Texas § IN.1203.002 - CERTAIN COORDINATION OF BENEFITS PROVISIONS PROHIBITED

§ IN.1203.002. CERTAIN COORDINATION OF BENEFITS PROVISIONS PROHIBITED

CERTAIN COORDINATION OF BENEFITS PROVISIONS PROHIBITED. (a) An accident and health insurance policy or evidence of coverage may not be delivered, issued for delivery, or renewed in this state if: (1) a provision of the policy or evidence of coverage excludes or reduces the payment of benefits to or on behalf of an insured or enrollee; (2) the reason for the exclusion or reduction is that benefits are also payable or have been paid to or on behalf of the insured or enrollee under a supplemental policy of accident and health insurance; and (3) the supplemental policy is individually underwritten and individually issued as a plan of coverage for: (A) hospital confinement indemnity; (B) a specified disease; or (C) a limited benefit. (b) Application of Subsection (a) to a provision of an accident and health insurance policy or evidence of coverage is not affected by: (1) the mode or channel by which the premium for a supplemental policy of accident and health insurance is paid to the insurer; or (2) a reduction in the premium for a supplemental policy of accident and health insurance because of the insured's membership in an organization or status as an employee. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.