Sec. 1252.206. DETERMINATION OF BENEFITS AVAILABLE UNDER REPLACED PLAN. (a) If a succeeding carrier requires a determination of the benefits available under the previous carrier's health benefit plan, the previous carrier shall provide at the request of the succeeding carrier:
(1) a statement of the benefits available under the previous carrier's plan; or
(2) pertinent information sufficient either to allow verification of those benefits or to allow the succeeding carrier to make a determination of those benefits.
(b) A determination of benefits under this section must be made using the definitions of, and in accordance with all of the conditions and covered expense provisions of, the previous carrier's plan as if that plan had not been replaced.
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