S.B. No. 1257 introduces a new chapter, Chapter 1373, to the Texas Insurance Code, which mandates health benefit plans to cover adverse effects and reversals related to gender transition procedures. The bill defines "gender transition" and "gender transition procedure or treatment," outlining that any health benefit plan providing coverage for such procedures must also cover all possible adverse consequences, necessary follow-up testing, and any procedures required to manage or reverse the effects of the transition. This coverage is applicable to all enrollees, regardless of their enrollment status at the time of the procedure.

The bill specifies that it applies to various types of health benefit plans, including those issued by insurance companies, health maintenance organizations, and Medicaid programs, among others. However, it does not apply to self-funded health benefit plans as defined by the Employee Retirement Income Security Act of 1974. The provisions of this act will take effect on September 1, 2025, and will only apply to plans delivered, issued for delivery, or renewed on or after January 1, 2026. Additionally, if a state agency determines that federal authorization is needed for implementation, it may delay the provision until such authorization is granted.

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