas.gov/wc/wcnet/impmntSB822.html
Surveys
None at this time.
Data calls
- Advertising Annual Certification of Compliance report is due annually.
- The quarterly balance billing data call collects data on billing and payment practices of health plan issuers and licensing entities. Submissions are due February 1, May 1, August 1, and November 1 of each year.
- Claims Data Reporting (HB610 / SB418) – TDI requires this data call to determine carriers’ compliance with prompt pay requirements on claims submitted by providers under Texas Insurance Code (TIC) Chapter 1301, Subchapters C and C-1; TIC Chapter 843, Subchapter J; and 28 Texas Administrative Code Chapter 21, Subchapter T.
- Credit life and credit accident and health data call – Data call conducted to assess credit insurance rates.
- The Consumer choice health benefit plans data certification is due June 1 of each year.
- The Emergency services billing data call due date for 2026 will be established by rule. As proposed, the due date will be 30 days after the date the rule becomes effective.
- Health care reimbursement rate report is due May 1st of each year.
- Health plan compare - Annual report covering plan cost information for comprehensive health coverage, as well as general information about health plan issuers.
- Life settlement provider annual report is due by March 1 of each year.
- Long-term care reports – Long-term care policy data is collected via five reporting forms and is due by June 30 of each year.
- Mandated benefits data call is due June 1 of each year.
- Medicare supplement refund calculation data call – Collects data concerning Medicare supplement refunds.
- Mental health and substance use disorder parity data call - Data call about mental health and substance abuse disorder parity.
- Pharmaceutical benefits data call is due March 1 of each year.
- The small employer health benefit plan report is due March 1 of each year.