An HMO may not require an enrollee in a group health plan to pay a premium or contribution that is different from the premium or contribution for a similarly situated enrollee based on a health status-related factor. For purposes of this section, the term "similarly situated" has the meaning assigned to it in 45 CFR §146.121 (concerning Prohibiting Discrimination Against Participants and Beneficiaries Based on a Health Factor). An HMO may not establish policies or procedures that are based on health status-related factors for the eligibility of any individual to enroll under a group plan.

Source Note: The provisions of this §11.1500 adopted to be effective August 1, 2017, 42 TexReg 2169