2023 Texas Statutes › Insurance Code › Title 4 - Regulation of Solvency › Subtitle D - Guaranty Associations › Chapter 463 - Texas Life and Health Insurance Guaranty Association › Subchapter E. Coverage Provided by Association › Section 463.204. Obligations Excluded

Sec. 463.204.  OBLIGATIONS EXCLUDED.  A contractual obligation does not include:
(1)  death benefits in an amount in excess of $300,000 or a net cash surrender or net cash withdrawal value in an amount in excess of $100,000 under one or more life insurance policies on a single life;
(2)  an amount in excess of:
(A)  $250,000 in the present value under one or more annuity contracts issued with respect to a single life under individual annuity policies or group annuity policies; or
(B)  $5 million in unallocated annuity contract benefits with respect to a single contract owner regardless of the number of those contracts;
(3)  an amount in excess of the following amounts, including any net cash surrender or cash withdrawal values, under one or more accident, health, accident and health, or long-term care insurance policies on a single life:
(A)  $500,000 for health benefit plans;
(B)  $300,000 for disability income and long-term care insurance, as those terms are defined by this code or rules adopted by the commissioner; or
(C)  $200,000 for coverages that are not defined as health benefit plans, disability income, or long-term care insurance;
(4)  an amount in excess of $250,000 in present value annuity benefits, in the aggregate, including any net cash surrender and net cash withdrawal values, with respect to each individual participating in a governmental retirement benefit plan established under Section 401, 403(b), or 457, Internal Revenue Code of 1986 (26 U.S.C. Sections 401, 403(b), and 457), covered by an unallocated annuity contract or the beneficiary or beneficiaries of the individual if the individual is deceased;
(5)  an amount in excess of $250,000 in present value annuity benefits, in the aggregate, including any net cash surrender and net cash withdrawal values, with respect to each payee of a structured settlement annuity or the beneficiary or beneficiaries of the payee if the payee is deceased;
(6)  aggregate benefits in an amount in excess of $300,000 with respect to a single life, except with respect to:
(A)  benefits paid under health benefit plans, described by Subdivision (3)(A), in which case the aggregate benefits are $500,000; and
(B)  benefits paid to one owner of multiple nongroup policies of life insurance, whether the policy owner is an individual, firm, corporation, or other person, and whether the persons insured are officers, managers, employees, or other persons, in which case the maximum benefits are $5 million regardless of the number of policies and contracts held by the owner;
(7)  an amount in excess of $5 million in benefits, with respect to either one plan sponsor whose plans own directly or in trust one or more unallocated annuity contracts not included in Subdivision (4) irrespective of the number of contracts with respect to the contract owner or plan sponsor or one contract owner provided coverage under Section 463.201(a)(3)(B), except that, if one or more unallocated annuity contracts are covered contracts under this chapter and are owned by a trust or other entity for the benefit of two or more plan sponsors, coverage shall be afforded by the association if the largest interest in the trust or entity owning the contract or contracts is held by a plan sponsor whose principal place of business is in this state, and in no event shall the association be obligated to cover more than $5 million in benefits with respect to all these unallocated contracts;
(8)  any contractual obligations of the insolvent or impaired insurer under a covered policy or contract that do not materially affect the economic value of economic benefits of the covered policy or contract; or
(9)  punitive, exemplary, extracontractual, or bad faith damages, regardless of whether the damages are:
(A)  agreed to or assumed by an insurer, insured, or covered person; or
(B)  imposed by a court.
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.013(d), eff. September 1, 2007.
Acts 2007, 80th Leg., R.S., Ch. 921 (H.B. 3167), Sec. 9.013(d), eff. September 1, 2007.
Acts 2011, 82nd Leg., R.S., Ch. 14 (S.B. 567), Sec. 8, eff. September 1, 2011.
Acts 2019, 86th Leg., R.S., Ch. 432 (S.B. 1153), Sec. 15, eff. September 1, 2019.