CHAPTER 1365. LOSS OR IMPAIRMENT OF SPEECH OR HEARING - Texas Statutes

INSURANCE CODE

TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES

SUBTITLE E. BENEFITS PAYABLE UNDER HEALTH COVERAGES

CHAPTER 1365. LOSS OR IMPAIRMENT OF SPEECH OR HEARING

Sec. 1365.001. APPLICABILITY OF CHAPTER. This chapter applies

only to a group health benefit plan that provides hospital and

medical coverage on an expense-incurred, service, or prepaid

basis, including a group policy, contract, or plan that is

offered in this state by:

(1) an insurer;

(2) a group hospital service corporation operating under Chapter

842; or

(3) a health maintenance organization operating under Chapter

843.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,

2005.

Sec. 1365.002. APPLICABILITY OF GENERAL PROVISIONS OF OTHER LAW.

The provisions of Chapter 1201, including provisions relating to

the applicability, purpose, and enforcement of that chapter,

construction of policies under that chapter, rulemaking under

that chapter, and definitions of terms applicable in that

chapter, apply to this chapter.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,

2005.

Sec. 1365.003. OFFER OF COVERAGE REQUIRED. (a) A group health

benefit plan issuer shall offer and make available under the plan

coverage for the necessary care and treatment of loss or

impairment of speech or hearing.

(b) Coverage required under this section:

(1) may not be less favorable than coverage for physical illness

generally under the plan; and

(2) must be subject to the same durational limits, dollar

limits, deductibles, and coinsurance factors as coverage for

physical illness generally under the plan.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,

2005.

Sec. 1365.004. RIGHT TO REJECT COVERAGE OR SELECT ALTERNATIVE

BENEFITS. An offer of coverage required under Section 1365.003

is subject to the right of the group contract holder to reject

the coverage or to select an alternative level of benefits that

is offered by or negotiated with the group health benefit plan

issuer.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,

2005.

Amended by:

Acts 2007, 80th Leg., R.S., Ch.

730, Sec. 3B.028, eff. September 1, 2007.

Acts 2007, 80th Leg., R.S., Ch.

921, Sec. 9.028, eff. September 1, 2007.