Sec. 1252.204. COVERAGE FOR PREEXISTING CONDITIONS. (a) A succeeding carrier's health benefit plan that limits coverage in accordance with a preexisting conditions provision, other than a waiting period, must provide, during the period the limitation on coverage is in effect, the level of benefits prescribed by this section to an individual covered by the succeeding carrier who:
(1) has a preexisting condition; and
(2) was covered by the previous carrier's plan on the date on which that plan was discontinued.
(b) The health benefit plan must provide a level of benefits equal to the lesser of:
(1) the level of benefits available under the succeeding carrier's plan as determined without applying the preexisting conditions provision; or
(2) the level of benefits that would have been available under the previous carrier's plan.
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 1252 - Discontinuation and Replacement of Group and Group-Type Health Benefit Plan Coverage
Subchapter C. Replacement of Coverage
Section 1252.201. Total Disability Status
Section 1252.202. Effective Date of Coverage Under Replacement Plan
Section 1252.203. Extension of Benefits for Total Disability
Section 1252.204. Coverage for Preexisting Conditions
Section 1252.205. Waiting Period
Section 1252.206. Determination of Benefits Available Under Replaced Plan