Regular Session
Texas Department of Insurance
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This bill's path through the Texas Legislature
BILL ANALYSIS
| Senate Research Center | S.B. 896 |
| 89R1818 CJD-D | By: Blanco |
| Health & Human Services | |
| 3/7/2025 | |
| As Filed |
AUTHOR'S / SPONSOR'S STATEMENT OF INTENT
In Texas, new parents covered under multiple employer welfare arrangements, small employer benefit plans, and large employer benefit plans have a limited window of 31 days to enroll their newborn in their health insurance plan. Given the numerous responsibilities that come with welcoming a new child, stakeholders have raised concerns about whether this timeframe provides adequate opportunity for parents to complete the enrollment process. By ensuring newborns are covered under their parents' health benefit plans for 60 days, S.B. 896 will give parents more time to enroll their newborn children into their health benefit plans.
S.B. 896 extends the period for parents covered under multiple employer welfare arrangements (MEWAs), small employer benefit plans, and large employer benefit plans to enroll their newborns into their employer health benefit plan from 31 days after the child's birth date to 60 days after that date.
C.S.S.B 896 will additionally require individual or group health benefit plans under Chapter 1367, Insurance Code to cover a newborn child for 60 days after the child's birth.
As proposed, S.B. 896 amends current law relating to the enrollment period for newborns under certain employer health benefit plans.
RULEMAKING AUTHORITY
This bill does not expressly grant any additional rulemaking authority to a state officer, institution, or agency.
SECTION BY SECTION ANALYSIS
SECTION 1. Amends Section 846.258(b), Insurance Code, as follows:
(b) Provides that coverage of a newborn child of a participating employee under Section 846.258 (Coverage for Newborn Children) ends on the 61st day, rather than the 32nd day, after the date of the child's birth unless:
(1) makes no changes to this subdivision; and
(2) not later than the 60th day, rather than the 31st day, after the date of birth, the arrangement receives certain documents.
SECTION 2. Amends Section 1501.157(b), Insurance Code, to make conforming changes.
SECTION 3. Amends Section 1501.607(b), Insurance Code, to make conforming changes.
SECTION 4. Makes application of this Act prospective to January 1, 2026.
SECTION 5. Effective date: September 1, 2025.
| S.B. No. 896 | ||
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| relating to the enrollment period for newborns under certain health | ||
| benefit plans. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Section 846.258(b), Insurance Code, is amended | ||
| to read as follows: | ||
| (b) Coverage of a newborn child of a participating employee | ||
| under this section ends on the 61st [ |
||
| child's birth unless: | ||
| (1) children are eligible for coverage under the | ||
| multiple employer welfare arrangement's plan document; and | ||
| (2) not later than the 60th [ |
||
| of birth, the arrangement receives: | ||
| (A) notice of the birth; and | ||
| (B) any required additional premium. | ||
| SECTION 2. Section 1367.003, Insurance Code, is amended to | ||
| read as follows: | ||
| Sec. 1367.003. CERTAIN LIMITATIONS ON COVERAGE FOR NEWBORN | ||
| CHILDREN PROHIBITED. A health benefit plan that provides maternity | ||
| benefits or accident and health coverage for additional newborn | ||
| children may not be issued in this state if the plan excludes or | ||
| limits: | ||
| (1) initial coverage of a newborn child before the | ||
| 61st day after the date of the child's birth [ |
||
| (2) coverage for congenital defects of a newborn | ||
| child; or | ||
| (3) coverage for administration of the newborn | ||
| screening tests required by Section 33.011, Health and Safety Code, | ||
| including for the cost of a newborn screening test kit in the amount | ||
| provided by the Department of State Health Services on its Internet | ||
| website under Section 33.019 of that code on the date the test was | ||
| administered. | ||
| SECTION 3. Section 1501.157(b), Insurance Code, is amended | ||
| to read as follows: | ||
| (b) Coverage of a newborn child of a covered employee under | ||
| this section ends on the 61st [ |
||
| child's birth unless, not later than the 60th [ |
||
| date of birth, the small employer health benefit plan issuer | ||
| receives: | ||
| (1) notice of the birth; and | ||
| (2) any required additional premium. | ||
| SECTION 4. Section 1501.607(b), Insurance Code, is amended | ||
| to read as follows: | ||
| (b) Coverage of a newborn child of a covered employee under | ||
| this section ends on the 61st [ |
||
| child's birth unless: | ||
| (1) children are eligible for coverage under the large | ||
| employer health benefit plan; and | ||
| (2) not later than the 60th [ |
||
| of birth, the large employer health benefit plan issuer receives: | ||
| (A) notice of the birth; and | ||
| (B) any required additional premium. | ||
| SECTION 5. The change in law made by this Act applies only | ||
| to a health benefit plan that is delivered, issued for delivery, or | ||
| renewed on or after January 1, 2026. A health benefit plan that is | ||
| delivered, issued for delivery, or renewed before January 1, 2026, | ||
| is governed by the law as it existed immediately before the | ||
| effective date of this Act, and that law is continued in effect for | ||
| that purpose. | ||
| SECTION 6. This Act takes effect September 1, 2025. | ||
| TO: | Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services |
| FROM: | Jerry McGinty, Director, Legislative Budget Board |
| IN RE: | SB896 by Blanco (Relating to the enrollment period for newborns under certain employer health benefit plans.), As Introduced |
| Source Agencies: | 454 Department of Insurance |
| LBB Staff: | JMc, NPe, GDZ, BFa |
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Common questions about SB896
SB896 mandates that all fully insured Texas health plans extend the automatic coverage and enrollment window for newborns from 31 days to 60 days. This statutory change applies to plan years beginning on or after January 1, 2026, requiring employers to reprogram benefits administration systems and update Qualifying Life Event (QLE) protocols to prevent wrongful denial of coverage liability. Implementation Timeline Effective Date: September 1, 2025.
SB896 was authored by Texas Senator Cesar Blanco during the Regular Session.
SB896 was signed into law by Governor Greg Abbott on June 20, 2025.
SB896 is enforced by Texas Department of Insurance.
The compliance urgency for SB896 is rated as "moderate". Businesses and organizations should review the requirements and timeline to ensure timely compliance.
The cost impact of SB896 is estimated as "low". This may vary based on industry and implementation requirements.
SB896 addresses topics including health, health--children's insurance, insurance and insurance--health & accident.
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