Texas § 1271.054 INFORMATION ABOUT COMPLAINTS AND APPEALS.

Texas Statutes

§ 1271.054 — INFORMATION ABOUT COMPLAINTS AND APPEALS.

Texas § 1271.054

Code INInsurance Code

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Bluebook

Tex. Insurance Code Code Ann. § 1271.054 (2026).

Text

Sec. 1271.054. INFORMATION ABOUT COMPLAINTS AND APPEALS.

(a)An evidence of coverage must contain a clear and understandable description of the health maintenance organization's methods for resolving enrollee complaints, including:

(1)the enrollee's right to appeal denial of an adverse determination to an independent review organization; and

(2)the procedures for appealing to an independent review organization.

(b)A health maintenance organization may indicate a subsequent change to the methods for resolving enrollee complaints in a separate document issued to the enrollee.

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Sec. 1271.054. INFORMATION ABOUT COMPLAINTS AND APPEALS. (a) An evidence of coverage must contain a clear and understandable description of the health maintenance organization's methods for resolving enrollee complaints, including:
(1) the enrollee's right to appeal denial of an adverse determination to an independent review organization; and
(2) the procedures for appealing to an independent review organization.
(b) A health maintenance organization may indicate a subsequent change to the methods for resolving enrollee complaints in a separate document issued to the enrollee.