reglab/housing_qa huggingface dataset:
TX Ins Code § 1502.002 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1502 - Health Benefit Plans for Children|Subchapter A. General Provisions|Section 1502.002. Rules

Sec. 1502.002.  RULES.  (a) The commissioner may adopt rules to implement this chapter, including rules necessary to:(1)  increase the availability of coverage to children younger than 19 years of age;(2)  establish an open enrollment period; and(3)  establish qualifying events as exceptions to the open enrollment period, including loss of coverage when a child becomes ineligible for coverage under the state child health plan.(b)  The commissioner may adopt rules on an emergency basis using the procedures established under Section 2001.034, Government Code.(c)  Notwithstanding Subsection (b), the commissioner is not required to make a finding under Section 2001.034(a), Government Code, before adopting rules on an emergency basis.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.Amended by: Acts 2011, 82nd Leg., R.S., Ch. 1147 (H.B. 1951), Sec. 9.001, eff. September 1, 2011.|
TX Ins Code § 1502.051 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1502 - Health Benefit Plans for Children|Subchapter B. Children's Health Benefit Plan|Section 1502.051. Children's Health Benefit Plan

Sec. 1502.051.  CHILDREN'S HEALTH BENEFIT PLAN.  A health benefit plan issuer may offer a children's health benefit plan that provides coverage only to children younger than 18 years of age.  The issuer may offer the plan only if the commissioner approves the plan's structure and the benefits offered under the plan.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1502.052 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1502 - Health Benefit Plans for Children|Subchapter B. Children's Health Benefit Plan|Section 1502.052. Mandated Benefit Provisions Inapplicable

Sec. 1502.052.  MANDATED BENEFIT PROVISIONS INAPPLICABLE.  A children's health benefit plan is not subject to any law that requires coverage or the offer of coverage of a health care service or benefit.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1502.053 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1502 - Health Benefit Plans for Children|Subchapter B. Children's Health Benefit Plan|Section 1502.053. Exemption From Certain Taxes

Sec. 1502.053.  EXEMPTION FROM CERTAIN TAXES.  (a)  The issuer of a children's health benefit plan approved under Section 1502.051 is not subject to the premium tax or the tax on revenues imposed under Chapter 222 with respect to money received for coverage provided under that plan.(b)  The issuer of a children's health benefit plan approved under Section 1502.051 is not subject to the retaliatory tax imposed under Chapter 281 with respect to money received for coverage provided under that plan.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.Amended by: Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.062(a), eff. September 1, 2005.Acts 2007, 80th Leg., R.S., Ch. 932 (H.B. 3315), Sec. 19, eff. June 15, 2007.|
TX Ins Code § 1504.001 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1504 - Medical and Dental Child Support|Subchapter A. General Provisions|Section 1504.001. Definitions

Sec. 1504.001.  DEFINITIONS.  In this chapter:(1)  "Child" has the meaning assigned by Section 101.003, Family Code.(2)  "Child support agency" has the meaning assigned by Section 101.004, Family Code.(3)  "Custodial parent" means an individual who:(A)  is a managing conservator of a child or a possessory conservator of a child who is a parent of the child;  or(B)  is a guardian of the person or other custodian of a child and is designated as guardian or custodian by a court or administrative agency of this or another state.(4)  "Benefit plan issuer" means:(A)  an insurance company, group hospital service corporation, or health maintenance organization that delivers or issues for delivery an individual, group, blanket, or franchise insurance policy or agreement, a group hospital service contract, or an evidence of coverage that provides benefits for medical or surgical expenses incurred as a result of an accident or sickness, or dental expenses;(B)  a governmental entity subject to Subchapter D, Chapter 1355, Subchapter C, Chapter 1364, Chapter 1578, Article 3.51-1, 3.51-4, or 3.51-5, or Chapter 177, Local Government Code;(C)  the issuer of a multiple employer welfare arrangement as defined by Section 846.001; or(D)  the issuer of a group health plan as defined by Section 607, Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1167).(5)  "Medical assistance" means medical assistance under the state Medicaid program.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.Amended by: Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2G.016, eff. April 1, 2009.Acts 2015, 84th Leg., R.S., Ch. 1150 (S.B. 550), Sec. 60, eff. September 1, 2018.|
TX Ins Code § 1504.002 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1504 - Medical and Dental Child Support|Subchapter A. General Provisions|Section 1504.002. Rules

