Texas § IN.1301.1581 - INFORMATION CONCERNING EXCLUSIVE PROVIDER BENEFIT PLANS

§ IN.1301.1581. INFORMATION CONCERNING EXCLUSIVE PROVIDER BENEFIT PLANS

INFORMATION CONCERNING EXCLUSIVE PROVIDER BENEFIT PLANS. (a) In this section, "prospective insured" has the meaning assigned by Section 1301.158 . (b) In addition to the information required to be provided under Section 1301.158 , an insurer that offers an exclusive provider benefit plan shall provide to a current or prospective group contract holder or current or prospective insured notice that the benefit plan includes limited coverage for services provided by a physician or health care provider that is not a preferred provider. (c) An identification card or similar document issued by an insurer to an insured in an exclusive provider benefit plan must display: (1) the first date on which the insured became insured under the plan; (2) a toll-free number that a physician or health care provider may use to obtain the date on which the insured became insured under the plan; and (3) the acronym "EPO" or the phrase "Exclusive Provider Organization" on the card in a location of the insurer's choice. Added by Acts 2011, 82nd Leg., R.S., Ch. 288 (H.B. 1772 ), Sec. 10, eff. September 1, 2011.