Tex.
Ins. Code Section 1369.053
Exception
(1)
a health benefit plan that provides coverage:(A)
only for a specified disease or for another single benefit;(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;(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 1369.052 (Applicability of Subchapter);(6)
the child health plan program under Chapter 62 (Child Health Plan for Certain Low-income Children), Health and Safety Code, or the health benefits plan for children under Chapter 63 (Health Benefits Plan for Certain Children), Health and Safety Code; or(7)
a Medicaid managed care program operated under Chapter 533, Government Code, or a Medicaid program operated under Chapter 32 (Medical Assistance Program), Human Resources Code.(1)
a health benefit plan that provides coverage:(A)
only for a specified disease or for another single benefit;(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;(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 1369.052 (Applicability of Subchapter);(6)
the child health plan program under Chapter 62 (Child Health Plan for Certain Low-income Children), Health and Safety Code, or the health benefits plan for children under Chapter 63 (Health Benefits Plan for Certain Children), Health and Safety Code; or(7)
a Medicaid managed care program operated under Chapter 540 (Medicaid Managed Care Program) or 540A (Medicaid Managed Transportation Services), Government Code, as applicable, or a Medicaid program operated under Chapter 32 (Medical Assistance Program), Human Resources Code.
Source:
Section 1369.053 — Exception, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1369.htm#1369.053 (accessed Jun. 5, 2024).
