Section 1370.002 - Exceptions(a) This chapter does not apply to:(1) a plan that provides coverage:(A) only for benefits for a specified disease or for another limited benefit, other than a plan that provides benefits for cancer treatment or similar services;(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) only for dental or vision care; or(F) 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) a workers' compensation insurance policy;(4) medical payment insurance coverage provided under an automobile insurance policy;(5) a credit insurance policy;(6) a limited benefit policy that does not provide coverage for physical examinations or wellness exams; or(7) 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 1370.001.(b) To the extent that providing coverage for ovarian cancer screening under this chapter would otherwise require this state to make a payment under 42 U.S.C. Section 18031(d)(3)(B)(ii), a qualified health plan, as defined by 45 C.F.R. Section 155.20, is not required to provide a benefit for the ovarian cancer screening under this chapter that exceeds the specified essential health benefits required under 42 U.S.C. Section 18022(b).Tex. Ins. Code § 1370.002
Amended by Acts 2015, Texas Acts of the 84th Leg. - Regular Session, ch. 176,Sec. 2, eff. 9/1/2015.Added by Acts 2005, 79th Leg., Ch. 577, Sec. 1, eff. 9/1/2005.