reglab/housing_qa huggingface dataset:
TX Ins Code § 1358.101 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1358 - Diabetes|Subchapter C. Cost-Sharing Limit|Section 1358.101. Applicability of Subchapter

Sec. 1358.101.  APPLICABILITY OF SUBCHAPTER.  (a)  This subchapter applies only to a health benefit plan that provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, including an individual, group, blanket, or franchise insurance policy or insurance agreement, a group hospital service contract, or a small or large employer group contract or similar coverage document that is offered by:(1)  an insurance company;(2)  a group hospital service corporation operating under Chapter 842;(3)  a fraternal benefit society operating under Chapter 885;(4)  a stipulated premium company operating under Chapter 884;(5)  a reciprocal exchange operating under Chapter 942;(6)  a health maintenance organization operating under Chapter 843;(7)  a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846; or(8)  an approved nonprofit health corporation that holds a certificate of authority under Chapter 844.(b)  This subchapter applies to group health coverage made available by a school district in accordance with Section 22.004, Education Code.(c)  Notwithstanding any provision in Chapter 1551, 1575, 1579, or 1601 or any other law, this subchapter applies to:(1)  a basic coverage plan under Chapter 1551;(2)  a basic plan under Chapter 1575;(3)  a primary care coverage plan under Chapter 1579; and(4)  basic coverage under Chapter 1601.(d)  Notwithstanding any other law, this subchapter applies to coverage under:(1)  the child health plan program under Chapter 62, Health and Safety Code, or the health benefits plan for children under Chapter 63, Health and Safety Code; and(2)  the medical assistance program under Chapter 32, Human Resources Code.|Added by Acts 2021, 87th Leg., R.S., Ch. 589 (S.B. 827), Sec. 1, eff. September 1, 2021.|
TX Ins Code § 1358.102 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1358 - Diabetes|Subchapter C. Cost-Sharing Limit|Section 1358.102. Exception

Sec. 1358.102.  EXCEPTION.  This subchapter does not apply to:(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);(3)  medical payment insurance coverage provided under a motor vehicle insurance policy;(4)  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 1358.101;(5)  health and accident coverage provided by a risk pool created under Chapter 172, Local Government Code; or(6)  a workers' compensation insurance policy.|Added by Acts 2021, 87th Leg., R.S., Ch. 589 (S.B. 827), Sec. 1, eff. September 1, 2021.|
TX Ins Code § 1358.103 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1358 - Diabetes|Subchapter C. Cost-Sharing Limit|Section 1358.103. Limit on Cost-Sharing Requirement

Sec. 1358.103.  LIMIT ON COST-SHARING REQUIREMENT.  (a)  In this section, "insulin" means a prescription drug that contains insulin and is used to treat diabetes.  The term does not include an insulin drug that is administered to a patient intravenously.(b)  A health benefit plan may not impose a cost-sharing provision for insulin that is included in the health benefit plan's formulary if the total amount the enrollee is required to pay exceeds $25 per prescription for a 30-day supply, regardless of the amount or type of insulin needed to fill the enrollee's prescription.|Added by Acts 2021, 87th Leg., R.S., Ch. 589 (S.B. 827), Sec. 1, eff. September 1, 2021.|
TX Ins Code § 1358.104 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1358 - Diabetes|Subchapter C. Cost-Sharing Limit|Section 1358.104. Formulary Requirement

Sec. 1358.104.  FORMULARY REQUIREMENT.  A health benefit plan must include at least one insulin from each therapeutic class in the plan's formulary.|Added by Acts 2021, 87th Leg., R.S., Ch. 589 (S.B. 827), Sec. 1, eff. September 1, 2021.|
TX Ins Code § 1364.001 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1364 - Coverage Provisions Relating to Hiv, Aids, or HIV-Related Illnesses|Subchapter A. Exclusion From or Denial of Coverage Prohibited|Section 1364.001. Applicability of Subchapter

