Tex. Ins. Code Section 1201.109
Notice of Rate Increase for Major Medical Expense Insurance Policy


(a)

Not less than 60 days before the date on which a premium rate increase takes effect on an individual accident and health insurance policy that provides major medical expense coverage and that is delivered or issued for delivery in this state by an insurer, the insurer shall:

(1)

give written notice to the insured of the effective date of the increase; and

(2)

provide the insured a table that clearly lists:

(A)

the actual dollar amount of the premium on the date of the notice;

(B)

the actual dollar amount of the premium after the premium rate increase; and

(C)

the percentage change between the amounts described by Paragraphs (A) and (B).

(b)

The notice required by this section must be based on coverage in effect on the date of the notice.

(c)

This section may not be construed to prevent an insurer, at the request of an insured, from negotiating a change in benefits or rates after delivery of the notice required by this section.

(d)

An insurer may not require an insured entitled to notice under this section to respond to the insurer to renew the policy or take other action relating to the renewal or extension of the policy before the 45th day after the date the notice described by Subsection (a) is given.

(e)

The notice required by this section must include:

(1)

contact information for the department, including information concerning how to file a complaint with the department;

(2)

contact information for the Texas Consumer Health Assistance Program, including information concerning how to request from the program consumer protection information or assistance with filing a complaint; and

(3)

the addresses of Internet websites that provide consumer information related to rate increase justifications, including the websites of the department and the United States Department of Health and Human Services.

(f)

For purposes of this section, “major medical expense coverage” means an individual major medical expense insurance policy to which this chapter applies under Section 1201.003 (Applicability of Chapter) that constitutes creditable coverage under Section 1205.004 (Creditable Coverage).
Added by Acts 2011, 82nd Leg., R.S., Ch. 1147 (H.B. 1951), Sec. 3.002, eff. September 1, 2011.
Amended by:
Acts 2013, 83rd Leg., R.S., Ch. 454 (S.B. 853), Sec. 1, eff. June 14, 2013.
Acts 2013, 83rd Leg., R.S., Ch. 454 (S.B. 853), Sec. 2, eff. June 14, 2013.

Source: Section 1201.109 — Notice of Rate Increase for Major Medical Expense Insurance Policy, https://statutes.­capitol.­texas.­gov/Docs/IN/htm/IN.­1201.­htm#1201.­109 (accessed Jun. 5, 2024).

1201.001
Definitions
1201.002
Purpose
1201.003
Applicability of Chapter
1201.004
Construction of Chapter
1201.005
References to Chapter
1201.006
Rulemaking Authority
1201.007
Notice and Hearing
1201.008
Judicial Review
1201.009
Nonconforming Policy
1201.010
Third-party Ownership of Policy
1201.011
Coverage for Premium Period with Limitations by Age or Date
1201.012
Defense of Claim
1201.013
Programs Promoting Disease Prevention, Wellness, and Health
1201.051
Entire Consideration
1201.052
Time of Effectiveness and Termination
1201.053
Persons Insured
1201.054
Appearance of Text
1201.055
Exceptions and Reductions of Indemnity
1201.056
Form Number
1201.057
Incorporation of or Reference to Other Documents
1201.058
Notification that Policy Is Returnable
1201.059
Termination of Coverage Based on Age of Child in Individual, Blanket, or Group Policy
1201.061
Coverage for Adopted Child
1201.062
Coverage for Certain Children in Individual or Group Policy or in Plan or Program
1201.063
Prohibition of Certain Criteria Relating to Child’s Coverage in Individual or Group Policy
1201.064
Coverage for Child of Spouse in Individual or Group Policy
1201.065
Age and School Enrollment Eligibility Criteria for Dependent Children in Individual or Group Policy
1201.101
Standards for Policy Provisions
1201.102
Prohibition of Policy Provisions
1201.103
Compliance with Minimum Standards for Benefits
1201.104
Minimum Standards for Benefits
1201.105
Minimum Standards for Benefits for Long-term Care in Individual, Group, or Blanket Policy
1201.106
Identification of Policies According to Coverage Provided
1201.107
Outline of Coverage Required
1201.108
Format and Content of Outline of Coverage
1201.109
Notice of Rate Increase for Major Medical Expense Insurance Policy
1201.151
Compliance with Subchapter
1201.152
Coverage Under Simplified Application Form
1201.154
Coverage for Certain Previously Covered Persons
1201.201
Policy Provisions Required
1201.202
Order of Required Policy Provisions
1201.203
Other Policy Provisions
1201.204
Policy Provisions Required by Other Jurisdiction
1201.205
Policy Provisions for Policy Delivered Outside This State
1201.206
Filing Procedure
1201.207
Policy Provision: Entirety of Contract
1201.208
Policy Provision: Incontestability
1201.209
Policy Provision: Grace Period
1201.210
Policy Provision: Reinstatement
1201.211
Policy Provision: Notice of Claim
1201.212
Policy Provision: Claim Forms
1201.213
Policy Provision: Proof of Loss
1201.214
Policy Provision: Time of Payment of Claims
1201.215
Policy Provision: Payment of Claims
1201.216
Policy Provision: Physical Examinations and Autopsy
1201.217
Policy Provision: Legal Actions
1201.218
Policy Provision: Change of Beneficiary
1201.219
Policy Provision: Change of Occupation
1201.220
Policy Provision: Misstatement of Age
1201.221
Policy Provision: Excess Insurance
1201.222
Policy Provision: Relation of Earnings to Insurance
1201.223
Policy Provision: Unpaid Premium
1201.224
Policy Provision: Cancellation
1201.225
Policy Provision: Conformity with State Statutes
1201.226
Policy Provision: Illegal Occupation
1201.271
Alteration of Policy Application
1201.272
False Statements
1201.273
Binding Statements
1201.274
Insurer’s Evidentiary Use of Application for Reinstatement or Renewal
1201.0601
Required Definitions: Specified Disease Policy
1201.701
Civil Penalty
1201.702
Action Against Certificate of Authority or License

Accessed:
Jun. 5, 2024

§ 1201.109’s source at texas​.gov