CHAPTER 1425. APPLICATION OF SUBTITLE TO CERTAIN COVERAGE - Texas Statutes

INSURANCE CODE

TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES

SUBTITLE E. BENEFITS PAYABLE UNDER HEALTH COVERAGES

CHAPTER 1425. APPLICATION OF SUBTITLE TO CERTAIN COVERAGE

Sec. 1425.001. EXEMPTION FROM APPLICATION OF SUBTITLE. (a)

Except as provided by Section 1425.002, a provision of this

subtitle that becomes effective on or after January 2, 2010, does

not apply to:

(1) a plan that provides coverage only:

(A) for a specified disease or diseases or under an individual

limited benefit policy;

(B) for accidental death or dismemberment;

(C) as a supplement to a liability insurance policy; or

(D) for dental or vision care;

(2) disability income insurance coverage or a combination of

accident-only and disability income insurance coverage;

(3) credit insurance coverage;

(4) a hospital confinement indemnity policy;

(5) a Medicare supplemental policy as defined by Section

1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);

(6) a workers' compensation insurance policy;

(7) medical payment insurance coverage provided under a motor

vehicle insurance policy;

(8) a long-term care insurance policy, including a nursing home

fixed indemnity policy, except as provided by Subsection (b); or

(9) an occupational accident policy.

(b) A long-term care insurance policy, including a nursing home

fixed indemnity policy, is subject to this subtitle if the

commissioner determines that the policy provides benefits so

comprehensive that it is a health benefit plan and should not be

subject to the exemption provided under this section.

Added by Acts 2009, 81st Leg., R.S., Ch.

228, Sec. 1, eff. May 27, 2009.

Sec. 1425.002. SPECIFIC LANGUAGE CONTROLS. A provision of this

subtitle that becomes effective on or after January 2, 2010, and

that requires coverage or the offer of coverage of a health care

service or benefit applies to a plan or policy described by

Section 1425.001(a) only to the extent expressly and specifically

provided by law.

Added by Acts 2009, 81st Leg., R.S., Ch.

228, Sec. 1, eff. May 27, 2009.