Sec. 1504.002.  RULES.  (a)  The commissioner shall adopt reasonable rules as necessary to implement this chapter and 42 U.S.C. Section 1396a(a)(60), including rules that define acts that constitute unfair or deceptive practices under Subchapter I, Chapter 541.(b)  The commissioner shall adopt rules that define "comparable health or dental coverage" in a manner that:(1)  is consistent with federal law; and(2)  complies with the requirements necessary to maintain federal Medicaid funding.|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. 61, eff. September 1, 2018.|
TX Ins Code § 1504.003 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1504 - Medical and Dental Child Support|Subchapter A. General Provisions|Section 1504.003. Violation of Chapter: Relief Available to Injured Person

Sec. 1504.003.  VIOLATION OF CHAPTER:  RELIEF AVAILABLE TO INJURED PERSON.  A benefit plan issuer that violates this chapter is subject to the same penalties, and an injured person has the same rights and remedies, as those provided by Subchapter D, Chapter 541.|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. 62, eff. September 1, 2018.|
TX Ins Code § 1504.051 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1504 - Medical and Dental Child Support|Subchapter B. Duties of Benefit Plan Issuer|Section 1504.051. Enrollment of Certain Children Required

Sec. 1504.051.  ENROLLMENT OF CERTAIN CHILDREN REQUIRED.  (a)  A benefit plan issuer shall permit a parent to enroll a child in dependent health or dental coverage offered through the issuer regardless of any enrollment period restriction if the parent is:(1)  eligible for dependent health or dental coverage; and(2)  required by a court order or administrative order to provide health or dental insurance coverage for the child.(b)  A benefit plan issuer shall enroll a child of a parent described by Subsection (a) in dependent health or dental coverage offered through the issuer if:(1)  the parent does not apply to obtain health or dental coverage for the child through the issuer; and(2)  the child, a custodial parent of the child, or a child support agency having a duty to collect or enforce support for the child applies for the coverage.|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. 64, eff. September 1, 2018.|
TX Ins Code § 1504.052 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1504 - Medical and Dental Child Support|Subchapter B. Duties of Benefit Plan Issuer|Section 1504.052. Child Residing Outside Service Area; Comparable Health or Dental Coverage Required

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 child's parent on the ground that the child does not reside in the issuer's 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 issuer's service area but inside the United States.(c)  For a covered child who resides outside the benefit plan issuer's 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.|
TX Ins Code § 1504.053 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1504 - Medical and Dental Child Support|Subchapter B. Duties of Benefit Plan Issuer|Section 1504.053. Cancellation or Nonrenewal of Coverage for Certain Children

Sec. 1504.053.  CANCELLATION OR NONRENEWAL OF COVERAGE FOR CERTAIN CHILDREN.  (a)  A benefit plan issuer may not cancel or refuse to renew health or dental coverage provided to a child who is enrolled or entitled to enrollment under this chapter unless satisfactory written evidence is filed with the issuer showing that:(1)  the court or administrative order that required the coverage is not in effect; or(2)  the child:(A)  is enrolled in comparable health or dental coverage; or(B)  will be enrolled in comparable health or dental coverage that takes effect not later than the effective date of the cancellation or nonrenewal.(b)  For purposes of this section, a child is not enrolled or entitled to enrollment under this chapter if the child's eligibility for health or dental coverage ends because the parent ceases to be eligible for dependent health or dental coverage.|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. 66, eff. September 1, 2018.|
TX Ins Code § 1504.054 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1504 - Medical and Dental Child Support|Subchapter B. Duties of Benefit Plan Issuer|Section 1504.054. Continuation or Conversion of Coverage

Sec. 1504.054.  CONTINUATION OR CONVERSION OF COVERAGE.  (a)  If a child's eligibility for dependent health or dental coverage ends because the parent ceases to be eligible for the coverage and the coverage provides for the continuation or conversion of the coverage for the child, the benefit plan issuer shall notify the custodial parent and the child support agency of the costs and other requirements for continuing or converting the coverage.(b)  The benefit plan issuer shall, on application of a parent of the child, a child support agency, or the child, enroll or continue enrollment of a child whose eligibility for coverage ended under Subsection (a).|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. 67, eff. September 1, 2018.|
TX Ins Code § 1504.055 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1504 - Medical and Dental Child Support|Subchapter B. Duties of Benefit Plan Issuer|Section 1504.055. Procedure for Claims

