Texas Insurance Code 1301.1581 – Information Concerning Exclusive Provider Benefit Plans
Current as of: 2024 | Check for updates
|
Other versions
(a) In this section, “prospective insured” has the meaning assigned by § 1301.158.
(b) In addition to the information required to be provided under § 1301.158, an insurer that offers an exclusive provider benefit plan shall provide to a current or prospective group contract holder or current or prospective insured notice that the benefit plan includes limited coverage for services provided by a physician or health care provider that is not a preferred provider.
Terms Used In Texas Insurance Code 1301.1581
- Contract: A legal written agreement that becomes binding when signed.
(c) An identification card or similar document issued by an insurer to an insured in an exclusive provider benefit plan must display:
(1) the first date on which the insured became insured under the plan;
(2) a toll-free number that a physician or health care provider may use to obtain the date on which the insured became insured under the plan; and
(3) the acronym “EPO” or the phrase “Exclusive Provider Organization” on the card in a location of the insurer’s choice.