On Oct. 31, TX INS issued bulletin on issuer extensions, exceptions.
TX INS issued Bulletin B-0018-24 on requirements under TX Insurance codeTX INS 8-E-1369-A-1369.094 (SB 622, 2023) for health benefit plan issuers that cover drugs.
To provide information on covered prescription drug to enrollee or provider on request.
Issuer Extensions and Exceptions
If request by standard application programming interface (API), respond in real time.
Permits issuer with fewer than 10,000 enrollees to receive additional time to comply.
Issuer may register for a 12-month extension by submitting information stating the total number of enrollees covered in health benefit plans offered by the issuer.
Issuer that receives an extension must comply with the requirements of the section for health benefit plan delivered, issued for delivery, or renewed on or after Jan. 1, 2026.
Unless it receives temporary exception from one or more of the requirements.
After 12-month extension, issuer may request temporary exception by submitting request, show compliance imposes unreasonable cost relative to public value gained.
Does not authorize the department to grant extensions to issuers that do not qualify.
Effectiveness
Apply to health benefit plans delivered, issued for delivery, renewed after Jan. 1, 2025.
Regulators
TX INS
Entity Types
Ins
Reference
Bul B-0018-24, 10/31/2024; Citation: TX INS 8-E-1369-A-1369;
