Insights

TX State Updates - 2015 Jan 14 No.01


On July 2, 2015, the Texas Department of Insurance (TDI) adopted amendments and a new section concerning changes to the Wellness Program rules, which are located at 28 TAC Chapter 21, Subchapter MM, Sections 21.4701-21.4708. These changes are due to updates adopted in the federal regulations, which became effective Jan. 1, 2014 and are located at 45 CFR 146 and 147. Specifically, the Texas regulations were more restrictive than necessary with regard to options and incentives carriers and employers may provide to insureds in wellness programs and were no longer aligned with the comparable federal regulations. The Texas regulations were also unclear regarding applicability to HMO coverage. For example, the federal regulations are applicable to small and large employer coverage, individual and group coverage and health maintenance organization coverage. However, the Texas rules only addressed small and large employer coverage. TDI has now adopted the amendments and new section to reflect the necessary changes. The adopted rule is effective July 22, 2015.

Adopted Rule »