Coverage Required

Sec. 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: (1) a screening test for hearing loss from birth through the date the child is 30 days of age, as provided by Chapter 47, Health and Safety Code; and (2) necessary diagnostic follow-up care related to the screening test from birth through the date the child is 24 months of age. (b) For purposes of Subsection (a), a covered child is a child who, as a result of the child's relationship to an insured or enrollee in a health benefit plan, would be entitled to coverage under an accident and health insurance policy under Section 1201.061, 1201.062, 1201.063, or 1201.064. (c) This section does not require a health benefit plan to provide the coverage described by this section to a child of an individual residing in this state if the individual is: (1) employed outside this state; and (2) covered under a health benefit plan maintained for the individual by the individual's employer as an employment benefit. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.