Sec. 1251.101. REQUIRED PROVISIONS. (a) A group accident and health insurance policy, including a group contract issued by a group hospital service corporation, may not be delivered in this state unless the policy contains in substance the provisions prescribed by this subchapter or provisions in relation to provisions prescribed by this subchapter that, in the opinion of the commissioner, are:
(1) more favorable to the insureds under the policy; or
(2) at least as favorable to the insureds under the policy and more favorable to the policyholder.
(b) The standard provisions required for individual health insurance policies do not apply to group health insurance policies.
(c) If any provision of this subchapter is wholly or partly inapplicable to or inconsistent with the coverage provided by a particular form of policy, the insurer, with the approval of the commissioner, shall:
(1) omit the inapplicable provision or part from the policy; or
(2) modify the inconsistent provision in a manner that makes the provision as contained in the policy consistent with the coverage provided by the policy.
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 B - Group Health Coverage
Chapter 1251 - Group and Blanket Health Insurance
Subchapter C. Group Accident and Health Insurance: Required Provisions
Section 1251.101. Required Provisions
Section 1251.102. Payment of Premiums
Section 1251.103. Incontestability of Policy
Section 1251.104. Entire Contract
Section 1251.105. Statement Made by Policyholder or Insured
Section 1251.106. Distinction Based on Marital Status Prohibited
Section 1251.107. Evidence of Insurability
Section 1251.108. Exclusion or Limitation of Coverage for Preexisting Conditions
Section 1251.109. Adjustment of Premiums or Benefits if Age of Insured Is Misstated
Section 1251.110. Deadline for Notice of Claim
Section 1251.112. Deadline for Claim
Section 1251.113. Prompt Payment of Benefits Required
Section 1251.114. Payment of Benefits
Section 1251.115. Right to Conduct Physical Examination or Autopsy