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HB388

Regular Session

Relating to a uniform coordination of benefits questionnaire for health benefit plans.

Moderate
Low Cost
Effective:2025-06-20
HB388
Relating to a uniform coordination of benefits questionnaire for health benefit plans.
Moderate Urgency
Passed with Opposition
House Vote141 - 1
YEA
99% in favor142 voting
Senate Vote31 - 0
YEA
100% in favor31 voting
1
Total Opposition Votes
Cost Impact
Low
Effective
2025-06-20
Enforcing Agencies
Texas Department of Insurance
Primary Author: Rep. Caroline Harris Davila
89th Texas Legislature
jdkey.com
01

Compliance Analysis

Key implementation requirements and action items for compliance with this legislation

Implementation Timeline

  • Effective Date: June 20, 2025 (Legal enactment).
  • Compliance Deadline: February 1, 2026. (Hard deadline: The new uniform questionnaire must be used for all COB activities on or after this date).
  • Agency Rulemaking: The Texas Department of Insurance (TDI) is statutorily required to adopt rules and publish the final questionnaire by January 1, 2026.
  • *Warning:* This creates a dangerous 30-day "sprint" window between the finalization of the form and the mandatory implementation date.

Immediate Action Plan

  • 1. Audit Current Workflows: Identify every touchpoint where a COB inquiry is currently triggered and inventory the data fields you currently collect.
  • 2. Notify IT Vendors: Alert your internal IT or external software vendors immediately that a mandatory system update will be required in January 2026 with a non-negotiable February 1 go-live.
  • 3. Engage in Rulemaking: Assign a representative to monitor TDI stakeholder meetings in late 2025 to influence the design of the form so it remains operationally viable for your adjudication logic.
  • 4. Freeze Form Stock: Stop ordering or printing bulk stock of current proprietary COB forms to avoid waste.

Operational Changes Required

Contracts

  • TPA/ASO Agreements: Review Master Services Agreements with Third-Party Administrators immediately. Ensure they are contractually obligated to implement state-mandated form changes by the statutory deadline without passing "custom programming" costs to the plan sponsor.
  • Provider Agreements: Update provider manuals to reference the new Uniform COB Questionnaire as the sole acceptable instrument for COB inquiries.

Hiring/Training

  • Claims Adjudication Staff: Retrain intake teams to recognize and accept *only* the new state-mandated Uniform COB Questionnaire.
  • Customer Service: Equip support staff with scripts explaining that the change in forms is a state mandate, not a carrier policy change, to mitigate provider friction.

Reporting & Record-Keeping

  • Data Mapping: Internal claims systems must be re-mapped to ingest the specific data points defined in the forthcoming TDI rules.
  • Audit Trails: You must maintain documentation proving that the uniform questionnaire—and not a legacy proprietary form—was the instrument used for any COB determination made on or after February 1, 2026.

Fees & Costs

  • IT Development: Budget for Q4 2025 and Q1 2026 IT spend to update provider portals, downloadable form libraries, and data ingestion triggers.
  • No State Fees: There are no new filing fees associated with this legislation.

Strategic Ambiguities & Considerations

The legislation leaves specific operational details to TDI rulemaking. Watch for the following during the stakeholder process:

  • 1. Digital Equivalence: The law mandates a "questionnaire" but does not explicitly validate web-based forms vs. static PDFs. We must verify if a digital intake flow mirroring the questions satisfies the requirement.
  • 2. "Made Available": The statute requires you to make the form available to providers. Rulemaking will define if a website link is sufficient or if active distribution is required.
  • 3. Supplemental Questions: It is currently unclear if carriers can ask *additional* questions alongside the uniform form, or if the state form is the *exclusive* data gathering tool. Assume the latter until clarified.

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Information presented is for general knowledge only and is provided without warranty, express or implied. Consult qualified government affairs professionals and legal counsel before making compliance decisions.

02

Legislative Timeline

This bill's path through the Texas Legislature

Filed
Nov 12, 2024
Passed House
Apr 29, 2025
Passed Senate
May 25, 2025
Signed
Jun 20, 2025
TopicsInsuranceInsurance--health & AccidentInsurance, Commissioner ofEmployee Benefits & Leave
03

House Authors

Rep. Caroline Harris DavilaRepublican · Primary Author

Senate Sponsors

Sen. Bryan HughesRepublican · Primary Sponsor
Cosponsors (1)

Bill Text(with markup)

View bill text in multiple formats on Texas Legislature website

Fiscal NoteView Original

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Quick Reference

Frequently Asked Questions

Common questions about HB388

Q

What does Texas HB388 do?

Texas has mandated the standardization of the Coordination of Benefits (COB) process, effectively outlawing the use of proprietary carrier forms for health benefit plans, including those sponsored by Professional Employer Organizations (PEOs). All entities managing health claims must transition to a single, state-designed questionnaire by February 1, 2026, creating a critical operational pivot point for claims adjudication systems. Implementation Timeline Effective Date: June 20, 2025 (Legal enactment).

Q

Who authored HB388?

HB388 was authored by Texas Representative Caroline Harris Davila during the Regular Session.

Q

When was HB388 signed into law?

HB388 was signed into law by Governor Greg Abbott on June 20, 2025.

Q

Which agencies enforce HB388?

HB388 is enforced by Texas Department of Insurance.

Q

How urgent is compliance with HB388?

The compliance urgency for HB388 is rated as "moderate". Businesses and organizations should review the requirements and timeline to ensure timely compliance.

Q

What is the cost impact of HB388?

The cost impact of HB388 is estimated as "low". This may vary based on industry and implementation requirements.

Q

What topics does HB388 address?

HB388 addresses topics including insurance, insurance--health & accident, insurance, commissioner of and employee benefits & leave.

Legislative data provided by LegiScanLast updated: November 25, 2025

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