Texas State Capitol building in downtown Austin, Texas. Photo: Dennis Burnett/ALM
Texas is trying to solve one of the problems that makes the state's employers miserable: differences in coordination-of-benefits forms.
Gov. Greg Abbott last week signed a bill that requires the Texas insurance commissioner to adopt a uniform coordination of benefits questionnaire by Feb. 1, 2026.
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The new law could help plan administrators and workers when the workers or their household members have coverage from two or more sources, such as separate plans for a husband and a wife, or ordinary employer plan coverage and Medicare coverage for a worker who's already 65.
The backdrop: Health coverage providers often ask for almost identical information on their coordination-of-benefits forms in a slightly different format, and in such a way that a patient and plan administrator cannot simply use one plan's form to satisfy all plans' information needs.
The list of states that have developed or tried to develop uniform coordination-of-benefit rules or forms includes California, Florida, New York and Washington state as well as Texas.
One obstacle has been variations in the underlying structure of the plans involved.
Law details: The new Texas law will apply to every kind of plan that state regulators can regulate, including insurance companies, managed care companies, Texas government employer plans and Medicaid plans.
The law does not apply directly to federally regulated plans, such as ordinary self-insured employer health plans.
Related: Transforming coordination of benefits: Challenges, technology, and the path forward
The Texas insurance commissioner is supposed to work with "appropriate stakeholders" to develop the uniform coordination-of-benefits questionnaire.
Legislative mechanics: The bill creating the law was introduced by Rep. Caroline Harris Davila, R-Round Rock, Texas.
The bill passed by a 141-1 vote in the Texas House in April and by a 31-0 vote in the Texas Senate in May.
The bill had the support of the Texas chapter of the National Association of Benefits and Insurance Professionals.
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Allison Bell
Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.
