Sec. 1251.101. REQUIRED PROVISIONS  


Latest version.
  • (a) A group accident and health insurance policy, including a group contract issued by a group hospital service corporation, may not be delivered in this state unless the policy contains in substance the provisions prescribed by this subchapter or provisions in relation to provisions prescribed by this subchapter that, in the opinion of the commissioner, are:

    (1) more favorable to the insureds under the policy; or

    (2) at least as favorable to the insureds under the policy and more favorable to the policyholder.

    (b) The standard provisions required for individual health insurance policies do not apply to group health insurance policies.

    (c) If any provision of this subchapter is wholly or partly inapplicable to or inconsistent with the coverage provided by a particular form of policy, the insurer, with the approval of the commissioner, shall:

    (1) omit the inapplicable provision or part from the policy; or

    (2) modify the inconsistent provision in a manner that makes the provision as contained in the policy consistent with the coverage provided by the policy.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.