Sec. 1364.001.  APPLICABILITY OF SUBCHAPTER.  This subchapter applies only to a group health benefit plan that is delivered, issued for delivery, or renewed and that is:(1)  a group accident and health insurance policy;(2)  a group contract issued by a group hospital service corporation operating under Chapter 842;  or(3)  a group evidence of coverage issued by a health maintenance organization operating under Chapter 843.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1364.002 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1364 - Coverage Provisions Relating to Hiv, Aids, or HIV-Related Illnesses|Subchapter A. Exclusion From or Denial of Coverage Prohibited|Section 1364.002. Exception

Sec. 1364.002.  EXCEPTION.  This subchapter does not apply to:(1)  a credit accident and health insurance policy subject to Chapter 1153;(2)  any group specifically provided for or authorized by law in existence and covered under a policy filed with the State Board of Insurance before April 1, 1975;(3)  accident or health coverage that is incidental to any form of a group automobile, casualty, property, workers' compensation, or employers' liability policy approved by the department;  or(4)  any policy or contract of insurance with a state agency, department, or board providing health services:(A)  to eligible individuals under Chapter 32, Human Resources Code;  or(B)  under a state plan adopted in accordance with 42 U.S.C. Sections 1396-1396g, as amended, or 42 U.S.C. Section 1397aa et seq., as amended.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1364.003 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1364 - Coverage Provisions Relating to Hiv, Aids, or HIV-Related Illnesses|Subchapter A. Exclusion From or Denial of Coverage Prohibited|Section 1364.003. Prohibition

Sec. 1364.003.  PROHIBITION.  A group health benefit plan may not exclude or deny coverage for:(1)  human immunodeficiency virus (HIV);(2)  acquired immune deficiency syndrome (AIDS);  or(3)  an HIV-related illness.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1364.004 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1364 - Coverage Provisions Relating to Hiv, Aids, or HIV-Related Illnesses|Subchapter A. Exclusion From or Denial of Coverage Prohibited|Section 1364.004. Rules

Sec. 1364.004.  RULES.  The commissioner may adopt rules necessary to administer this subchapter.  A rule adopted under this section is subject to notice and hearing as provided by Section 1201.007 for a rule adopted under Chapter 1201.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1364.051 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1364 - Coverage Provisions Relating to Hiv, Aids, or HIV-Related Illnesses|Subchapter B. Cancellation of Group Coverage Prohibited|Section 1364.051. Definitions

Sec. 1364.051.  DEFINITIONS.  In this subchapter, "AIDS" and "HIV" have the meanings assigned by Section 81.101, Health and Safety Code.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1364.052 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1364 - Coverage Provisions Relating to Hiv, Aids, or HIV-Related Illnesses|Subchapter B. Cancellation of Group Coverage Prohibited|Section 1364.052. Applicability of Subchapter

Sec. 1364.052.  APPLICABILITY OF SUBCHAPTER.  This subchapter applies to an insurer that delivers or issues for delivery a group health insurance policy or contract in this state, including a group hospital service corporation operating under Chapter 842.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1364.053 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1364 - Coverage Provisions Relating to Hiv, Aids, or HIV-Related Illnesses|Subchapter B. Cancellation of Group Coverage Prohibited|Section 1364.053. Prohibition

Sec. 1364.053.  PROHIBITION.  (a)  Except as provided by Subsection (b), an insurer may not cancel during the term of a group health insurance policy or contract an individual's coverage provided by the policy or contract because the individual:(1)  has been diagnosed as having AIDS or HIV;(2)  has been treated for AIDS or HIV;  or(3)  is being treated for AIDS or HIV.(b)  The insurer may cancel the coverage provided by the policy or contract for fraud or misrepresentation in the obtaining of coverage by failure to disclose a diagnosis of AIDS or an HIV-related condition.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1364.101 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1364 - Coverage Provisions Relating to Hiv, Aids, or HIV-Related Illnesses|Subchapter C. Certain Coverages Provided by Local Governments|Section 1364.101. Prohibition on Exclusion or Limitation of Coverages

