(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;
(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.
(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.
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