CHAPTER 1502. HEALTH BENEFIT PLANS FOR CHILDREN
INSURANCE CODE
TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES
SUBTITLE G. HEALTH COVERAGE AVAILABILITY
CHAPTER 1502. HEALTH BENEFIT PLANS FOR CHILDREN
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 1502.001. APPLICABILITY OF CHAPTER. This chapter applies
only to the issuer of a health benefit plan that:
(1) provides benefits for medical or surgical expenses incurred
as a result of a health condition, accident, or sickness,
including:
(A) an individual, group, blanket, or franchise insurance policy
or insurance agreement, a group hospital service contract, or an
individual or group evidence of coverage that is offered by:
(i) an insurance company;
(ii) a group hospital service corporation operating under
Chapter 842;
(iii) a fraternal benefit society operating under Chapter 885;
(iv) a stipulated premium company operating under Chapter 884;
or
(v) a health maintenance organization operating under Chapter
843; and
(B) to the extent permitted by the Employee Retirement Income
Security Act of 1974 (29 U.S.C. Section 1001 et seq.), a health
benefit plan that is offered by:
(i) a multiple employer welfare arrangement as defined by
Section 3 of that Act or another analogous benefit arrangement;
or
(ii) an entity not authorized under this code or another
insurance law of this state that contracts directly for health
care services on a risk-sharing basis, including a capitation
basis; or
(2) is offered by an approved nonprofit health corporation that
holds a certificate of authority under Chapter 844.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Sec. 1502.0011. EXCEPTION. This chapter does not apply to a
health benefit plan provided under the state Medicaid program or
the state child health plan.
Added by Acts 2005, 79th Leg., Ch.
728, Sec. 11.061(a), eff. September 1, 2005.
Sec. 1502.002. RULES. The commissioner may adopt rules to
implement this chapter.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
SUBCHAPTER B. CHILDREN'S HEALTH BENEFIT PLAN
Sec. 1502.051. CHILDREN'S HEALTH BENEFIT PLAN. A health benefit
plan issuer may offer a children's health benefit plan that
provides coverage only to children younger than 18 years of age.
The issuer may offer the plan only if the commissioner approves
the plan's structure and the benefits offered under the plan.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Sec. 1502.052. MANDATED BENEFIT PROVISIONS INAPPLICABLE. A
children's health benefit plan is not subject to any law that
requires coverage or the offer of coverage of a health care
service or benefit.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Sec. 1502.053. EXEMPTION FROM CERTAIN TAXES. (a) The issuer of
a children's health benefit plan approved under Section 1502.051
is not subject to the premium tax or the tax on revenues imposed
under Chapter 222 with respect to money received for coverage
provided under that plan.
(b) The issuer of a children's health benefit plan approved
under Section 1502.051 is not subject to the retaliatory tax
imposed under Chapter 281 with respect to money received for
coverage provided under that plan.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1,
2005.
Amended by:
Acts 2005, 79th Leg., Ch.
728, Sec. 11.062(a), eff. September 1, 2005.
Acts 2007, 80th Leg., R.S., Ch.
932, Sec. 19, eff. June 15, 2007.