TITLE: Relating to the provision and use of health coverage information to educate consumers purchasing individual health benefit coverage.

SUMMARY: Relating to the provision and use of health coverage information to educate consumers purchasing individual health benefit coverage.

FULL TEXT:
AN ACT relating to the provision and use of health coverage information to educate consumers purchasing individual health benefit coverage. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Subtitle B, Title 5, Insurance Code, is amended by adding Chapter 526 to read as follows: CHAPTER 526. CONSUMER HEALTH COVERAGE EDUCATION Sec. 526.001. DEFINITIONS. In this chapter: (1) "Agent" means a person who may act as an agent for the sale of a health benefit plan under a license issued under Title 13. (2) "Individual health benefit plan" means: (A) an individual accident and health insurance policy to which Chapter 1201 applies; or (B) individual health maintenance organization coverage. Sec. 526.002. PROVISION OF REQUIRED INFORMATION. (a) A health benefit plan issuer that offers an individual health benefit plan shall provide health coverage information adopted by the commissioner under Section 526.003 to each agent who acts on behalf of the health benefit plan issuer with respect to the sale of the individual health benefit plan. (b) An agent who receives health coverage information described by Subsection (a) may not sell or receive an application for an individual health benefit plan issued by the health benefit plan issuer that provided the information until the agent provides the health coverage information to the prospective purchaser of the individual health benefit plan. Sec. 526.003. RULES. (a) The commissioner by rule shall adopt the form and content of the health coverage information required under Section 526.002. (b) The health coverage information adopted under Subsection (a) must be designed to educate a prospective purchaser of an individual health benefit plan about policy and coverage provisions, including copayments, deductibles, and coinsurance, provider networks, and financial responsibilities for in-network and out-of-network services. SECTION 2. This Act takes effect January 1, 2018.