Sec. 1504.055.  PROCEDURE FOR CLAIMS.  (a)  A benefit plan issuer that provides health or dental coverage to a child through a covered parent of the child shall:(1)  provide to each custodial parent of the child or to an adult child documents and other information necessary for the child to obtain benefits under the coverage, including:(A)  the name of the issuer;(B)  the number of the policy or evidence of coverage;(C)  a copy of the policy or evidence of coverage and schedule of benefits;(D)  a health or dental coverage membership card;(E)  claim forms; and(F)  any other document or information necessary to submit a claim in accordance with the issuer's policies and procedures;(2)  permit a custodial parent, health care provider, state agency that has been assigned medical or dental support rights, or adult child to submit claims for covered services without the approval of the covered parent; and(3)  make payments on covered claims submitted in accordance with this subsection directly to a custodial parent, health care or dental care provider, adult child, or state agency making a claim.(b)  A benefit plan issuer shall provide to a state agency that provides medical assistance, including medical assistance for dental services, to the child or shall provide to a child support agency that enforces medical or dental support on behalf of a child the information necessary to obtain reimbursement of medical or dental services provided to or paid on behalf of the child.|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. 68, eff. September 1, 2018.|
TX Ins Code § 1504.101 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1504 - Medical and Dental Child Support|Subchapter C. Prohibited Conduct|Section 1504.101. Denial of Enrollment on Certain Grounds Prohibited

Sec. 1504.101.  DENIAL OF ENROLLMENT ON CERTAIN GROUNDS PROHIBITED.  A benefit plan issuer may not deny enrollment of a child under the health or dental coverage of the child's parent on the ground that the child:(1)  has a preexisting condition;(2)  was born out of wedlock;(3)  is not claimed as a dependent on the parent's federal income tax return;(4)  does not reside with the parent; or(5)  receives or has applied for medical assistance.|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. 69, eff. September 1, 2018.|
TX Ins Code § 1504.102 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1504 - Medical and Dental Child Support|Subchapter C. Prohibited Conduct|Section 1504.102. Assignment of Medical or Dental Support Rights: Different Requirements Prohibited

Sec. 1504.102.  ASSIGNMENT OF MEDICAL OR DENTAL SUPPORT RIGHTS:  DIFFERENT REQUIREMENTS PROHIBITED.  A benefit plan issuer may not require a state agency that has been assigned the rights of an individual who is eligible for medical assistance and is covered for health or dental benefits from the issuer to comply with a requirement that is different from a requirement imposed on an agent or assignee of any other covered individual.|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. 70, eff. September 1, 2018.|
TX Ins Code § 1507.001 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1507 - Consumer Choice of Benefits Plans|Subchapter A. Consumer Choice of Benefits Health Insurance Plans|Section 1507.001. Purpose

Sec. 1507.001.  PURPOSE.  The legislature recognizes the need for individuals, employers, and other purchasers of coverage in this state to have the opportunity to choose health insurance plans that are more affordable and flexible than existing market policies offering accident and sickness insurance coverage.  The legislature, therefore, seeks to increase the availability of health insurance coverage by allowing insurers authorized to engage in the business of insurance in this state to issue accident and sickness policies that, in whole or in part, do not offer or provide state-mandated health benefits.|Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.074(a), eff. September 1, 2005.|
TX Ins Code § 1507.002 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1507 - Consumer Choice of Benefits Plans|Subchapter A. Consumer Choice of Benefits Health Insurance Plans|Section 1507.002. Definitions

Sec. 1507.002.  DEFINITIONS.  In this subchapter:(1)  "Health carrier" means any entity authorized under this code or another insurance law of this state that provides health insurance or health benefits in this state.  The term includes an insurance company, a group hospital service corporation under Chapter 842, and a stipulated premium company under Chapter 884.(2)  "Standard health benefit plan" means an accident or sickness insurance policy that, in whole or in part, does not offer or provide state-mandated health benefits, but that provides creditable coverage as defined by Section 1205.004(a) or 1501.102(a).|Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.074(a), eff. September 1, 2005.|
TX Ins Code § 1507.004 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1507 - Consumer Choice of Benefits Plans|Subchapter A. Consumer Choice of Benefits Health Insurance Plans|Section 1507.004. Standard Health Benefit Plans Authorized; Minimum Requirement

