Texas Insurance Code - Not Codified - Article 21.20-2. Advertisements For Certain Health Benefit Plans
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Art. 21.20-2. ADVERTISEMENTS FOR CERTAIN HEALTH BENEFIT
PLANS.
Scope of Article
Sec. 1. (a) This article applies only to a health benefit plan
that provides benefits for medical or surgical expenses incurred as
a result of a health condition, accident, or sickness, including an
individual, group, blanket, or franchise insurance policy or
agreement, a group hospital service contract, or an individual or
group evidence of coverage issued by:
(1) an insurance company;
(2) a group hospital service corporation operating under
Chapter 20 of this code;
(3) a health maintenance organization operating under the
Texas Health Maintenance Organization Act (Chapter 20A, Vernon's
Texas Insurance Code); or
(4) an approved nonprofit health corporation that is
certified under Section 5.01(a), Medical Practice Act (Article
4495b, Vernon's Texas Civil Statutes), and that holds a certificate
of authority issued by the commissioner under Article 21.52F of
this code.
(b) This article does not apply to:
(1) a health benefit plan that provides coverage:
(A) only for a specified disease;
(B) only for accidental death or dismemberment; or
(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; or
(2) a long-term care 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 Subsection (a) of this
section.
Disclaimers
Sec. 2. (a) Subject to Article 21.21 of this code, an
advertisement for a health benefit plan may include rate
information without including information about all benefit
exclusions and limitations if the advertisement includes prominent
disclaimers that clearly indicate that:
(1) the rates are illustrative;
(2) a person should not send money to the issuer of the
health benefit plan in response to the advertisement;
(3) a person cannot obtain coverage under the health benefit
plan until the person completes an application for coverage; and
(4) benefit exclusions and limitations may apply to the
health benefit plan.
(b) Any rate mentioned in the advertisement shall indicate
the age, gender, and geographic location on which that rate is
based.
Added by Acts 1997, 75th Leg., ch. 489, Sec. 1, eff. Sept. 1, 1997.
Article: 5.172 7.01 7.02 7.19-1 7.20 7.20-1 21.11-2 21.20-2 21.28-A 21.28-C 21.28-D 21.28-E 21.31 21.32 21.32A
Last modified: August 11, 2007
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