Cook’s bill ordering a health coverage guide

The text as introduced · 462 words

89R3422 RDR-D

By: Cook, et al.
S.B. No. 1307

A BILL TO BE ENTITLED

AN ACT

relating to a biennial health coverage reference guide developed by

the Texas Department of Insurance.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Subtitle B, Title 5, Insurance Code, is amended

by adding Chapter 524A to read as follows:

CHAPTER 524A. PUBLIC EDUCATION ON HEALTH COVERAGE

Sec. 524A.001. BIENNIAL HEALTH COVERAGE REFERENCE GUIDE.

(a) The department shall develop and publish on the department's

Internet website a biennial reference guide designed to educate the

public about health coverage in this state. The department shall

also publish the guide in a printed form available to the public on

request.

(b) The reference guide must include the following

information:

(1) the biennial period covered by the current

edition;

(2) definitions of the term "health insurance" and

terms used to describe other forms of health coverage;

(3) sources from which consumers may obtain health

coverage, including through employers, and an explanation of how

coverage may be obtained from each of those sources;

(4) a guide to consumer rights and resources related

to health coverage;

(5) a health coverage shopping guide that includes:

(A) an explanation of discount cards, health care

sharing ministries, and other non-insurance health coverage

products and a comparison of those products to health insurance;

(B) an explanation and comparison of common types

of short-term or disease-specific health coverage;

(C) an explanation and comparison of preferred

provider benefit plans, exclusive provider benefit plans, health

maintenance organizations, and point-of-service plans;

(D) an explanation of provider networks and the

differences between in-network providers and out-of-network

providers;

(E) an explanation of the Affordable Care Act

marketplace plan categories of bronze, silver, gold, and platinum;

(F) an explanation of the out-of-pocket costs of

health coverage, including premiums, deductibles, copayments, and

coinsurance; and

(G) information on how to recognize health

coverage scams;

(6) an explanation of the effect of the Consolidated

Omnibus Budget Reconciliation Act of 1985 (Pub. L. No. 99-272) on

consumers' health coverage;

(7) a basic overview of federal, state, and local

programs that may assist consumers to obtain health care services;

(8) methods for a consumer to resolve disputes with a

health coverage issuer or administrator;

(9) methods to seek assistance from the department for

a complaint regarding a health coverage plan or product; and

(10) the areas of health coverage regulated by the

department and those regulated by federal law, including the

Employee Retirement Income Security Act of 1974 (29 U.S.C. Section

1001 et seq.).

SECTION 2. The Texas Department of Insurance shall publish

the first biennial reference guide under Section 524A.001,

Insurance Code, as added by this Act, not later than January 1,

2026.

SECTION 3. This Act takes effect September 1, 2025.