Sec. 1364.101.  PROHIBITION ON EXCLUSION OR LIMITATION OF COVERAGES.  A political subdivision that provides group health insurance coverage, health maintenance organization coverage, or self-insured health care coverage to the political subdivision's officers or employees may not contract for or provide coverage that excludes or limits coverage or services for:(1)  acquired immune deficiency syndrome, as defined by the Centers for Disease Control and Prevention of the United States Public Health Service;  or(2)  human immunodeficiency virus infection.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1366.001 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1366 - Benefits Related to Fertility and Childbirth|Subchapter A. Coverage for in Vitro Fertilization Procedures|Section 1366.001. Applicability of Subchapter

Sec. 1366.001.  APPLICABILITY OF SUBCHAPTER.  This subchapter applies only to a group health benefit plan that provides benefits for hospital, medical, or surgical expenses incurred as a result of accident or sickness, including a group health insurance policy, health care service contract or plan, or other provision of group health benefits, coverage, or services in this state that is issued, entered into, or provided by:(1)  an insurer;(2)  a group hospital service corporation operating under Chapter 842;(3)  a health maintenance organization operating under Chapter 843;  or(4)  an employer, multiple employer, union, association, trustee, or other self-funded or self-insured welfare or benefit plan, program, or arrangement.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1366.002 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1366 - Benefits Related to Fertility and Childbirth|Subchapter A. Coverage for in Vitro Fertilization Procedures|Section 1366.002. Exception

Sec. 1366.002.  EXCEPTION.  This subchapter does not apply to:(1)  a credit accident and health insurance policy subject to Chapter 1153;(2)  any group specifically provided for or authorized by law in existence and covered under a policy filed with the State Board of Insurance before April 1, 1975;(3)  accident and health coverages that are incidental to any form of a group automobile, casualty, property, workers' compensation, or employers' liability policy approved by the commissioner;  or(4)  any policy or contract of insurance with a state agency, department, or board providing health services:(A)  to eligible individuals under Chapter 32, Human Resources Code;  or(B)  under a state plan adopted in accordance with 42 U.S.C. Sections 1396-1396g, as amended, or 42 U.S.C. Section 1397aa et seq., as amended.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1366.003 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1366 - Benefits Related to Fertility and Childbirth|Subchapter A. Coverage for in Vitro Fertilization Procedures|Section 1366.003. Offer of Coverage Required

Sec. 1366.003.  OFFER OF COVERAGE REQUIRED.  (a)  Subject to this subchapter, an issuer of a group health benefit plan that provides pregnancy-related benefits for individuals covered under the plan shall offer and make available to each holder or sponsor of the plan coverage for services and benefits on an expense incurred, service, or prepaid basis for outpatient expenses that arise from in vitro fertilization procedures.(b)  Benefits for in vitro fertilization procedures required under this section must be provided to the same extent as benefits provided for other pregnancy-related procedures under the plan.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1366.004 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1366 - Benefits Related to Fertility and Childbirth|Subchapter A. Coverage for in Vitro Fertilization Procedures|Section 1366.004. Rejection of Offer

Sec. 1366.004.  REJECTION OF OFFER.  A rejection of an offer under Section 1366.003 to provide coverage for in vitro fertilization procedures must be in writing.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1366.005 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1366 - Benefits Related to Fertility and Childbirth|Subchapter A. Coverage for in Vitro Fertilization Procedures|Section 1366.005. Conditions Applicable to Coverage

Sec. 1366.005.  CONDITIONS APPLICABLE TO COVERAGE.  The coverage offered under Section 1366.003 is required only if:(1)  the patient for the in vitro fertilization procedure is an individual covered under the group health benefit plan;(2)  the fertilization or attempted fertilization of the patient's oocytes is made only with the sperm of the patient's spouse;(3)  the patient and the patient's spouse have a history of infertility of at least five continuous years' duration or the infertility is associated with:(A)  endometriosis;(B)  exposure in utero to diethylstilbestrol (DES);(C)  blockage of or surgical removal of one or both fallopian tubes;  or(D)  oligospermia;(4)  the patient has been unable to attain a successful pregnancy through any less costly applicable infertility treatments for which coverage is available under the group health benefit plan;  and(5)  the in vitro fertilization procedures are performed at a medical facility that conforms to the minimal standards for programs of in vitro fertilization adopted by the American Society for Reproductive Medicine.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1366.006 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1366 - Benefits Related to Fertility and Childbirth|Subchapter A. Coverage for in Vitro Fertilization Procedures|Section 1366.006. Certain Issuers of Health Benefit Plans Not Required to Offer Coverage