Sec. 1507.004.  STANDARD HEALTH BENEFIT PLANS AUTHORIZED; MINIMUM REQUIREMENT.  (a)  A health carrier may offer one or more standard health benefit plans.(b)  Any standard health benefit plan must include coverage for direct services to an obstetrical or gynecological care provider as required by Subchapter F, Chapter 1451.|Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.074(a), eff. September 1, 2005.|
TX Ins Code § 1507.005 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1507 - Consumer Choice of Benefits Plans|Subchapter A. Consumer Choice of Benefits Health Insurance Plans|Section 1507.005. Notice to Policyholder

Sec. 1507.005.  NOTICE TO POLICYHOLDER.  (a)  Each written application for participation in a standard health benefit plan must contain the following language at the beginning of the document in bold type:"You have the option to choose this Consumer Choice of Benefits Health Insurance Plan that, either in whole or in part, does not provide state-mandated health benefits normally required in accident and sickness insurance policies in Texas.  This standard health benefit plan may provide a more affordable health insurance policy for you, although, at the same time, it may provide you with fewer health benefits than those normally included as state-mandated health benefits in policies in Texas.  If you choose this standard health benefit plan, please consult with your insurance agent to discover which state-mandated health benefits are excluded in this policy."(b)  Each standard health benefit plan must contain the following language at the beginning of the document in bold type:"This Consumer Choice of Benefits Health Insurance Plan, either in whole or in part, does not provide state-mandated health benefits normally required in accident and sickness insurance policies in Texas.  This standard health benefit plan may provide a more affordable health insurance policy for you, although, at the same time, it may provide you with fewer health benefits than those normally included as state-mandated health benefits in policies in Texas.  Please consult with your insurance agent to discover which state-mandated health benefits are excluded in this policy."|Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.074(a), eff. September 1, 2005.|
TX Ins Code § 1507.006 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1507 - Consumer Choice of Benefits Plans|Subchapter A. Consumer Choice of Benefits Health Insurance Plans|Section 1507.006. Disclosure Statement

Sec. 1507.006.  DISCLOSURE STATEMENT.  (a)  A health carrier providing a standard health benefit plan must provide a proposed policyholder or policyholder with a written disclosure statement that:(1)  acknowledges that the standard health benefit plan being purchased does not provide some or all state-mandated health benefits;(2)  lists those state-mandated health benefits not included in the standard health benefit plan; and(3)  if the standard health benefit plan is issued to an individual policyholder, provides a notice that purchase of the plan may limit the policyholder's future coverage options in the event the policyholder's health changes and needed benefits are not available under the standard health benefit plan.(b)  Each applicant for initial coverage must sign the disclosure statement provided by the health carrier under Subsection (a) and return the statement to the health carrier.  Under a group policy or contract, the term "applicant" means the employer.(c)  A health carrier must:(1)  retain the signed disclosure statement in the health carrier's records; and(2)  on request from the commissioner, provide the signed disclosure statement to the department.|Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.074(a), eff. September 1, 2005.Amended by: Acts 2019, 86th Leg., R.S., Ch. 657 (S.B. 1852), Sec. 1, eff. September 1, 2019.|
TX Ins Code § 1507.007 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1507 - Consumer Choice of Benefits Plans|Subchapter A. Consumer Choice of Benefits Health Insurance Plans|Section 1507.007. Additional Policies

Sec. 1507.007.  ADDITIONAL POLICIES.  A health carrier that offers one or more standard health benefit plans under this subchapter must also offer at least one accident or sickness insurance policy that provides state-mandated health benefits and is otherwise authorized by this code.|Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.074(a), eff. September 1, 2005.|
TX Ins Code § 1507.008 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1507 - Consumer Choice of Benefits Plans|Subchapter A. Consumer Choice of Benefits Health Insurance Plans|Section 1507.008. Rates

Sec. 1507.008.  RATES.  A health carrier shall file for informational purposes the rates to be used with a standard health benefit plan.  Nothing in this section shall be construed as granting the commissioner any power or authority to determine, fix, prescribe, or promulgate the rates to be charged for any individual accident and sickness insurance policy or policies.|Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.074(a), eff. September 1, 2005.|