Texas Insurance Code Title 8, Chapter 1367 - Coverage Of Children

SUBCHAPTER A NEWBORN CHILDREN

• Texas Section 1367.001 - Applicability Of Subchapter
  This subchapter applies only to a health benefit plan delivered or issued for delivery in this state that is an individual or group policy of...
• Texas Section 1367.002 - Applicability Of General Provisions Of Other Law
  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...

SUBCHAPTER B CHILDHOOD IMMUNIZATIONS

• Texas Section 1367.003 - Certain Limitations On Coverage For Newborn Children Prohibited
  A health benefit plan that provides maternity benefits or accident and health coverage for additional newborn children may not be issued in this state if...
• Texas Section 1367.051 - Applicability Of Subchapter
  This subchapter applies only to a health benefit plan that: (1) provides benefits for medical or surgical expenses incurred as a result of a health...
• Texas Section 1367.052 - Exception
  This subchapter does not apply to: (1) a plan that provides coverage: (A) only for a specified disease or for another limited benefit; (B) only...
• Texas Section 1367.053 - Coverage Required
  (a) A health benefit plan that provides coverage for a family member of an insured or enrollee shall provide for each covered child from birth...
• Texas Section 1367.054 - Copayment, Deductible, Or Coinsurance Requirement Prohibited
  (a) Coverage required under Section 1367.053(a) may not be made subject to a deductible, copayment, or coinsurance requirement. (b) This section does not prohibit the...

SUBCHAPTER C HEARING TEST

• Texas Section 1367.055 - Rules
  The commissioner may adopt rules necessary to implement this subchapter. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005. Amended...
• Texas Section 1367.101 - Applicability Of Subchapter
  (a) This subchapter applies only to a health benefit plan that: (1) provides benefits for medical or surgical expenses incurred as a result of a...
• Texas Section 1367.102 - Exception
  This subchapter does not apply to: (1) a plan that provides coverage: (A) only for a specified disease or for another limited benefit; (B) only...
• Texas Section 1367.103 - Coverage Required
  (a) A health benefit plan that provides coverage for a family member of an insured or enrollee shall provide to each covered child coverage for:...
• Texas Section 1367.104 - Copayment Or Coinsurance Requirement Permitted; Deductible Requirement Or Dollar Limit Prohibited; Notice Required
  (a) Coverage required under this subchapter: (1) may be subject to a copayment or coinsurance requirement; and (2) may not be subject to a deductible...

SUBCHAPTER D CHILD CRANIOFACIAL ABNORMALITIES

• Texas Section 1367.105 - Rules
  The commissioner may adopt rules necessary to implement this subchapter. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
• Texas Section 1367.151 - Applicability Of Subchapter
  This subchapter applies only to a health benefit plan that: (1) provides benefits for medical or surgical expenses incurred as a result of a health...
• Texas Section 1367.152 - Exception
  This subchapter does not apply to: (1) a plan that provides coverage: (A) only for a specified disease or for another limited benefit; (B) only...
• Texas Section 1367.153 - Reconstructive Surgery For Craniofacial Abnormalities; Definition Required
  A health benefit plan that provides coverage for a child who is younger than 18 years of age must define "reconstructive surgery for craniofacial abnormalities"...

SUBCHAPTER E DEVELOPMENTAL DELAYS

• Texas Section 1367.154 - Rules
  The commissioner shall adopt rules necessary to administer this subchapter. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
• Texas Section 1367.201 - Definition
  In this subchapter, rehabilitative and habilitative therapies include: (1) occupational therapy evaluations and services; (2) physical therapy evaluations and services; (3) speech therapy evaluations and...
• Texas Section 1367.202 - Applicability Of Subchapter
  This subchapter applies only to a health benefit plan that: (1) provides benefits for medical or surgical expenses incurred as a result of a health...
• Texas Section 1367.203 - Exception
  This subchapter does not apply to: (1) a plan that provides coverage: (A) only for a specified disease or for another limited benefit; (B) only...
• Texas Section 1367.204 - Offer Of Coverage Required
  (a) A health benefit plan issuer must offer coverage that complies with this subchapter. (b) The individual or group policy or contract holder may reject...
• Texas Section 1367.205 - Coverage Of Certain Therapies
  (a) A health benefit plan that provides coverage for rehabilitative and habilitative therapies under this subchapter may not prohibit or restrict payment for covered services...
• Texas Section 1367.206 - Prohibited Actions
  Under the coverage required to be offered under this subchapter, a health benefit plan issuer may not: (1) apply the cost of rehabilitative and habilitative...
• Texas Section 1367.207 - Rules
  The commissioner may adopt rules necessary to implement this subchapter. Added by Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.040(a), eff. September 1,

Last modified: September 28, 2016