(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.

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Terms Used In Texas Insurance Code 843.2071

  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • 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.
  • United States: includes a department, bureau, or other agency of the United States of America. See Texas Government Code 311.005
  • Written: includes any representation of words, letters, symbols, or figures. See Texas Government Code 311.005

(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.