Health Insurance information from Texas Department of Insurance

Health Insurance

Highlights

Texas Health Insurance Pool

• An individual health insurance program created by the Texas Legislature to provide health insurance to Texans who cannot obtain coverage because of a medical condition or HIPAA-related health insurance portability issues.
• Premium subsidy application form for enrollees whose household incomes are at or below 300 percent of the federal poverty level.
• Texas Health Insurance Pool Publication (PDF)

NOTICE! - Information regarding rate increase filings subject to Federal Health Reform

• Health Insurance Reimbursement Rates Consumer Information Guide
• TexasHealthOptions.com - A service of the State of Texas with links to government & other Web sites to help Texans shop for health insurance.
• Mediation for Out-of-Network Hospital-based Health Care Provider Claims
• Consumer Complaint Information
• Texas Mandated Benefits/Offers/Coverages
• LHL Advisory Committees and Stakeholder Groups - Includes CEDE and TACCP Meeting Information

More Highlights: Compact with Texans | Services Offered | Help by Service | More On TDI

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Healthy Texas - Health Insurance for Small Businesses

Healthy Texas has reached its enrollment limit and carriers are not accepting new groups.
Learn more about the Healthy Texas enrollment limit.

Employers

If you have two to 50 employees, Healthy Texas can make health insurance a possibility for you and your employees.

Employees

Hard-working people deserve the peace of mind that comes from health insurance. Learn more about getting Healthy Texas at your workplace.

Agents

Strengthen your product portfolio with this affordable, easy-to-use plan designed specifically for small businesses.

Participating Carriers:

Visit Celtic's Healthy Texas page

Visit UnitedHealthcare's Healthy Texas page

Help For	Toll-Free #
Consumers	800-252-3439
Injured Workers	800-252-7031
Reporting Arson	877-434-7345
Reporting Fraud	800-252-3439
Safety Violations	800-452-9595
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POOL ENROLLMENT AS OF JUNE 2013:         23,218

TOTAL TEXANS ENROLLED SINCE INCEPTION:    ±93,000

      

• Important Notice about Your Pool Coverage and the Affordable Care Act
   
  
• The Pool provides premium assistance to qualified lower income enrollees.  See the Premium Rates page of this website for more information.
   
  
• Click here for the Texas Department of Insurance Federal Health Care Reform Bill Resource page

 

Click here for Healthcare.gov, the new federal website for insurance consumers

 

Are you losing Employer Group Coverage?  Read about your COBRA and State Continuation options here

 

Financial Resources links for programs that provide assistance with premiums and copayments (pdf)

 

Need assistance from a professional health insurance agent?  Click here for the National Association of Health Underwriters (NAHU) Agent
Finder tool.  (Hint: After entering your zip code info, check Individual Plans in the Practice Areas section.  Then click Find NAHU Members.)

 

Important Medicare notice link for members and applicants (pdf)

• 24/7 Nurse Help Line & Audio Health Library link: 1-800-581-0368 (pdf)

• Texas Health Options from Texas Department of Insurance link:  www.texashealthoptions.com

• BlueExtras^SM  Use your Pool ID card to take advantage of discounts on health and wellness services, including vision, hearing, weight management and vitamins.  For more information, log into BlueAccess for Members, click the 'My Health' tab, and then the 'BlueExtras Discount Program' link.

• Shortcut to the Texas Health Insurance Pool Application page

• Shortcut to the Pool's Premium Rates

Health Related Publications

Chinese (traditional) Versions

• Workers' Compensation Health Care Networks - (PDF)

• Workers' Compensation Health Care Networks: Information for Injured Workers - (PDF)

English Versions

• A Shopper's Guide to Long-Term Care Insurance - (PDF)

• Health Care Coverage for Texas Children - (HTML)

• Healthy Texas - (PDF)

• How Federal Health Care Reform will Affect You - (HTML)

• Insurance for Texans with Disabilities - (HTML)

• Long-Term Care Insurance Rate Guide - (HTML)

• Texas Health Insurance Pool - (PDF)

