Senate Bill No. 1257 aims to amend the Texas Insurance Code by introducing Chapter 1373, 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," establishing 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 regardless of whether the enrollee was part of the plan at the time of the procedure.

The bill specifies that it applies to various types of health benefit plans, including those offered by insurance companies, health maintenance organizations, and Medicaid programs, among others. However, it excludes 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 apply only to plans delivered, issued, 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's implementation until such authorization is granted.

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