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
- The Annual small employer health benefit plan report is due March 1 of each year. Completed reports should be sent to HealthData@tdi.texas.gov.
- 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.
- 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.
- Credit life and credit accident and health data call – Annual data call conducted to assess credit insurance rates. Submit reports and questions to AHCreditCall@tdi.texas.gov.
- The Consumer choice health benefit plans data certification is due June 1 of each year. Completed reports and questions should be emailed to HealthData@tdi.texas.gov.
- Health care reimbursement rate report – Health claims reimbursement rate data is due May 1st of each year. Completed reports should be sent to ReimbursementRates@tdi.texas.gov.
- Pharmaceutical benefits data call – Annual report due by March 1 of each year. Submit reports and questions to HealthReports@tdi.texas.gov.
- Health plan compare - Annual report covering plan cost information for comprehensive health coverage, as well as general information about health plan issuers.
- Long-term care reports – Long-term care policy data is collected via five reporting forms and is due by June 30 of each year. Completed reports and questions should be emailed to AHLTCAnnualRpts@tdi.texas.gov.
- Life settlement provider annual report – Annual report due by March 1 of each year. Completed reports and questions should be emailed to LifeHealth@tdi.texas.gov.
- Mandated benefits data call – Annual data call collects data about the cost and utilization of mandated health benefits and offers. Reports are due June 1 of each year. For questions, contact MBSurvey@tdi.texas.gov.
- Medicare supplement refund calculation data call – Collects data concerning Medicare supplement refunds. Submit reports and questions to MedSuppRefund@tdi.texas.gov.
- Mental health and substance use disorder parity data call - Annual data call collects data about mental health and substance abuse disorder parity. Completed reports and questions should be emailed to HealthParity@tdi.texas.gov