Texas Insurance Code
Sec. § 1504.052
Child Residing Outside Service Area; Comparable Health or Dental Coverage Required


(a)

A benefit plan issuer may not deny enrollment of a child under the health or dental coverage of the childs parent on the ground that the child does not reside in the issuers service area.

(b)

A benefit plan issuer may not enforce an otherwise applicable provision of the health or dental coverage that would deny, limit, or reduce payment of a claim for a covered child who resides outside the issuers service area but inside the United States.

(c)

For a covered child who resides outside the benefit plan issuers service area and whose coverage under a policy or plan is required by a medical support order or dental support order, the issuer shall provide coverage that is comparable health or dental coverage to that provided to other dependents under the policy or plan.

(d)

Comparable health or dental coverage may include coverage in which a benefit plan issuer uses different procedures for service delivery and health care provider reimbursement. Comparable health or dental coverage may not include coverage:

(1)

that is limited to emergency services only; or

(2)

for which the issuer charges a higher premium.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Amended by:
Acts 2015, 84th Leg., R.S., Ch. 1150 (S.B. 550), Sec. 65, eff. September 1, 2018.
Source
Last accessed
Apr. 3, 2020