Tex. Ins. Code Section 463.201
Persons Covered


(a)

Subject to Subsections (b) and (c), this chapter provides coverage for a policy or contract described by Section 463.202 (Policies and Contracts Covered) to a person who is:

(1)

a person, other than a certificate holder under a group policy or contract who is not a resident, who is a beneficiary, assignee, or payee, including a health care provider who renders services covered under a health insurance policy or certificate, of a person described by Subdivision (2);

(2)

a person who is an owner of or certificate holder or enrollee under a policy or contract specified by Section 463.202 (Policies and Contracts Covered), other than an unallocated annuity contract or structured settlement annuity, and who is:

(A)

a resident; or

(B)

not a resident, but only under all of the following conditions:
(i)
the member insurers that issued the policies or contracts are domiciled in this state;
(ii)
the state in which the person resides has an association similar to the association; and
(iii)
the person is not eligible for coverage by an association in any other state because the insurer or health maintenance organization was not licensed in the state at the time specified in that state’s guaranty association law;

(3)

a person who is the owner of an unallocated annuity contract issued to or in connection with:

(A)

a benefit plan whose plan sponsor has the sponsor’s principal place of business in this state; or

(B)

a government lottery, if the owner is a resident; or

(4)

a person who is the payee under a structured settlement annuity, or beneficiary of the payee if the payee is deceased, if:

(A)

the payee is a resident, regardless of where the contract owner resides;

(B)

the payee is not a resident, the contract owner of the structured settlement annuity is a resident, and the payee is not eligible for coverage by the association in the state in which the payee resides; or

(C)

the payee and the contract owner are not residents, the insurer that issued the structured settlement annuity is domiciled in this state, the state in which the contract owner resides has an association similar to the association, and neither the payee or, if applicable, the payee’s beneficiary, nor the contract owner is eligible for coverage by the association in the state in which the payee or contract owner resides.

(b)

This chapter does not provide coverage to:

(1)

a person who is a payee or the beneficiary of a payee with respect to a contract the owner of which is a resident of this state, if the payee or the payee’s beneficiary is afforded any coverage by the association of another state;

(2)

a person otherwise described by Subsection (a)(3), if any coverage is provided by the association of another state to that person; or

(3)

a person who acquires rights to receive payments through a structured settlement factoring transaction as defined by Section 5891(c)(3)(A), Internal Revenue Code of 1986 (26 U.S.C. Section 5891(c)(3)(A)), regardless of whether the transaction occurred before, on, or after the date that section became effective.

(c)

This chapter is intended to provide coverage to persons who are residents of this state, and in those limited circumstances as described in this chapter, to nonresidents. In order to avoid duplicate coverage, if a person who would otherwise receive coverage under this chapter is provided coverage under the laws of any other state, the person may not be provided coverage under this chapter. In determining the application of the provisions of this subsection in situations in which a person could be covered by the association of more than one state, whether as an owner, payee, enrollee, beneficiary, or assignee, this chapter shall be construed in conjunction with other state laws to result in coverage by only one association.
Added by Acts 2005, 79th Leg., Ch. 727 (H.B. 2017), Sec. 1, eff. April 1, 2007.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 3B.018(a), eff. September 1, 2007.
Acts 2007, 80th Leg., R.S., Ch. 921 (H.B. 3167), Sec. 9.018(a), eff. September 1, 2007.
Acts 2019, 86th Leg., R.S., Ch. 432 (S.B. 1153), Sec. 12, eff. September 1, 2019.

Source: Section 463.201 — Persons Covered, https://statutes.­capitol.­texas.­gov/Docs/IN/htm/IN.­463.­htm#463.­201 (accessed Mar. 23, 2024).

463.001
Short Title
463.002
Purpose
463.003
General Definitions
463.004
Construction
463.005
Immunity
463.006
Rules
463.007
Construction of Long-term Care Rider
463.0031
Definition of Principal Place of Business of Plan Sponsor or Other Person
463.0032
Use of Terms Policy and Contract
463.051
Purpose and Regulation of Association
463.052
Required Participation in Association
463.053
Board of Directors
463.054
Eligibility to Serve as Public Representative
463.055
Term
463.056
Compensation of Board Members
463.057
Financial Statement of Board Member
463.058
Conflict of Interest
463.059
Meetings by Telephone and Videoconference
463.101
General Powers and Duties
463.102
Plan of Operation
463.103
Personnel
463.104
Association Records
463.105
Accounts
463.106
Delegation of Powers and Duties
463.107
Exemption from Taxation
463.108
Detection and Prevention of Impairment and Insolvency
463.109
Association Appearance Before Court
463.110
Annual Report
463.111
Board and Association Advice and Assistance
463.112
Board Access to Records
463.113
Board Report at Conclusion of Insolvency
463.114
Summary Document
463.151
Making and Payment of Assessment
463.152
Classes of Assessments
463.153
Amount of Assessments
463.154
Deferment
463.155
Deposit of Assessments
463.156
Certificate of Contribution
463.157
Refunds
463.158
Use of Assessments
463.159
Failure to Pay
463.160
Premium Tax Credit for Class a Assessment
463.161
Premium Tax Credit for Class B Assessment
463.162
Assignment or Transfer of Credit
463.163
Insured’s Liability Under Assessment Plan
463.201
Persons Covered
463.202
Policies and Contracts Covered
463.203
Policies and Contracts Excluded
463.204
Obligations Excluded
463.205
Protection Provided by Other Jurisdiction
463.206
Association Discretion in Manner of Providing Benefits
463.251
Impaired Domestic Insurer
463.252
Impaired Domestic, Foreign, or Alien Insurer Not Paying Claims
463.253
Insolvent Insurer
463.254
Life or Health Insurance Policies or Contracts
463.255
Policy or Contract with Guaranteed Interest Rate
463.256
Alternative Policy
463.257
Imposition of Lien or Moratorium
463.258
Premium for Reissuance of Terminated Coverage
463.259
Premium Due During Receivership
463.260
Limits on and Termination of Association Obligation
463.261
Assignment of Rights
463.262
Effect of Subrogation and Assignment of Rights and Available Assets on Association Obligation
463.263
Deposit to Be Paid to Association
463.264
Reinsurance
463.301
Issuance or Renewal of Policies Following Conservatorship or Receivership
463.302
Distributions to Shareholders and Affiliates
463.303
Assets Attributable to Covered Policies
463.304
Distribution of Ownership Rights of Impaired or Insolvent Insurer
463.351
Notice of Commissioner Actions
463.352
Advice from Board
463.353
Examination
463.354
Demand to Cure Impairment
463.355
Failure to Comply with Plan of Operation
463.356
Assumption of Powers and Duties of Association
463.357
Notification of Effect of Chapter
463.358
Statement of Premiums
463.401
Appeal to Commissioner
463.402
Venue
463.403
Appeal Bond
463.404
Stay of Proceedings
463.451
Prohibited Use of Protection Provided by Chapter

Accessed:
Mar. 23, 2024

§ 463.201’s source at texas​.gov