CHAPTER 1202. CANCELLATION AND CONTINUATION OF POLICIES IN GENERAL
INSURANCE CODE
TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES
SUBTITLE A. HEALTH COVERAGE IN GENERAL
CHAPTER 1202. CANCELLATION AND CONTINUATION OF POLICIES IN
GENERAL
SUBCHAPTER A. CONTINUOUS POLICIES
Sec. 1202.001. CONTINUOUS POLICIES. (a) A guaranteed renewable
insurance policy or a noncancellable insurance policy is
considered to be a continuous policy, subject only to the policy
terms and conditions, including payment of the policy premium.
(b) A guaranteed renewable insurance policy or a noncancellable
insurance policy:
(1) is continued in effect by the payment of the policy premium
in accordance with the policy terms and conditions; and
(2) may not be considered or treated as a renewed policy by the
payment of the policy premium.
(c) This section does not apply to a small employer health
benefit plan adopted in accordance with Chapter 1501.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
SUBCHAPTER B. INDIVIDUAL HEALTH INSURANCE POLICIES
Sec. 1202.051. RENEWABILITY AND CONTINUATION OF INDIVIDUAL
HEALTH INSURANCE POLICIES. (a) This section applies only to an
individual health insurance policy that provides benefits for
medical care under a hospital, medical, or surgical policy.
(b) Except as provided by Subsection (c), an insurer shall renew
or continue an individual health insurance policy at the option
of the individual.
(c) An insurer may decline to renew or continue an individual
health insurance policy:
(1) for failure to pay a premium or contribution in accordance
with the terms of the policy;
(2) for fraud or intentional misrepresentation;
(3) because the insurer is ceasing to offer coverage in the
individual market in accordance with rules adopted by the
commissioner;
(4) because an individual no longer resides, lives, or works in
an area in which the insurer is authorized to provide coverage,
but only if all policies are not renewed or not continued under
this subdivision uniformly without regard to any health-status
related factor of covered individuals; or
(5) in accordance with federal law, including regulations.
(d) The commissioner shall adopt rules necessary to:
(1) implement this section; and
(2) meet the minimum requirements of federal law, including
regulations.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Sec. 1202.052. CANCELLATION PROHIBITED FOR AIDS OR HIV. (a) In
this section, "AIDS" and "HIV" have the meanings assigned by
Section 81.101, Health and Safety Code.
(b) Except as provided by Subsection (c), an insurer that
delivers or issues for delivery an individual accident and health
insurance policy in this state may not cancel that policy during
its term because the insured:
(1) has been diagnosed as having AIDS or HIV;
(2) has been treated for AIDS or HIV; or
(3) is being treated for AIDS or HIV.
(c) The insurer may cancel the policy for:
(1) failure to pay a premium when due; or
(2) fraud or misrepresentation in obtaining coverage by not
disclosing a diagnosis of an AIDS or HIV-related condition.
(d) The provisions of Chapter 1201, including provisions
relating to the applicability, purpose, and enforcement of that
chapter, construction of policies under that chapter, rulemaking
under that chapter, and definitions of terms applicable in that
chapter, apply to this section.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.