Tex.
Ins. Code Section 1352.002
Exception; Application to Qualified Health Plan
(a)
This chapter does not apply to:(1)
a plan that provides coverage:(A)
only for a specified disease or for another limited benefit other than an accident policy;(B)
only for accidental death or dismemberment;(C)
for wages or payments in lieu of wages for a period during which an employee is absent from work because of sickness or injury;(D)
as a supplement to a liability insurance policy;(E)
for credit insurance;(F)
only for dental or vision care;(G)
only for hospital expenses; or(H)
only for indemnity for hospital confinement;(2)
a Medicare supplemental policy as defined by Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss), as amended;(3)
a workers’ compensation insurance policy;(4)
medical payment insurance coverage provided under a motor vehicle insurance policy; or(5)
a long-term care insurance policy, including a nursing home fixed indemnity policy, unless the commissioner determines that the policy provides benefit coverage so comprehensive that the policy is a health benefit plan as described by Section 1352.001 (Applicability of Chapter).(b)
This chapter does not apply to a standard health benefit plan issued under Chapter 1507 (Consumer Choice of Benefits Plans).(c)
To the extent that a change in law made to this chapter after January 1, 2013, would otherwise require this state to make a payment under 42 U.S.C. Section 18031(d)(3)(B)(ii), a qualified health plan, as defined by 45 C.F.R. Section 155.20, is not required to provide a benefit under this section that exceeds the specified essential health benefits required under 42 U.S.C. Section 18022(b).
Source:
Section 1352.002 — Exception; Application to Qualified Health Plan, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1352.htm#1352.002 (accessed May 4, 2024).
