INSURANCE CODE

TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES

SUBTITLE G. HEALTH COVERAGE AVAILABILITY

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chapter heading effective on September 1, 2018

CHAPTER 1504. MEDICAL AND DENTAL CHILD SUPPORT

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chapter heading effective until September 1, 2018

CHAPTER 1504. MEDICAL CHILD SUPPORT

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HYPERLINK "43864.37942"

SUBCHAPTER A. GENERAL PROVISIONS

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1504.001.

DEFINITIONS. In this chapter:

"Child" has the meaning assigned by

Section 101.003, Family Code.

"Child support agency" has the meaning assigned by

Section 101.004, Family Code.

"Custodial parent" means an individual who:

is a managing conservator of a child or a possessory conservator of a child who is a parent of the child; or

is a guardian of the person or other custodian of a child and is designated as guardian or custodian by a court or administrative agency of this or another state.

Text of subdivision effective until September 01, 2018

"Health benefit plan issuer" means:

an insurance company, group hospital service corporation, or health maintenance organization that delivers or issues for delivery an individual, group, blanket, or franchise insurance policy or agreement, a group hospital service contract, or an evidence of coverage that provides benefits for medical or surgical expenses incurred as a result of an accident or sickness;

a governmental entity subject to Subchapter D,

Chapter 1355, Subchapter C,

Chapter 1364,

Chapter 1578,

Article 3.51-1, 3.51-4, or 3.51-5, or

Chapter 177, Local Government Code;

the issuer of a multiple employer welfare arrangement as defined by

Section 846.001; or

the issuer of a group health plan as defined by

Section 607, Employee Retirement Income Security Act of 1974 (29 U.S.C.

Section 1167).

Text of subdivision effective on September 01, 2018

"Benefit plan issuer" means:

an insurance company, group hospital service corporation, or health maintenance organization that delivers or issues for delivery an individual, group, blanket, or franchise insurance policy or agreement, a group hospital service contract, or an evidence of coverage that provides benefits for medical or surgical expenses incurred as a result of an accident or sickness, or dental expenses;

a governmental entity subject to Subchapter D,

Chapter 1355, Subchapter C,

Chapter 1364,

Chapter 1578,

Article 3.51-1, 3.51-4, or 3.51-5, or

Chapter 177, Local Government Code;

the issuer of a multiple employer welfare arrangement as defined by

Section 846.001; or

the issuer of a group health plan as defined by

Section 607, Employee Retirement Income Security Act of 1974 (29 U.S.C.

Section 1167).

"Medical assistance" means medical assistance under the state Medicaid program.

Added by Acts 2003, 78th Leg., ch. 1274,

Sec. 3, eff. April 1, 2005.

Amended by:

Acts 2007, 80th Leg., R.S., Ch. 730 (H.B.

HYPERLINK "http://www.legis.state.tx.us/tlodocs/80R/billtext/html/HB02636F.HTM"

Sec. 2G.016, eff. April 1, 2009.

Acts 2015, 84th Leg., R.S., Ch. 1150 (S.B.

HYPERLINK "http://www.legis.state.tx.us/tlodocs/84R/billtext/html/SB00550F.HTM"

Sec. 60, eff. September 1, 2018.

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1504.002.

RULES. (

a) The commissioner shall adopt reasonable rules as necessary to implement this

chapter and 42 U.S.C.

Section 1396a(a)(60), including rules that define acts that constitute unfair or deceptive practices under Subchapter I,

Chapter 541.

Text of subsection effective until September 01, 2018

The commissioner shall adopt rules that define "comparable health coverage" in a manner that:

is consistent with federal law; and

complies with the requirements necessary to maintain federal Medicaid funding.

Text of subsection effective on September 01, 2018

The commissioner shall adopt rules that define "comparable health or dental coverage" in a manner that:

is consistent with federal law; and

complies with the requirements necessary to maintain federal Medicaid funding.

Added by Acts 2003, 78th Leg., ch. 1274,

Sec. 3, eff. April 1, 2005.

