Texas Insurance Code 1507.056 – Disclosure Statement
(a) A health maintenance organization providing a standard health benefit plan must provide a proposed contract holder or a contract holder with a written disclosure statement that:
(1) acknowledges that the standard health benefit plan being purchased does not provide some or all state-mandated health benefits;
(2) lists those state-mandated health benefits not included in the standard health benefit plan; and
(3) if the standard health benefit plan is issued to an individual certificate holder, provides a notice that purchase of the plan may limit the certificate holder’s future coverage options in the event the certificate holder’s health changes and needed benefits are not available under the standard health benefit plan.
(b) Each applicant for initial enrollment must sign the disclosure statement provided by the health maintenance organization under Subsection (a) and return the statement to the health maintenance organization. Under a group evidence of coverage, the term “applicant” means the employer.
Terms Used In Texas Insurance Code 1507.056
- Contract: A legal written agreement that becomes binding when signed.
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Signed: includes any symbol executed or adopted by a person with present intention to authenticate a writing. See Texas Government Code 311.005
- Written: includes any representation of words, letters, symbols, or figures. See Texas Government Code 311.005
(c) A health maintenance organization must:
(1) retain the signed disclosure statement in the organization’s records; and
(2) on request from the commissioner, provide the signed disclosure statement to the department.