1. (a) The notices required by §21.2103(a)(1), (3) and (4) of this title (relating to Mandatory Benefit Notices) shall be issued to enrollees of a health benefit plan that is delivered, issued for delivery, or renewed on or after January 1, 1998, and shall be provided according to the following paragraphs:

   1. (1) The notice shall be provided:

      1. (A) within 60 days of March 29, 1998 to enrollees whose plans were renewed or issued between January 1, 1998 and March 29, 1998;
      2. (B) within 60 days of enrollment to new enrollees, whether in a newly issued or newly delivered health benefit plan, or an existing plan which is renewed after March 29, 1998; or
      3. (C) within 60 days of renewal date to existing enrollees of an existing plan which is renewed after March 29, 1998.
   2. (2) Except as specified in paragraph (6) of this subsection, the notices shall be delivered to enrollees through the U.S. Postal Service.
   3. (3) The notice may be delivered with other health benefit plan documents as long as the time frames set forth in paragraph (1) of this subsection are met. For example, the notice may be delivered with the policy, certificate, evidence of coverage, or enrollment/insurance card.
   4. (4) If the notices are provided to the primary enrollee's last known address, the requirements of this section are satisfied with respect to all enrollees residing at that address.
   5. (5) If a covered spouse or dependent's last known address is different than the primary enrollee, separate notices are required to be provided to the spouse or the dependent at the spouse's or dependent's last known address.
   6. (6) For group health benefit plans, the notice may be provided to the group master contract holder for distribution to enrollees if the carrier has an agreement with the group master contract holder that the notice will be delivered in accordance with the timelines specified in paragraph (1) of this subsection; however, the carrier will be held responsible for ensuring that notice is provided to the enrollees.

2. (b) The notices required by §21.2103(a)(2) of this title shall be issued to enrollees of a health benefit plan and shall be provided according to the following paragraphs.

   1. (1) The enrollment notice required by §21.2103(a)(2)(A) of this title shall be issued to each enrollee upon enrollment in the health benefit plan.
   2. (2) The annual notice required by §21.2103(a)(2)(B) of this title shall be issued to each enrollee annually.
   3. (3) Notwithstanding §21.2103(a)(2) of this title, a carrier may elect to issue the enrollment notice required by §21.2103(a)(2)(A) of this title to satisfy the annual notice requirements set forth in §21.2103(a)(2)(B) of this title.
   4. (4) The provisions of subsection (a)(2) - (6) of this section shall also apply to these notices, except for the timeline requirements of subsection (a)(1) of this section.
3. (c) The notice required by §21.2103(a)(6) of this title shall be issued to enrollees of a health benefit plan and subsections (a)(2) - (6) of this section shall also apply to the notice, except for the timeline requirements of subsection (a)(1) of this section.

Source Note:The provisions of this §21.2105 adopted to be effective March 29, 1998, 23 TexReg 3009; amended to be effective April 14, 1999, 24 TexReg 3356; amended to be effective January 8, 2001, 26 TexReg 202; amended to be effective April 2, 2002, 27 TexReg 2506.