Section 1352.002 - Exception; Application to Qualified Health Plan(a) This chapter does not apply to:(1) a plan that provides coverage:(A) only for a specified disease or for another limited benefit other than an accident policy;(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) , as amended;(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 1352.001.(b) This chapter does not apply to a standard health benefit plan issued under Chapter 1507.(c) To the extent that a change in law made to this chapter after January 1, 2013, would otherwise require this state to make a payment under 42 U.S.C. Section 18031(d)(3)(B)(ii), a qualified health plan, as defined by 45 C.F.R. Section 155.20, is not required to provide a benefit under this section that exceeds the specified essential health benefits required under 42 U.S.C. Section 18022(b).Tex. Ins. Code § 1352.002
Amended by Acts 2013, 83rd Leg. - Regular Session, ch. 370,Sec. 2, eff. 9/1/2013.Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. 4/1/2005. See Acts 2013, 83rd Leg. - Regular Session, ch. 370, Sec. 6.