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April 02, 2020
State Insurance Spotlight: Texas Department of Insurance Guidance Concerning COVID-19
State insurance departments across the country are continuing to provide guidance in response to the COVID-19 outbreak. In this update, Faegre Drinker spotlights the current Texas Department of Insurance (TDI) guidance with respect to COVID-19 issues.
TDI Bulletins
Bulletin B-0017-20: Coverage for COVID-19 Testing and Network Adequacy (April 2, 2020)
- TDI expects EPOs and HMOs to monitor and verify that their provider networks are adequate to handle increased demand and minimize the need for services outside the network; when a network provider is not reasonably available, carriers must ensure that the consumer is protected, as contemplated by the CARES Act and by Texas' laws.
Bulletin B-0016-20: Coverage for COVID-19 Testing (March 31, 2020)
- TDI encourages issuers of alternative health plans to consider taking the following actions, as applicable, related to prevention, testing and treatment of COVID-19.
- Waive copayments, co-insurance and deductibles for COVID-19 testing that is consistent with guidance issued by the Centers for Disease Control and Prevention (CDC), and cover the full cost to get the test and related testing services.
- Waive consumer cost-sharing and facilitate expanded use of telemedicine.
- Cover necessary medical equipment, supplies and services.
- Waive penalties, restrictions and claims denials for necessary out-of-network services.
- Waive requirements for preauthorization, referrals, notification of hospital admission or medical necessity reviews for care consistent with CDC guidance.
- Allow extra time for health providers and facilities to file claims.
- Authorize payment to pharmacies for up to a 90-day supply of any prescription medication for individuals, regardless of when the prescription was filled.
- Waive copayments, co-insurance and deductibles for qualifying coronavirus preventive services as defined under the CARES Act.
- Develop consumer materials, such as a resource page on a plan’s website, to explain coverage for COVID-19 testing and treatment under the plan and related information.
B-0015-20: Tolling Claim-Submission Deadlines Under Prompt Payment Laws (March 27, 2020)
- All insurers licensed to write life and accident and health insurance, HMOs and health care providers are reminded that providers may toll the deadline by which they must submit claims under the state’s prompt payment laws when a provider cannot meet the deadline due to a catastrophic event, such as the COVID-19 pandemic.
- Providers must notify TDI if they cannot meet submission deadline.
B-0014-20: Managed Care Quality Assurance Filing Requirements (March 27, 2020)
- Allows for electronic filing, and electronic signatures, sworn statements, affidavits and notarization on filings required by the Managed Care Quality Assurance Section.
- Includes a modified filings chart giving extension times and email addresses.
- Allows filings without fingerprints.
B-0013-20: Electronic Signatures for Escrow Checks and Directly Issued Policies (March 27, 2020)
- Provides guidance to title industry relating to electronic signatures and countersignatures.
- Suspends workers’ compensation requirements during the Governor’s COVID-19 declaration of:
- Compliance standards for searching for work for supplemental income benefits.
- Requirements for designated doctors regarding testing, training, application and rating recertification of medical improvement and impairment rating.
- Required medical exams.
B-0011-20: Escrow Check Signature and Escrow Audit Report Filing (March 25, 2020)
- Allows for one escrow officer’s non-electronic signature on escrow checks that would usually require two signatures.
- Provides 45-day extension of filing deadline for escrow audit reports.
- Allows title agents to use electronic submission for escrow audit reports.
- Allows filings to be made with electronic signatures and without sworn statements, affidavits or notarization — TDI will contact agents later regarding those filings.
B-0010-20: Coronavirus (COVID-19) — Workers’ Compensation Issues (March 25, 2020)
- Workers’ compensation insurance carriers must:
- Provide timely claims adjusting services.
- Process and deliver indemnity benefits and medical payments in a timely manner.
- Authorize payments to pharmacies for up to a 90-day supply for prescriptions.
- Exam suspension:
- Cease orders for DD exams and holding requests.
- Suspends REM, DD and referral exams that have already been ordered.
- Late submission of medical bills will be deemed an exception due to catastrophic event.
B-0009-20: Financial Filing Requirements and Related Fees (March 25, 2020)
- To: All insurers licensed to write life and accident and health insurance, health maintenance organizations, third-party administrators, MEWAs licensed in Texas; all insurance companies, corporations, exchanges, mutual, reciprocals, associations, Lloyds, or other insurers writing property and casualty insurance in Texas, including workers compensation insurance; and premium finance companies.
- Announcements that TDI has issued a modified filings chart that describes, by license type, filing requirements, deadline extensions and instructions for payment.
B-0008-20: COVID-19: Suspension of Certain Licensing Requirements and Fees (March 24, 2020)
- Notification that certain licensing requirements and fees are suspended for Texas-licensed insurance agents, adjusters, title agents, escrow officers, life settlement brokers, life settlement providers and certain others:
- Renewal period extended to May 31, 2020, for licenses that expired on or before February 29, 2020.
- Waiver of late fees and continuing education fines for licenses that expire between March 31 and April 30, 2020 if license is renewed by May 31, 2020.
- New and current temporary licenses issued remain active until further notice.
- Temporary license fee ($100) is waived until further notice.
- Requirement that temporary agent licensees obtain training in a classroom setting is waived and applicants may substitute approved webinars and courses listed as “classroom equivalent” to fulfill 10-hour classroom training requirement.
- Fingerprint submission requirement for temporary license is delayed until further notice.
- Waiver of requirement that during any two consecutive quarters at least 70% of an organization’s applicants for temporary licenses take required licensing examination.
B-0007-20: COVID-19: Claim-Handling Deadlines and Premium Payments (March 23, 2020)
- Prompt Payment Deadline Extension
- 15-day extension to claim-handling deadlines imposed by state’s prompt payment laws.
- Statement that carriers must continue to promptly identify, evaluate and resolve claims; promptly acknowledge receipt of a claim; promptly make appropriate assignments to investigate a claim.
- Encourages carriers to provide premium grace periods for policyholders with financial hardships caused by the COVID-19 outbreak.
B-0005-20: COVID-19: Testing and Preparation (March 11, 2020)
- Strongly encourages insurers to waive consumer costs related to prevention, testing and treatment of COVID-19, including:
- Waive consumer cost-sharing for COVID-19 cost of visit and cost of testing services.
- Expand use of telemedicine, and waive cost to consumers to use telemedicine.
- Cover cost of necessary medical equipment, supplies and services.
- Waive penalties, restrictions and claims denials for necessary out-of-network services.
- Waive requirements for preauthorization, referrals, notification of hospital admission or medical necessity reviews for care consistent with CDC guidance.
- Allow health providers extra time to file claims.
- Authorize payments to pharmacies for up to a 90-day supply of any prescription medications for individuals.
TDI FAQs
- Worker’s Compensation Resources for Employers, Employees and Health-Care Providers
- Do I Need Travel Insurance?
- Industry and Business Q and As
- Business Interruption & Other Business Insurance
- Consumer Questions and Answers
- Texas Medical Board
- Telemedicine Emergency Rule
Other TDI Guidance
- Guidance on COVID-19 and the Workplace (March 30, 2020)
- TDI Expedites Review of COVID-19 Filings (March 30, 2020)
- TDI to Provide Regulatory Relief to Aid COVID-19 Response (March 19, 2020)
- TDI COVID-19 Emergency Rules (March 17, 2020)
- Update on TDI Actions Related to COVID-19 (March 16, 2020)
- TDI Encourages Proactive Planning for COVID-19 (February 28, 2020)
Additional Information
For additional Texas COVID-19 information, please visit: