H.B. No. 2583 amends the Texas Insurance Code to clarify the obligations of group health benefit plan policyholders regarding premium payments after an individual's eligibility for group coverage has ended. The bill introduces new provisions that allow health maintenance organizations and insurers to waive the contract holder's liability for premiums if they are notified of the termination of an enrollee's or individual's eligibility later than the end of the month in which the eligibility terminated. This waiver is contingent upon the condition that no covered services were provided to the enrollee or individual after their eligibility ended.

Specifically, the bill adds Subsection (e) to both Section 843.210 and Section 1301.0061 of the Insurance Code, detailing the circumstances under which the waiver applies. The intent of this legislation is to relieve group contract holders and policyholders from financial responsibility for premiums in cases where timely notification of eligibility termination was not provided, thereby promoting fairness in the management of health coverage. The bill is set to take effect immediately upon receiving a two-thirds vote from both houses or on September 1, 2025, if that threshold is not met.

Statutes affected:
Introduced: Insurance Code 843.210, Insurance Code 1301.0061 (Insurance Code 843, Insurance Code 1301)
House Committee Report: Insurance Code 843.210, Insurance Code 1301.0061 (Insurance Code 843, Insurance Code 1301)