Bill Text: TX HB388 | 2025-2026 | 89th Legislature | Introduced
Bill Title: Relating to a uniform coordination of benefits questionnaire for health benefit plans.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced) 2024-11-12 - Filed [HB388 Detail]
Download: Texas-2025-HB388-Introduced.html
89R724 MEW-D | ||
By: Harris Davila | H.B. No. 388 |
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relating to a uniform coordination of benefits questionnaire for | ||
health benefit plans. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Chapter 1203, Insurance Code, is amended by | ||
adding Subchapter D to read as follows: | ||
SUBCHAPTER D. COORDINATION OF BENEFITS QUESTIONNAIRE | ||
Sec. 1203.151. APPLICABILITY OF SUBCHAPTER. (a) This | ||
subchapter applies only to a health benefit plan that provides | ||
benefits for medical or surgical expenses incurred as a result of a | ||
health condition, accident, or sickness, including an individual, | ||
group, blanket, or franchise insurance policy or insurance | ||
agreement, a group hospital service contract, or an individual or | ||
group evidence of coverage or similar coverage document that is | ||
issued by: | ||
(1) an insurance company; | ||
(2) a group hospital service corporation operating | ||
under Chapter 842; | ||
(3) a health maintenance organization operating under | ||
Chapter 843; | ||
(4) an approved nonprofit health corporation that | ||
holds a certificate of authority under Chapter 844; | ||
(5) a multiple employer welfare arrangement that holds | ||
a certificate of authority under Chapter 846; | ||
(6) a stipulated premium company operating under | ||
Chapter 884; | ||
(7) a Lloyd's plan operating under Chapter 941; or | ||
(8) an exchange operating under Chapter 942. | ||
(b) Notwithstanding any other law, this subchapter applies | ||
to: | ||
(1) a small employer health benefit plan subject to | ||
Chapter 1501, including coverage provided through a health group | ||
cooperative under Subchapter B of that chapter; | ||
(2) a standard health benefit plan issued under | ||
Chapter 1507; | ||
(3) a basic coverage plan under Chapter 1551; | ||
(4) a basic plan under Chapter 1575; | ||
(5) a primary care coverage plan under Chapter 1579; | ||
(6) a plan providing basic coverage under Chapter | ||
1601; | ||
(7) alternative health benefit coverage offered by a | ||
subsidiary of the Texas Mutual Insurance Company under Subchapter | ||
M, Chapter 2054; | ||
(8) group health coverage made available by a school | ||
district in accordance with Section 22.004, Education Code; | ||
(9) the state Medicaid program, including the Medicaid | ||
managed care program operated under Chapter 540, Government Code; | ||
(10) the child health plan program under Chapter 62, | ||
Health and Safety Code; | ||
(11) a regional or local health care program operated | ||
under Section 75.104, Health and Safety Code; and | ||
(12) a self-funded health benefit plan sponsored by a | ||
professional employer organization under Chapter 91, Labor Code. | ||
Sec. 1203.152. CREATION OF UNIFORM COORDINATION OF BENEFITS | ||
QUESTIONNAIRE. In collaboration with appropriate stakeholders, | ||
the commissioner shall adopt rules establishing a uniform | ||
coordination of benefits questionnaire to be used by all health | ||
benefit plan issuers in this state. | ||
Sec. 1203.153. UNIFORM COORDINATION OF BENEFITS | ||
QUESTIONNAIRE REQUIRED. Each health benefit plan issuer that | ||
issues a health benefit plan that includes a coordination of | ||
benefits provision shall use the uniform coordination of benefits | ||
questionnaire established under Section 1203.152 and make the | ||
questionnaire available to health care providers as appropriate. | ||
SECTION 2. (a) Not later than January 1, 2026, the | ||
commissioner of insurance shall adopt rules establishing the | ||
uniform coordination of benefits questionnaire under Section | ||
1203.152, Insurance Code, as added by this Act. | ||
(b) The changes in law made by this Act apply only to the use | ||
of a coordination of benefits questionnaire on or after February 1, | ||
2026. | ||
SECTION 3. This Act takes effect September 1, 2025. |