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
SB 1332 amends the Texas Insurance Code to address when a group health plan policyholder or contract holder may remain liable for premiums after an employee or other enrollee loses eligibility for group coverage. Under the bill, if the insurer or health maintenance organization is notified of the termination after the end of the month in which coverage ended, the carrier may waive the policyholder’s obligation to pay premiums for later months, so long as no covered services were provided after the month of termination.
The bill applies to both health maintenance organizations and group health insurance policies, creating parallel provisions in Sections 843.210 and 1301.0061 of the Insurance Code. Its practical effect is to give insurers discretion to relieve employers or other group sponsors from paying premiums for periods after coverage should have ended, but only when no services were actually used after the termination month. The bill took effect immediately after passage.
Impact
SB 1332 narrows and clarifies premium-liability rules for group health coverage in Texas by adding discretionary waiver authority for insurers and HMOs when late notice of termination is given. It affects group contract holders and policyholders, as well as insurers and health maintenance organizations, by reducing potential premium exposure for months after an enrollee’s eligibility ends. The bill amends the Texas Insurance Code and does not create a mandatory waiver; it permits carriers to waive liability under specified conditions.
Sentiment
The bill appears to have been broadly noncontroversial and received strong bipartisan support. It passed the Senate unanimously with one present-not-voting and passed the House overwhelmingly with no votes against it, indicating general agreement on the need to adjust premium obligations when termination notices are delayed. The absence of committee transcript debate suggests the measure was likely viewed as a technical or administrative clarification rather than a major policy change.
Contention
There is little evidence of significant opposition in the available record. The main policy point embedded in the bill is whether insurers should be allowed, rather than required, to waive premium liability when notice of termination is late; the bill resolves that issue in favor of insurer discretion. Any potential concern would likely come from insurers, employers, or plan sponsors over administrative burden or premium recovery, but the recorded votes show no meaningful contention on the floor.
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.