Relating to a group health benefit plan policy or contract holder's obligation to pay premiums on behalf of an individual after the individual's eligibility for group coverage terminates.
Summary
HB 2583 would change Texas insurance law to allow a group health plan insurer or health maintenance organization to waive a policyholder’s or contract holder’s liability for premiums on an individual after that person’s group coverage has ended, if the employer or other group sponsor gives late notice of the termination. The waiver would apply only to premiums for months after the month in which eligibility ended, and only if no covered services were provided to the individual after that month.
The bill amends both the Health Maintenance Organization provisions in the Insurance Code and the group health insurance provisions for insurers. In practical terms, it creates a discretionary remedy for situations where a group policyholder fails to promptly report that an employee or dependent is no longer eligible for coverage, potentially preventing the policyholder from owing premiums for coverage that should have ended earlier.
Impact
HB 2583 would modify Sections 843.210 and 1301.0061 of the Texas Insurance Code by adding parallel provisions for HMOs and insurers. It does not require a waiver, but authorizes the carrier to forgive premium liability for months after eligibility ends when notice is delayed and no post-termination covered services were used. The bill affects group health plan sponsors, employers, insurers, HMOs, and potentially administrators handling eligibility terminations and premium reconciliation.
Sentiment
The available record shows little public debate or recorded opposition: there are no committee transcript snippets and no recorded votes in the provided materials. The bill advanced through the Insurance committees but ultimately was laid on the table subject to call in the House, suggesting it had some legislative interest but did not complete the process in the available session record. Overall, the bill appears to have been a technical insurance administration measure rather than a highly controversial policy proposal.
Contention
The main policy issue is whether insurers and HMOs should have discretion to waive premium charges when a group sponsor reports a termination late. Supporters would likely view the bill as a fairness and administrative cleanup measure that prevents payment for coverage periods that should have ended, while any concern would center on whether the waiver could create uncertainty in premium billing or shift costs if late notice is common. Because the waiver is permissive and conditioned on no services being provided after termination, the bill appears designed to limit disputes rather than expand coverage.
Identical
Relating to a group health benefit plan policy or contract holder's obligation to pay premiums on behalf of an individual after the individual's eligibility for group coverage terminates.
Relating to a group health benefit plan policy or contract holder's obligation to pay premiums on behalf of an individual after the individual's eligibility for group coverage terminates.
Requires every individual or group health insurance contract effective on or after January 1, 2027, to provide coverage to the insured and the insured's spouse and dependents for all FDA-approved contraceptive drugs, devices and other products.
Requires every individual or group health insurance contract effective on or after January 1, 2027, to provide coverage to the insured and the insured's spouse and dependents for all FDA-approved contraceptive drugs, devices and other products.
Requires every individual or group health insurance contract effective on or after January 1, 2026, to provide coverage to the insured and the insured's spouse and dependents for all FDA-approved contraceptive drugs, devices and other products.
Requires every individual or group health insurance contract, plan, or policy to provide coverage for at least one type of buprenorphine for each form of administration.
Relates to the basic health program; permits a person or an eligible small group to purchase coverage from a basic health plan on behalf of an individual and any qualified dependents through the basic health program buy-in as long as the individual and any qualified dependents otherwise meet certain eligibility requirements (Part A); relates to consumer protection from health care costs (Part B).
Requires Medicaid provide health benefits coverage, and places certain requirements on insurers and State Health Benefits Program regarding existing mandate on health benefits coverage, for certain over-the-counter contraceptives.