Sec. 1366.006.  CERTAIN ISSUERS OF HEALTH BENEFIT PLANS NOT REQUIRED TO OFFER COVERAGE.  An insurer, health maintenance organization, or self-insuring employer that is owned by or that is part of an entity, group, or order that is directly affiliated with a bona fide religious denomination that includes as an integral part of its beliefs and practices that in vitro fertilization is contrary to moral principles that the religious denomination considers to be an essential part of its beliefs is not required to offer coverage for in vitro fertilization under Section 1366.003.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1366.007 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1366 - Benefits Related to Fertility and Childbirth|Subchapter A. Coverage for in Vitro Fertilization Procedures|Section 1366.007. Rules

Sec. 1366.007.  RULES.  The commissioner may adopt rules necessary to administer this subchapter.  A rule adopted under this section is subject to notice and hearing as provided by Section 1201.007 for a rule adopted under Chapter 1201.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1366.051 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1366 - Benefits Related to Fertility and Childbirth|Subchapter B. Minimum Inpatient Stay Following Birth of Child and Postdelivery Care|Section 1366.051. Short Title

Sec. 1366.051.  SHORT TITLE.  This subchapter may be cited as the Lee Alexandria Hanley Act.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1366.052 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1366 - Benefits Related to Fertility and Childbirth|Subchapter B. Minimum Inpatient Stay Following Birth of Child and Postdelivery Care|Section 1366.052. Definitions

Sec. 1366.052.  DEFINITIONS.  In this subchapter:(1)  "Attending physician" means an obstetrician, pediatrician, or other physician who attends a woman who has given birth to a child or who attends a newborn child.(2)  "Postdelivery care" means postpartum health care services provided in accordance with accepted maternal and neonatal physical assessments.  The term includes parent education, assistance and training in breast-feeding and bottle-feeding, and the performance of any necessary and appropriate clinical tests.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1366.053 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1366 - Benefits Related to Fertility and Childbirth|Subchapter B. Minimum Inpatient Stay Following Birth of Child and Postdelivery Care|Section 1366.053. Applicability of Subchapter

Sec. 1366.053.  APPLICABILITY OF SUBCHAPTER.  This subchapter applies only to a health benefit plan that:(1)  provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, including:(A)  an individual, group, blanket, or franchise insurance policy or insurance agreement, a group hospital service contract, or an individual or group evidence of coverage that is offered by:(i)  an insurance company;(ii)  a group hospital service corporation operating under Chapter 842;(iii)  a fraternal benefit society operating under Chapter 885;(iv)  a stipulated premium company operating under Chapter 884;  or(v)  a health maintenance organization operating under Chapter 843;  and(B)  to the extent permitted by the Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.), a health benefit plan that is offered by:(i)  a multiple employer welfare arrangement as defined by Section 3 of that Act;(ii)  an entity not authorized under this code or another insurance law of this state that contracts directly for health care services on a risk-sharing basis, including a capitation basis;  or(iii)  another analogous benefit arrangement;  or(2)  is offered by an approved nonprofit health corporation that holds a certificate of authority under Chapter 844.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1366.054 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle E - Benefits Payable Under Health Coverages|Chapter 1366 - Benefits Related to Fertility and Childbirth|Subchapter B. Minimum Inpatient Stay Following Birth of Child and Postdelivery Care|Section 1366.054. Exception

Sec. 1366.054.  EXCEPTION.  This subchapter does not apply to:(1)  a plan that provides coverage:(A)  only for a specified disease or for another limited 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;  or(G)  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);(3)  a workers' compensation insurance policy;(4)  medical payment insurance coverage provided under a motor vehicle insurance policy;  or(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 1366.053.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|