Relating to a uniform coordination of benefits questionnaire for health benefit plans.
Summary
HB 388 requires the Texas Department of Insurance commissioner to adopt rules creating a single, uniform coordination of benefits questionnaire for health benefit plans. The questionnaire is intended to be used when a health plan includes a coordination of benefits provision, which is the mechanism used to determine which insurer pays first when a person has more than one source of coverage. The bill directs the commissioner to work with appropriate stakeholders in developing the form and requires health benefit plan issuers to use the standardized questionnaire and make it available to health care providers as appropriate.
The bill applies broadly to many types of coverage, including individual and group health insurance, HMOs, hospital service corporations, multiple employer welfare arrangements, exchange plans, small employer plans, Medicaid and Medicaid managed care, CHIP, school district coverage, regional and local health care programs, and certain self-funded plans sponsored by professional employer organizations. The rulemaking deadline is January 1, 2026, and the law applies to questionnaires used on or after February 1, 2026. The act takes effect September 1, 2025.
Impact
HB 388 amends Chapter 1203 of the Insurance Code by adding a new subchapter that standardizes coordination-of-benefits questionnaires across a wide range of health benefit plans. It gives the insurance commissioner authority to adopt implementing rules and imposes a uniform compliance requirement on issuers that include coordination-of-benefits provisions in their plans. The bill is designed to reduce variation in insurer forms and improve consistency for consumers, providers, and payers when determining primary and secondary coverage.
Sentiment
The bill appears to have been broadly supported and noncontroversial. It passed the House overwhelmingly, 141-1 on third reading, and passed the Senate unanimously, 31-0. The lack of recorded committee testimony in the provided materials also suggests limited opposition or public dispute around the measure.
Contention
There is little evidence of substantive contention in the available record. Any potential concerns would likely center on administrative burden for insurers and plan administrators who must conform to a state-mandated form, as well as the scope of the bill’s applicability to many public and private coverage arrangements. However, the near-unanimous votes indicate those issues did not generate significant opposition among lawmakers.