AI-assisted research summary: Small employer health benefit plan issuers and agents must give reasonable disclosure materials when offering a plan for sale, and issuers must disclose benefits and premiums on request by a small employer.
Sec. 1501.354. REQUIRED DISCLOSURES. (a) In connection with offering a small employer health benefit plan for sale, each small employer health benefit plan issuer and agent shall make a reasonable disclosure, as part of its solicitation and sales materials, of: (1) the extent to which premium rates for a specific small employer are established or adjusted based on the actual or expected variation in: (A) claim costs; or (B) health status of the employer's employees and their dependents; (2) provisions concerning the issuer's right to change premium rates and factors other than claims experience that affect changes in premium rates; (3) provisions relating to renewability of policies and contracts; and (4) any preexisting condition provisions. (b) On request by a small employer, each small employer health benefit plan issuer shall disclose the benefits and premiums available under all small employer coverage for which the employer is qualified. (c) A small employer health benefit plan issuer is not required to disclose information to a small employer that is proprietary or trade secret information under applicable law. (d) Information provided under this section to a small employer must be provided in a manner that is: (1) understandable by the average small employer; and (2) sufficient to reasonably inform a small employer of its rights and obligations under a small employer health benefit plan. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.