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).
Section 1352.002 — Exception; Application to Qualified Health Plan,
https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1352.htm#1352.002 (accessed Dec. 9, 2023).