Section 1369.303 - Exception This subchapter does not apply to:
(1) a health benefit plan that provides coverage:(A) only for a specified disease or for another single benefit;(B) only for accidental death or dismemberment;(C) for wages or payments in lieu of wages for a period during which an employee is absent from work because of sickness or injury;(D) as a supplement to a liability insurance policy;(E) for credit insurance;(F) only for dental or vision care;(G) only for hospital expenses; or(H) only for indemnity for hospital confinement;(2) a Medicare supplemental policy as defined by Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss) ;(3) medical payment insurance coverage provided under a motor vehicle insurance policy;(4) a long-term care insurance policy, including a nursing home fixed indemnity policy, unless the commissioner determines that the policy provides benefit coverage so comprehensive that the policy is a health benefit plan as described by Section 1369.302;(5) health and accident coverage provided by a risk pool created under Chapter 172, Local Government Code; or(6) a workers' compensation insurance policy.Tex. Ins. Code § 1369.303
Amended by Acts 2015, Texas Acts of the 84th Leg. - Regular Session, ch. 1236,Sec. 21.002, eff. 9/1/2015.Amended by Acts 2015, Texas Acts of the 84th Leg. - Regular Session, ch. 1236,Sec. 21.001, eff. 9/1/2015.Added by Acts 2013, 83rd Leg. - Regular Session, ch. 1328,Sec. 1, eff. 9/1/2013, applicable only to a request for prior authorization of prescription drug benefits made on or after September 1, 2015.