• Understanding Annuities - (HTML)

• Understanding Life Insurance - (HTML)

• Workers' Compensation Health Care Networks - (HTML)

• Workers' Compensation Health Care Networks - (PDF)

• Workers' Compensation Health Care Networks: Information for Injured Workers - (PDF)

• Workers' Compensation Health Care Networks: Information for Injured Workers - (HTML)

• Your Health Care Coverage - (HTML)

• Disability Management Overview - (PDF)

• Medical Forms - (PDF)

• Review of Medical Necessity Disputes by an Independent Review Organization (IRO) - (PDF)

• Average Weekly Wage Calculations - (PDF)

• Death and Burial Benefits - (PDF)

• Impairment Income Benefits (IIBs) - (PDF)

• Lifetime Income Benefits (LIBs) - (PDF)

• Prescription Reimbursement - (PDF)

• Supplemental Income Benefits (SIBs) - (PDF)

• Temporary Income Benefits (TIBs) - (PDF)

• Workers' Compensation Benefits - (PDF)

• Workers' Compensation in Texas - (PDF)

• WorkingTogether for a Healthy Texas - (WORD)

• Designated Doctor Update, Volume 1 - January 2011 - (PDF)

• Designated Doctor Update, Volume 2 - March 2012 - (PDF)

• Designated Doctor Update, Volume 3 - August 2012 - (PDF)

• Designated Doctor Update, Volume 4 - October 2012 - (PDF)

• Division Introduces Comp Connection for Health Care Providers - (PDF)

• SARS Factsheet - (PDF)

• Aging in the Workplace - (PDF)

• Allergies - (PDF)

• Back Injury Prevention (for Healthcare Industry) Safety Training Program - (PDF)

• Bloodborne Pathogen Exposure Control Plan Sample OSHA Written Program - (WORD)

• Bloodborne Pathogens Questions and Answers - (PDF)

• Bloodborne Pathogens Safety Training Program - (PDF)

• Chickenpox FactSheet - (PDF)

• Chlorine - Take 5 for Safety - (PDF)

• Custom On-Site Safety and Health Training - (PDF)

• Decontaminating Pesticide-Exposed Clothing - Take 5 for Safety - (PDF)

• Flu Control Measures for Healthcare Facilities - (PDF)

• Fluid Replacement FactSheet - (PDF)

• Flu/Influenza Take 5 for Safety - (PDF)

• Foodborne Diseases - (PDF)

• Footwear Safety FactSheet - (PDF)

• Gastroenteritis FactSheet - (PDF)

• Hand Hygiene FactSheet - (PDF)

• Healthcare Provider Computer Keyboards and Bacteria Hazards - (PDF)

• HIV and Its Transmission FactSheet - (PDF)

• Hypothermia FactSheet - (PDF)

• Influenza FactSheet - (PDF)

• Latex Allergy - (PDF)

• Latex Allergy FactSheet - (PDF)

• Manual Material Handling- An Ergonomic Approach Workplace Program - (PDF)

• Office Ergonomics Workplace Program - (PDF)

• Preventing Heat-Related Injuries and Illness - (PDF)

• Preventing Occupational HIV Transmission to Health Care Personnel - (PDF)

• Proper Use of a Respirator - (PDF)

• SARS FactSheet - (PDF)

• Sleeping Restfully - (PDF)

• Smallpox FactSheet - (PDF)

• Stress Reduction Fact Sheet - (PDF)

• Stroke Prevention FactSheet - (PDF)

• Sunglasses Safety - (PDF)

• Tuberculosis - (PDF)

• Tuberculosis FactSheet - (PDF)

• Viral Hepatitis C - Take 5 for Safety - (PDF)

• West Nile Virus FactSheet - (PDF)

• West Nile Virus Mosquito Control - (PDF)

• Workplace Wellness Factsheet - (PDF)

• Workplace Wellness Strategies Fact Sheet - (PDF)

• X-Ray Machine Safety FactSheet - (PDF)

Korean Versions

• Workers' Compensation Health Care Networks - (PDF)

