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TDI proposes amendments to rules applicable to preferred and exclusive provider health benefit plans

The Texas Department of Insurance (TDI) proposes amending the rules applicable to preferred and exclusive provider health benefit plans. The amendments implement network adequacy requirements contained in House Bill 3359 [ [link removed] ] (88R, 2023) and out-of-network payment standards and balance billing protections from Senate Bill 2476 [ [link removed] ] (88R) and SB 1264 [ [link removed] ] (86R). The rules also address consumer protections, disclosures, guaranteed renewability, and contracting requirements, including provisions implementing additional legislation from 2023: HB 711, HB 1647, HB 1696, HB 2002, and SB 1003.

View the _proposal [ [link removed] ]_ (PDF) for the full text and how to submit comments. For other dates and documents related to this action, visit TDI?s 2023 rules webpage [ [link removed] ].








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