| (a) The issuer of a health benefit plan that provides
pharmacy benefits, or a pharmacy benefit manager or administrator
issuing standard identification cards to enrollees must issue standard
identification cards as follows:
(1) For a subscriber who is an enrollee, and who has
no enrolled dependents, a single card must be issued to the subscriber,
with additional cards available on request.
(2) For a subscriber who is an enrollee, and who has
enrolled dependents, either:
(A) a card must be issued to the subscriber and to
each of the enrolled dependents, with additional cards available on
request; or
(B) two cards must be issued to the subscriber for
use by the subscriber and all enrolled dependents, with additional
cards available on request.
(3) For coverage under an individual health benefit
plan in which the subscriber is not an enrollee, or for coverage under
a health benefit plan that is continued by an enrollee under Insurance
Code Chapter 1251, Subchapter E, either:
(A) a card must be issued to each enrollee, with additional
cards available on request; or
(B) two cards must be issued for use by all enrollees,
with additional cards available on request.
(b) Each standard identification card issued must,
at all times the card is in effect, include current information on
the front of each identification card as follows:
(1) the enrolled subscriber's or enrolled dependents'
names and identification codes, as follows:
(A) for cards issued under subsection (a)(1) of this
section, the enrolled subscriber's name and identification code;
(B) for cards issued under subsection (a)(2)(A) of
this section, the enrolled subscriber's name and identification code
on the enrolled subscriber's card, and on each enrolled dependent's
card, the name and identification code of the enrolled dependent to
whom the card will be issued;
(C) for cards issued under subsection (a)(2)(B) of
this section, the name and identification code of the enrolled subscriber
and the names and identification codes of all the enrolled dependents;
(D) for cards issued under subsection (a)(3)(A) of
this section, on each enrolled dependent's card, the name and identification
code of the enrolled dependent to whom the card will be issued;
(E) for cards issued under subsection (a)(3)(B) of
this section, the names and identification codes of all enrolled dependents;
(2) the name or logo of the issuer, or of the administrator
or pharmacy benefit manager that is administering the pharmacy benefits,
if different from the health benefit plan issuer;
(3) as applicable, the group number applicable to the
enrollee(s) covered by a group health benefit plan or the policy number
or evidence of coverage number applicable to the enrollee(s) covered
by an individual health benefit plan;
(4) the effective date of coverage;
(5) as applicable, the corresponding copayment or coinsurance
for generic and brand-name drugs; provided that, if the health benefit
plan uses a drug formulary with benefit levels in addition to generic
and brand-name prescription drugs, the card must include the corresponding
copayments or coinsurance for each tier level of the drug formulary.
In addition to disclosure of each benefit level, the card may include
a term such as "variable," to reflect benefit designs not fully revealed
by the drug formulary tier disclosure;
(6) as applicable, the International Identification
Number, also known as the Banking Identification Number, assigned
to the administrator or pharmacy benefit manager by the American National
Standards Institute; and
(7) for a plan issued under Insurance Code Chapters
843 or 1301, the letters "TDI" or "DOI" prominently displayed.
(c) In addition to the information required under subsection
(b) of this section, the issuer of a health benefit plan must include
on the identification card of each enrollee a telephone number of
an appropriate person for purposes of obtaining information relating
to the pharmacy benefits provided under the health benefit plan.
(d) Nothing in this section prohibits the issuer of
a health benefit plan, or an administrator or pharmacy benefit manager,
from issuing a standard identification card containing a magnetic
strip or other technological component enabling the electronic transmission
of information, provided that the information required by subsections
(b) and (c) of this section is printed on the card.
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