Texas Agreement to Reimburse for Insurance Premium
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If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.
We protect your documents and personal data by following strict security and privacy standards.
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FAQ
200bHealth Insurance Premium Payment (HIPP) Program. The Health Insurance Premium Payment (HIPP) Program is a program developed to help families, who have at least one person enrolled in Medical Assistance (MA), pay for private health insurance through an employer.
HIPP for Kids is a premium assistance program. It is for children under age19 enrolled in Medicaid who qualify for or are enrolled in qualified employer-sponsored coverage.
Refunds/Recoupments 180-Day Limit - This applies only to claims subject to the Texas prompt pay law. If 180 days have lapsed from the date payment was received, no refund is due. Carriers must first send a written refund request before automatically recouping money.
Assignment of Benefits: An arrangement by which a patient requests that their health benefit payments be made directly to a designated person or facility, such as a physician or hospital.
HIPP is the Texas Medicaid program that helps families pay for employer-sponsored health insurance premiums. It is for families with at least 1 person who gets Medicaid.
An insurer may not deliver, renew, or issue for delivery in this state a health insurance policy that prohibits or restricts a covered person from making a written assignment of benefits to a physician or other health care provider who provides health care services to the person.
The Texas Prompt Payment of Claims Act under Section 542 of the Texas Insurance Code: This law requires insurance companies to pay interest, in addition to the amount of the insurance claim, when an insurance company delays payment of a claim longer than the statute's imposed deadlines for making a claims decision.
Generally, you cannot use your Health Savings Account to pay premiums for health insurance coverage. Exceptions include COBRA premiums, long-term care premiums or premium payments that allow you to retain coverage while receiving unemployment compensation.
The Texas Insurance Code is the part of Texas state law that governs the way that insurance companies can operate in the state.
1204.251. PAYMENT TO CONSERVATOR OTHER THAN GROUP MEMBER.