Amended by:

Acts 2015, 84th Leg., R.S., Ch. 1150 (S.B.

HYPERLINK "http://www.legis.state.tx.us/tlodocs/84R/billtext/html/SB00550F.HTM"

Sec. 61, eff. September 1, 2018.

HYPERLINK "1504.003"

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section effective until September 01, 2018

1504.003.

VIOLATION OF CHAPTER: RELIEF AVAILABLE TO INJURED PERSON. A health benefit plan issuer that violates this

chapter is subject to the same penalties, and an injured person has the same rights and remedies, as those provided by Subchapter D,

Chapter 541.

Added by Acts 2003, 78th Leg., ch. 1274,

Sec. 3, eff. April 1, 2005.

Amended by:

Acts 2015, 84th Leg., R.S., Ch. 1150 (S.B.

HYPERLINK "http://www.legis.state.tx.us/tlodocs/84R/billtext/html/SB00550F.HTM"

Sec. 62, eff. September 1, 2018.

HYPERLINK "1504.003"

HYPERLINK "43867.158381"

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section effective on September 01, 2018

Sec. 1504.003.

VIOLATION OF CHAPTER:

RELIEF AVAILABLE TO INJURED PERSON.

A benefit plan issuer that violates this

chapter is subject to the same penalties, and an injured person has the same rights and remedies, as those provided by Subchapter D,

Chapter 541.

Added by Acts 2003, 78th Leg., ch. 1274,

Sec. 3, eff. April 1, 2005.

Amended by:

Acts 2015, 84th Leg., R.S., Ch. 1150 (S.B.

HYPERLINK "http://www.legis.state.tx.us/tlodocs/84R/billtext/html/SB00550F.HTM"

Sec. 62, eff. September 1, 2018.

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HYPERLINK "43868.158379"

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SUBCHAPTER B. DUTIES OF BENEFIT PLAN ISSUER

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SUBCHAPTER B. DUTIES OF HEALTH BENEFIT PLAN ISSUER

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section effective until September 01, 2018

1504.051.

ENROLLMENT OF CERTAIN CHILDREN REQUIRED. (

a) A health benefit plan issuer shall permit a parent to enroll a child in dependent health coverage offered through the issuer regardless of any enrollment period restriction if the parent is:

eligible for dependent health coverage; and

required by a court order or administrative order to provide health insurance coverage for the child.

A health benefit plan issuer shall enroll a child of a parent described by Subsection (

a) in dependent health coverage offered through the issuer if:

the parent does not apply to obtain health coverage for the child through the issuer; and

the child, a custodial parent of the child, or a child support agency having a duty to collect or enforce support for the child applies for the coverage.

Added by Acts 2003, 78th Leg., ch. 1274,

Sec. 3, eff. April 1, 2005.

Amended by:

Acts 2015, 84th Leg., R.S., Ch. 1150 (S.B.

HYPERLINK "http://www.legis.state.tx.us/tlodocs/84R/billtext/html/SB00550F.HTM"

Sec. 64, eff. September 1, 2018.

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HYPERLINK "43868.158379"

Text of subchapter heading effective on September 1, 2018

SUBCHAPTER B. DUTIES OF BENEFIT PLAN ISSUER

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HYPERLINK "43868.37945"

Text of subchapter heading effective until September 1, 2018

SUBCHAPTER B. DUTIES OF HEALTH BENEFIT PLAN ISSUER

HYPERLINK "1504.051"

HYPERLINK "43869.158382"

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section effective on September 01, 2018

Sec. 1504.051.

ENROLLMENT OF CERTAIN CHILDREN REQUIRED. (

a) A benefit plan issuer shall permit a parent to enroll a child in dependent health or dental coverage offered through the issuer regardless of any enrollment period restriction if the parent is:

eligible for dependent health or dental coverage; and

required by a court order or administrative order to provide health or dental insurance coverage for the child.

A benefit plan issuer shall enroll a child of a parent described by Subsection (

a) in dependent health or dental coverage offered through the issuer if:

the parent does not apply to obtain health or dental coverage for the child through the issuer; and

the chi