A health maintenance organization must give advance written notice and a detailed price table before increasing coverage charges, and it cannot require early renewal-related action from the enrollee.
Sec. 843.2071. NOTICE OF INCREASE IN CHARGE FOR COVERAGE. (a) Not less than 60 days before the date on which an increase in a charge for coverage under this chapter takes effect, a health maintenance organization shall: (1) give to each enrollee under an individual evidence of coverage written notice of the effective date of the increase; and (2) provide the enrollee a table that clearly lists: (A) the actual dollar amount of the charge for coverage on the date of the notice; (B) the actual dollar amount of the charge for coverage after the charge 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 a health maintenance organization, at the request of an enrollee, from negotiating a change in benefits or rates after delivery of the notice required by this section. (d) A health maintenance organization may not require an enrollee entitled to notice under this section to respond to the health maintenance organization to renew the coverage or take other action relating to the renewal or extension of the coverage 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. Added by Acts 2011, 82nd Leg., R.S., Ch. 1147 (H.B. 1951), Sec. 3.001, eff. September 1, 2011.