Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 11 - HEALTH MAINTENANCE ORGANIZATIONS
Subchapter P - PROHIBITED PRACTICES
Section 11.1500 - Discrimination Based on Health Status-Related Factors
Universal Citation: 28 TX Admin Code § 11.1500
Current through Reg. 50, No. 13; March 28, 2025
An HMO may not require an enrollee in a group health plan to pay a premium or contribution that is different from the premium or contribution for a similarly situated enrollee based on a health status-related factor. For purposes of this section, the term "similarly situated" has the meaning assigned to it in 45 CFR § 146.121 (concerning Prohibiting Discrimination Against Participants and Beneficiaries Based on a Health Factor). An HMO may not establish policies or procedures that are based on health status-related factors for the eligibility of any individual to enroll under a group plan.
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