• Workers' Compensation Health Care Networks: Information for Injured Workers - (PDF)

Spanish Versions

• Ayudándolo con sus Quejas de Seguros - (HTML)

• Cobertura de Servicios de Salud para los Niños de Texas - (HTML)

• Cómo Funcionan los Seguros de Vida - (HTML)

• La Reforma Federal para los Servicios de Salud y Usted - (HTML)

• Las Redes de Atención de Salud de Compensación al Trabajador - (PDF)

• Las Redes de Atención de Salud de Compensación al Trabajador: Información para los trabajadores lesionados - (PDF)

• Red de Servicios Médicos de Compensación para Trabajadores - (HTML)

• Redes de Servicios Médicos de Compensación para Trabajadores: Información para Empleados Lesionados - (HTML)

• Seguro para Tejanos con Incapacidades - (HTML)

• Su cobertura de cuidado de salud - (HTML)

• Beneficios de Compensación para Trabajadores - (PDF)

• Beneficios de Defunción y por Causa de Muerte - (PDF)

• Beneficios de Ingresos de Impedimento - (PDF)

• Beneficios de Ingresos Suplementales - (PDF)

• Beneficios de Ingresos Temporales - (PDF)

• Beneficios de por vida - (PDF)

• Cálculos de Promedio del Salario Semanal - (PDF)

• Compensación para Trabajadores en Texas - (PDF)

• Reembolso por Recetas Médicas - (PDF)

• Avoiding Finger, Hand and Wrist Injuries - (PDF)

• Avoid the Flu Take - (PDF)

• Bloodborne Pathogens - (PDF)

• Common Cold Fact Sheet - (PDF)

• Hand Hygiene FactSheet - (PDF)

• Hazards of Bacteria on Health Care Providers' Computer Keyboards - (PDF)

• Health Recommendations for Relief Workers - (PDF)

• Office Ergonomics - (PDF)

• Patógenos Transmitidos por la Sangre - (PDF)

• Preventing Occupational HIV Transmission to Health Care Personnel - (PDF)

• Proper Use of a Respirator - (PDF)

Vietnamese Versions

• Workers' Compensation Health Care Networks - (PDF)

• Workers' Compensation Health Care Networks: Information for Injured Workers - (PDF)

Accident and Health

• PPACA Resources for Health Carriers 
• Product Checklists
• Companies offering Long Term Care Insurance
• Long Term Care Consumer Disclosure Form
• Consumer Choice Health Benefit Plans Resources

List of companies that have approved or filed forms utilizing:

• PPO contract Provisions
• Dental contract Provisions
• Individual Health contract Provisions
• Medical Savings Account (MSA) contract Provisions
• Health Savings Account (HSA) contract Provisions
• Certifications 
• Chapter 26 Health Insurance Portability and Availability Act Regulations Small Employer Section; Large Employer Section (use your browser's "Back" key to return to TDI).
• Carriers offering coverage in the Mid-Size and Large Employer Market

Complaint Information

TDI can help you resolve complaints about property, title, health, and workers' compensation insurance.  Use the File a Complaint page to file a complaint online or to print the form and mail, email, or fax it to TDI. 

Complaint Resources

• Internet Complaint Information System (ICIS) - Provides summaries of complaint database files by quarter and by line of insurance.
• NAIC Consumer Information Source - CIS allows consumers to view a variety information about insurance companies and to file insurance company complaints.
• Insurance Company Profile - Provides company license information, history, financial data, and number of justified complaints filed against the company.
• HMO Profiles - Provides company contacts, service areas, general complaint and financial data, and other company information about HMOs. Information sorted by HMO company name. Also provides definitions for commonly used HMO terminology.

Texas Department of Insurance

333 Guadalupe, Austin, TX 78701
P.O. Box 149104, Austin 78714
512-463-6169    |   1- 800-252-3439

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Lewis Insurance
2525 S. Lamar Ste 11
Austin, TX
78704

www.nationwide.com/joshlewis

www.austinhealthbrokers.com

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