Tex. Ins. Code Section 1253.001
Limitation of Services and Benefits on Contract Renegotiation

(a)

In this section, “health benefit contract” means a contract providing group health care coverage for employees that is delivered, issued for delivery, or renewed in this state by:

(1)

an insurance company;

(2)

a group hospital service corporation operating under Chapter 842 (Group Hospital Service Corporations); or

(3)

a health maintenance organization operating under Chapter 843 (Health Maintenance Organizations).

(b)

Subject to Subsection (c), if an employer in this state agrees to renegotiate a health benefit contract, a change in the renegotiated contract may not operate solely to terminate eligibility with respect to any member of the group who, before the contract was renegotiated:

(1)

was covered under the contract; and

(2)

had a sickness or injury for which a service was being provided or a benefit was being paid under the contract.

(c)

A renegotiated health benefit contract may include a different durational or dollar limit or a different deductible amount or amount of coinsurance applicable to a sickness or injury for which a service was being provided or benefit was being paid before the contract was renegotiated if that same or a similar limit or amount applies to a service provided or benefit paid for a similar sickness or a related condition or injury covered by the contract.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.

Source: Section 1253.001 — Limitation of Services and Benefits on Contract Renegotiation, https://statutes.­capitol.­texas.­gov/Docs/IN/htm/IN.­1253.­htm#1253.­001 (accessed May 18, 2024).

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Accessed:
May 18, 2024

§ 1253.001’s source at texas​.gov