Sec. 1201.101. STANDARDS FOR POLICY PROVISIONS. (a) The commissioner shall adopt reasonable rules establishing specific standards for:
(1) the content of an individual accident and health insurance policy; and
(2) the manner of sale of an individual accident and health insurance policy, including disclosures required to be made in connection with the sale.
(b) Rules adopted under this section must establish standards for:
(1) policy readability; and
(2) full and fair policy disclosures.
(c) Standards established under this section may include standards that address:
(1) terms of policy renewability;
(2) initial and subsequent conditions of eligibility;
(3) nonduplication of coverage;
(4) coverage of dependents;
(5) preexisting conditions;
(6) termination of insurance;
(7) probationary periods;
(8) limitations;
(9) exceptions;
(10) reductions;
(11) elimination periods;
(12) requirements for replacement;
(13) recurrent conditions; and
(14) definitions of terms, including definitions of:
(A) "accident";
(B) "accidental means";
(C) "guaranteed renewable and noncancellable";
(D) "hospital";
(E) "injury";
(F) "nervous disorder";
(G) "partial disability";
(H) "physician";
(I) "sickness"; and
(J) "total disability."
(d) A definition of "hospital" adopted under Subsection (c) may not apply to a corporation operating under Chapter 842.
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
Subchapter C. General Policy Standards and Provisions
Section 1201.101. Standards for Policy Provisions
Section 1201.102. Prohibition of Policy Provisions
Section 1201.103. Compliance With Minimum Standards for Benefits
Section 1201.104. Minimum Standards for Benefits
Section 1201.106. Identification of Policies According to Coverage Provided
Section 1201.107. Outline of Coverage Required
Section 1201.108. Format and Content of Outline of Coverage
Section 1201.109. Notice of Rate Increase for Major Medical Expense Insurance Policy