State Codes and Statutes

Statutes > Texas > Insurance-code > Title-8-health-insurance-and-other-health-coverages > 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.

State Codes and Statutes

Statutes > Texas > Insurance-code > Title-8-health-insurance-and-other-health-coverages > 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.


State Codes and Statutes

State Codes and Statutes

Statutes > Texas > Insurance-code > Title-8-health-insurance-and-other-health-coverages > 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.