State Codes and Statutes
Statutes > Texas > Insurance-code > Title-8-health-insurance-and-other-health-coverages > Chapter-1550-certain-requirements-for-insurers-contracting-with-governmental-entities
INSURANCE CODE
TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES
SUBTITLE H. HEALTH BENEFITS AND OTHER COVERAGES FOR GOVERNMENTAL
EMPLOYEES
CHAPTER 1550. CERTAIN REQUIREMENTS FOR INSURERS CONTRACTING WITH
GOVERNMENTAL ENTITIES
SUBCHAPTER B. CERTAIN CONTRACTS
WITH MUNICIPALITIES
Sec. 1550.051. DEFINITION OF INSURER. In this subchapter,
"insurer" means:
(1) an insurance company, including a company providing
stop-loss or excess loss insurance;
(2) a health maintenance organization operating under Section
1367.053, Subchapter A, Chapter 1452, Subchapter B, Chapter 1507,
Chapter 222, 251, or 258, as applicable to a health maintenance
organization, Chapter 843, Chapter 1271, and Chapter 1272;
(3) an approved nonprofit health corporation that holds a
certificate of authority issued under Chapter 844; or
(4) a third-party administrator that holds a certificate of
authority under Chapter 4151.
Added by Acts 2007, 80th Leg., R.S., Ch.
730, Sec. 1G.002, eff. April 1, 2009.
Sec. 1550.052. BID REQUIREMENTS. (a) Except as provided by
Section 1550.054, an insurer that bids on a contract subject to
the competitive bidding and competitive proposal requirements
adopted under Section 252.021, Local Government Code, may not
submit a bid for a contract to provide stop-loss or other
insurance coverage that is subject to any qualification imposed
by the insurer that permits the insurer to modify or limit the
terms of insurance coverage to be provided after the contract has
been made.
(b) An insurer's bid submitted under Section 252.021, Local
Government Code, must contain the insurer's entire offer.
Added by Acts 2007, 80th Leg., R.S., Ch.
730, Sec. 1G.002, eff. April 1, 2009.
Sec. 1550.053. CERTAIN EXCLUSIONS AND INCREASED DEDUCTIBLES
PROHIBITED. Except as provided by Section 1550.054, an insurer
that provides stop-loss or other insurance coverage for health
benefits under a contract subject to this subchapter may not,
based on an individual's prior medical history:
(1) exclude from coverage an individual who is otherwise
eligible for the health benefits coverage; or
(2) assign a higher deductible to the individual.
Added by Acts 2007, 80th Leg., R.S., Ch.
730, Sec. 1G.002, eff. April 1, 2009.
Sec. 1550.054. EXCEPTION FOR WRITTEN WAIVER. By executing a
written waiver in favor of the insurer, a municipality as defined
by Section 1.005, Local Government Code, may waive a requirement
of Section 1550.052 or 1550.053(2).
Added by Acts 2007, 80th Leg., R.S., Ch.
730, Sec. 1G.002, eff. April 1, 2009.
State Codes and Statutes
Statutes > Texas > Insurance-code > Title-8-health-insurance-and-other-health-coverages > Chapter-1550-certain-requirements-for-insurers-contracting-with-governmental-entities
INSURANCE CODE
TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES
SUBTITLE H. HEALTH BENEFITS AND OTHER COVERAGES FOR GOVERNMENTAL
EMPLOYEES
CHAPTER 1550. CERTAIN REQUIREMENTS FOR INSURERS CONTRACTING WITH
GOVERNMENTAL ENTITIES
SUBCHAPTER B. CERTAIN CONTRACTS
WITH MUNICIPALITIES
Sec. 1550.051. DEFINITION OF INSURER. In this subchapter,
"insurer" means:
(1) an insurance company, including a company providing
stop-loss or excess loss insurance;
(2) a health maintenance organization operating under Section
1367.053, Subchapter A, Chapter 1452, Subchapter B, Chapter 1507,
Chapter 222, 251, or 258, as applicable to a health maintenance
organization, Chapter 843, Chapter 1271, and Chapter 1272;
(3) an approved nonprofit health corporation that holds a
certificate of authority issued under Chapter 844; or
(4) a third-party administrator that holds a certificate of
authority under Chapter 4151.
Added by Acts 2007, 80th Leg., R.S., Ch.
730, Sec. 1G.002, eff. April 1, 2009.
