# 28 Tex. Admin. Code § 21.3030: 28 TAC § 21.3030. Availability of Formulary Information, DIVISION 4. PRESCRIPTION DRUG FORMULARY COVERAGE AND DISCLOSURE REQUIREMENTS

> Texas · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T28_P1_C21_S21_3030

## Section

- **Citation:** 28 Tex. Admin. Code § 21.3030
- **Heading:** 28 TAC § 21.3030. Availability of Formulary Information, DIVISION 4. PRESCRIPTION DRUG FORMULARY COVERAGE AND DISCLOSURE REQUIREMENTS
- **Jurisdiction:** Texas
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Texas Administrative Code / Title 28 INSURANCE / Part 1 TEXAS DEPARTMENT OF INSURANCE / Chapter 21 TRADE PRACTICES / 28 TAC § 21.3030

## Text

(a) An issuer of a health benefit plan, or its delegated
 entity, that covers prescription drugs and uses one or more drug formularies
 must provide, in plain language, the disclosures required by Insurance
 Code §1369.054. The plain language disclosure must be in the
 coverage documentation provided to each enrollee and include the address
 and telephone number where the enrollee may contact the issuer of
 the health benefit plan, or its delegated entity, to determine if
 a specific prescription drug is on the formulary.
(b) An issuer of an individual health benefit plan
 must allow a current or prospective enrollee to obtain a paper copy
 of the formulary information required under §21.3032 and §21.3033
 of this title (relating to Formulary Disclosure Requirements for Individual
 Health Benefit Plans and Facilitating Comparison Shopping for Individual
 Health Benefit Plans) by calling the toll-free number listed on the
 summary health plan document.
(c) An issuer may elect to exclude the plan-level cost-sharing
 information required under §21.3031(c) of this title (relating
 to Formulary Information for Individual Health Benefit Plans on Issuer's
 Website) from the paper format if the document provides a toll-free
 number through which a current or prospective enrollee may obtain
 formulary information contained in §21.3032 and §21.3033,
 including the plan-specific cost-sharing information required under §21.3032(c),
 for any formulary drug.
(d) The paper copy of the formulary information must
 use at least 10-point font.

## Nearby sections

- [28 Tex. Admin. Code § 21.3001 28 TAC § 21.3001. Applicability and Severability, DIVISION 1. GENERAL PROVISIONS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T28_P1_C21_S21_3001.md)
- [28 Tex. Admin. Code § 21.3002 28 TAC § 21.3002. Definitions; Pharmacy Identification Cards, DIVISION 2. IDENTIFICATION CARDS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T28_P1_C21_S21_3002.md)
- [28 Tex. Admin. Code § 21.3003 28 TAC § 21.3003. Standard Identification Cards, DIVISION 2. IDENTIFICATION CARDS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T28_P1_C21_S21_3003.md)
- [28 Tex. Admin. Code § 21.3004 28 TAC § 21.3004. Issuance of Standard Identification Cards, DIVISION 2. IDENTIFICATION CARDS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T28_P1_C21_S21_3004.md)
- [28 Tex. Admin. Code § 21.3010 28 TAC § 21.3010. Definitions; Coverage of Off-Label Drugs, DIVISION 3. OFF-LABEL DRUGS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T28_P1_C21_S21_3010.md)
- [28 Tex. Admin. Code § 21.3011 28 TAC § 21.3011. Minimum Standards of Coverage for Off-Label Drug Use, DIVISION 3. OFF-LABEL DRUGS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T28_P1_C21_S21_3011.md)
- [28 Tex. Admin. Code § 21.3020 28 TAC § 21.3020. Definitions; Prescription Drug Formulary, DIVISION 4. PRESCRIPTION DRUG FORMULARY COVERAGE AND DISCLOSURE REQUIREMENTS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T28_P1_C21_S21_3020.md)
- [28 Tex. Admin. Code § 21.3022 28 TAC § 21.3022. Continuation of Benefits, DIVISION 4. PRESCRIPTION DRUG FORMULARY COVERAGE AND DISCLOSURE REQUIREMENTS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T28_P1_C21_S21_3022.md)
- [28 Tex. Admin. Code § 21.3023 28 TAC § 21.3023. Nonformulary Prescription Drugs; Adverse Determination, DIVISION 4. PRESCRIPTION DRUG FORMULARY COVERAGE AND DISCLOSURE REQUIREMENTS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T28_P1_C21_S21_3023.md)
- [28 Tex. Admin. Code § 21.3030 28 TAC § 21.3030. Availability of Formulary Information, DIVISION 4. PRESCRIPTION DRUG FORMULARY COVERAGE AND DISCLOSURE REQUIREMENTS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T28_P1_C21_S21_3030.md)
- [28 Tex. Admin. Code § 21.3031 28 TAC § 21.3031. Formulary Information for Individual Health Benefit Plans on Issuer's Website, DIVISION 4. PRESCRIPTION DRUG FORMULARY COVERAGE AND DISCLOSURE REQUIREMENTS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T28_P1_C21_S21_3031.md)
- [28 Tex. Admin. Code § 21.3032 28 TAC § 21.3032. Formulary Disclosure Requirements for Individual Health Benefit Plans, DIVISION 4. PRESCRIPTION DRUG FORMULARY COVERAGE AND DISCLOSURE REQUIREMENTS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T28_P1_C21_S21_3032.md)
- [28 Tex. Admin. Code § 21.3033 28 TAC § 21.3033. Facilitating Comparison Shopping for Individual Health Benefit Plans, DIVISION 4. PRESCRIPTION DRUG FORMULARY COVERAGE AND DISCLOSURE REQUIREMENTS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T28_P1_C21_S21_3033.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T28_P1_C21_S21_3030. Check the current official text before relying on it. Not legal advice.