| (a) A plan sponsor of a self-insured or self-funded
plan may elect to participate under Insurance Code Chapter 1275, concerning
Balance Billing Prohibitions and Out-of-Network Claim Dispute Resolution
for Certain Plans, by providing identifying information to the Texas
Department of Insurance as specified on the department's website at
www.tdi.texas.gov, including:
(1) the name and contact information of the plan sponsor;
(2) the name and contact information of the administrator
of the health benefit plan, if applicable;
(3) the health benefit plan year start and end dates;
(4) the requested effective date, which, except as
provided in subsection (d) of this section, must be the same as the
start date of the relevant plan year and at least 30 days after the
date the identifying information is submitted;
(5) the group number of the health benefit plan; and
(6) the number of enrollees covered under the health
benefit plan.
(b) Election under subsection (a) of this section applies
only to the relevant plan year. A plan sponsor must elect to apply
Insurance Code Chapter 1275 (which includes an election to participate
in out-of-network claim dispute resolution for applicable claims incurred
during the relevant plan year) with respect to each plan year and
must provide or update identifying information required by this section.
A plan sponsor that elects to apply Insurance Code Chapter 1275 to
a plan for the relevant plan year may not opt out until the end of
that relevant plan year.
(c) A plan sponsor or its authorized representative
may provide the identifying information required by this section.
(d) A health benefit plan with a plan year start date
between September 1, 2023, and February 1, 2024, may make an election
with a requested effective date that is after the first day of the
relevant plan year if the information required under subsection (a)
of this section is submitted not later than 45 days after the effective
date of this section. An election for a plan year with a start date
after February 1, 2024, must apply for the entirety of the plan year.
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