Title IN, Insurance Code

Sec. 1203.052. COORDINATION OF BENEFITS BETWEEN PRIMARY AND SECONDARY INSURERS. (a) This section applies if: (1) an insured is covered by at least two different insurance policies; and (2) each policy provides the insured dental benefits. (b) The primary insurer, as determined un…

Sec. 1203.053. CERTAIN COORDINATION OF BENEFITS PROVISIONS PROHIBITED. An insurance policy subject to this subchapter may not be delivered, issued for delivery, or renewed in this state if: (1) a provision of the policy excludes or reduces the payment of benefits for dental expen…

Sec. 1203.054. CERTAIN COORDINATION OF BENEFITS PROVISIONS VOID. A provision of an insurance policy that violates Section 1203.053 is void. Added by Acts 2015, 84th Leg., R.S., Ch. 572 (H.B. 3024), Sec. 1, eff. September 1, 2015. SUBCHAPTER C. VISION AND EYE CARE BENEFITS

Sec. 1203.101. DEFINITIONS. In this subchapter: (1) "Eye care expenses" means expenses related to vision or medical eye care services, procedures, or products. (2) "Health benefit plan" means a policy, agreement, contract, or evidence of coverage that provides comprehensive medic…

Sec. 1203.102. APPLICABILITY OF SUBCHAPTER. This subchapter applies only to a health benefit plan or vision benefit plan that provides or arranges for benefits for vision or medical eye care services, procedures, or products, including an individual, group, blanket, or franchise …

Sec. 1203.103. EXCEPTION. This subchapter does not apply to a supplemental insurance policy that only pays benefits directly to the policyholder. Added by Acts 2023, 88th Leg., R.S., Ch. 15 (S.B. 861), Sec. 1, eff. September 1, 2023.

Sec. 1203.104. COORDINATION OF BENEFITS BETWEEN PRIMARY AND SECONDARY PLAN ISSUERS. (a) This section applies if: (1) an enrollee is covered by at least two different health benefit plans or vision benefit plans; and (2) each plan provides the enrollee coverage for the same vision…

Sec. 1203.105. CERTAIN COORDINATION OF BENEFITS PROVISIONS PROHIBITED. (a) A health benefit plan or vision benefit plan subject to this subchapter may not be delivered, issued for delivery, or renewed in this state if: (1) a provision of the plan excludes or reduces the payment o…

Sec. 1203.106. CERTAIN COORDINATION OF BENEFITS PROVISIONS VOID. A provision of a health benefit plan or vision benefit plan that violates this subchapter is void. Added by Acts 2023, 88th Leg., R.S., Ch. 15 (S.B. 861), Sec. 1, eff. September 1, 2023.

Sec. 1203.107. RULES. The commissioner may adopt rules necessary to implement this subchapter. Added by Acts 2023, 88th Leg., R.S., Ch. 15 (S.B. 861), Sec. 1, eff. September 1, 2023. SUBCHAPTER D. COORDINATION OF BENEFITS QUESTIONNAIRE

Sec. 1203.151. APPLICABILITY OF SUBCHAPTER. (a) This subchapter 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 i…

Sec. 1203.152. CREATION OF UNIFORM COORDINATION OF BENEFITS QUESTIONNAIRE. In collaboration with appropriate stakeholders, the commissioner shall adopt rules establishing a uniform coordination of benefits questionnaire to be used by all health benefit plan issuers in this state.…

Sec. 1203.153. UNIFORM COORDINATION OF BENEFITS QUESTIONNAIRE REQUIRED. Each health benefit plan issuer that issues a health benefit plan that includes a coordination of benefits provision shall use the uniform coordination of benefits questionnaire established under Section 1203…