TX| Texas Department of Insurance Order No. 2026-10141 adopts amendments to 28 TAC §§26.9 and 26.305 implementing SB 896 for small- and large-employer health benefit plans subject to Texas Insurance Code Chapter 1501. The central operational change is an extension of automatic newborn coverage from 31 days to 60 days after birth: coverage now terminates on the 61st day unless the applicable notice and any additional premium are timely provided. The order was issued September 21, 2026; insurers and plan administrators should update enrollment materials, newborn-add procedures, billing workflows, and applicable plan administration practices to reflect the new 60-day timeline.
Some Key Points
- Maintain the separate 31-day enrollment framework for adopted children. The order changes newborn timelines only; adopted-child notice and premium deadlines remain generally 31 days after the relevant adoption proceeding or final adoption date, subject to the existing billing-cycle protection.
- Provide initial newborn coverage without limitation or exclusion under small- and large-employer health benefit plans; the child’s automatic coverage continues through the 60th day after birth and terminates on the 61st day if the required conditions are not met.
- Require notification of birth and any required additional premium no later than 60 days after birth to continue coverage beyond the automatic period. For small-employer coverage, the materials must be received or postmarked by the deadline; for large-employer coverage, the materials must be postmarked by the deadline.
- Do not terminate newborn coverage immediately when billing cycles do not align with the new 60-day deadline. The carrier must wait until the next billing cycle occurs and may terminate only if the additional required premium remains unpaid for 30 days after its due date.
- Revise insurer and employer-facing operational documents promptly—including enrollment forms, newborn/dependent add instructions, premium notices, plan certificates, administrative procedures, and customer-service scripts—to replace the prior 31-day/32nd-day framework with the 60-day/61st-day framework.