Sec. 1201.059. TERMINATION OF COVERAGE BASED ON AGE OF CHILD IN INDIVIDUAL, BLANKET, OR GROUP POLICY. (a) An accident and health insurance policy, including an individual, blanket, or group policy, and including a policy issued by a corporation operating under Chapter 842, that provides that coverage of a child terminates when the child attains a limiting age specified in the policy must provide in substance that the child's attainment of that age does not terminate coverage while the child is:
(1) incapable of self-sustaining employment because of mental retardation or physical disability; and
(2) chiefly dependent on the insured or group member for support and maintenance.
(b) To obtain coverage for a child as described by Subsection (a), the insured or group member must provide to the insurer proof of the child's incapacity and dependency:
(1) not later than the 31st day after the date the child attains the limiting age; and
(2) subsequently as the insurer requires, except that the insurer may not require proof more frequently than annually after the second anniversary of the date the child attains the limiting age.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Subtitle A - Health Coverage in General
Chapter 1201 - Accident and Health Insurance
Section 1201.051. Entire Consideration
Section 1201.052. Time of Effectiveness and Termination
Section 1201.053. Persons Insured
Section 1201.054. Appearance of Text
Section 1201.055. Exceptions and Reductions of Indemnity
Section 1201.057. Incorporation of or Reference to Other Documents
Section 1201.058. Notification That Policy Is Returnable; Effect of Return
Section 1201.060. Required Definition of "Emergency Care" in Individual or Group Policy
Section 1201.0601. Required Definitions: Specified Disease Policy
Section 1201.061. Coverage for Adopted Child
Section 1201.062. Coverage for Certain Children in Individual or Group Policy or in Plan or Program
Section 1201.064. Coverage for Child of Spouse in Individual or Group Policy