Tex.
Ins. Code Section 1352.005
Notice to Insureds and Enrollees
(a)
A health benefit plan issuer subject to this chapter, other than a small employer health benefit plan issuer, must annually notify each insured or enrollee under the plan in writing about the coverages described by Section 1352.003 (Required Coverages--health Benefit Plans Other than Small Employer Health Benefit Plans).(b)
The commissioner shall prescribe by rule the specific contents and wording of the notice required under this section.(c)
The notice required under this section must include:(1)
a description of the benefits listed under Section 1352.003 (Required Coverages--health Benefit Plans Other than Small Employer Health Benefit Plans);(2)
a statement that the fact that an acquired brain injury does not result in hospitalization or receipt of a specific treatment or service described by Section 1352.003 (Required Coverages--health Benefit Plans Other than Small Employer Health Benefit Plans) for acute care treatment does not affect the right of the insured or enrollee to receive benefits described by Section 1352.003 (Required Coverages--health Benefit Plans Other than Small Employer Health Benefit Plans) commensurate with the condition of the insured or enrollee; and(3)
a statement of the fact that benefits described by Section 1352.003 (Required Coverages--health Benefit Plans Other than Small Employer Health Benefit Plans) may be provided in a facility listed in Section 1352.007 (Treatment Facilities).
Source:
Section 1352.005 — Notice to Insureds and Enrollees, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1352.htm#1352.005 (accessed May 4, 2024).