Sec. 1550.052. BID REQUIREMENTS. (a) Except as provided by
Section 1550.054, an insurer that bids on a contract subject to
the competitive bidding and competitive proposal requirements
adopted under Section 252.021, Local Government Code, may not
submit a bid for a contract to provide stop-loss or other
insurance coverage that is subject to any qualification imposed
by the insurer that permits the insurer to modify or limit the
terms of insurance coverage to be provided after the contract has
been made.
(b) An insurer's bid submitted under Section 252.021, Local
Government Code, must contain the insurer's entire offer.
Added by Acts 2007, 80th Leg., R.S., Ch.
730, Sec. 1G.002, eff. April 1, 2009.
Sec. 1550.053. CERTAIN EXCLUSIONS AND INCREASED DEDUCTIBLES
PROHIBITED. Except as provided by Section 1550.054, an insurer
that provides stop-loss or other insurance coverage for health
benefits under a contract subject to this subchapter may not,
based on an individual's prior medical history:
(1) exclude from coverage an individual who is otherwise
eligible for the health benefits coverage; or
(2) assign a higher deductible to the individual.
Added by Acts 2007, 80th Leg., R.S., Ch.
730, Sec. 1G.002, eff. April 1, 2009.
Sec. 1550.054. EXCEPTION FOR WRITTEN WAIVER. By executing a
written waiver in favor of the insurer, a municipality as defined
by Section 1.005, Local Government Code, may waive a requirement
of Section 1550.052 or 1550.053(2).
Added by Acts 2007, 80th Leg., R.S., Ch.
730, Sec. 1G.002, eff. April 1, 2009.
State Codes and Statutes
Statutes >
Texas >
Insurance-code >
Title-8-health-insurance-and-other-health-coverages >
Chapter-1550-certain-requirements-for-insurers-contracting-with-governmental-entities INSURANCE CODE
TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES
SUBTITLE H. HEALTH BENEFITS AND OTHER COVERAGES FOR GOVERNMENTAL
EMPLOYEES
CHAPTER 1550. CERTAIN REQUIREMENTS FOR INSURERS CONTRACTING WITH
GOVERNMENTAL ENTITIES
SUBCHAPTER B. CERTAIN CONTRACTS
WITH MUNICIPALITIES
Sec. 1550.051. DEFINITION OF INSURER. In this subchapter,
"insurer" means:
(1) an insurance company, including a company providing
stop-loss or excess loss insurance;
(2) a health maintenance organization operating under Section
1367.053, Subchapter A, Chapter 1452, Subchapter B, Chapter 1507,
Chapter 222, 251, or 258, as applicable to a health maintenance
organization, Chapter 843, Chapter 1271, and Chapter 1272;
(3) an approved nonprofit health corporation that holds a
certificate of authority issued under Chapter 844; or
(4) a third-party administrator that holds a certificate of
authority under Chapter 4151.
Added by Acts 2007, 80th Leg., R.S., Ch.
730, Sec. 1G.002, eff. April 1, 2009.
Sec. 1550.052. BID REQUIREMENTS. (a) Except as provided by
Section 1550.054, an insurer that bids on a contract subject to
the competitive bidding and competitive proposal requirements
adopted under Section 252.021, Local Government Code, may not
submit a bid for a contract to provide stop-loss or other
insurance coverage that is subject to any qualification imposed
by the insurer that permits the insurer to modify or limit the
terms of insurance coverage to be provided after the contract has
been made.
(b) An insurer's bid submitted under Section 252.021, Local
Government Code, must contain the insurer's entire offer.
Added by Acts 2007, 80th Leg., R.S., Ch.
730, Sec. 1G.002, eff. April 1, 2009.
Sec. 1550.053. CERTAIN EXCLUSIONS AND INCREASED DEDUCTIBLES
PROHIBITED. Except as provided by Section 1550.054, an insurer
that provides stop-loss or other insurance coverage for health
benefits under a contract subject to this subchapter may not,
based on an individual's prior medical history:
(1) exclude from coverage an individual who is otherwise
eligible for the health benefits coverage; or
(2) assign a higher deductible to the individual.
Added by Acts 2007, 80th Leg., R.S., Ch.
730, Sec. 1G.002, eff. April 1, 2009.
Sec. 1550.054. EXCEPTION FOR WRITTEN WAIVER. By executing a
written waiver in favor of the insurer, a municipality as defined
by Section 1.005, Local Government Code, may waive a requirement
of Section 1550.052 or 1550.053(2).
Added by Acts 2007, 80th Leg., R.S., Ch.
730, Sec. 1G.002, eff. April 1, 2009.
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