Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 21 - TRADE PRACTICES
Subchapter P - MENTAL HEALTH PARITY
Division 4 - AUTISM SPECTRUM DISORDER
Section 21.2452 - Coordination of Provisions in Insurance Code Chapter 1355, Concerning Benefits for Certain Mental Disorders
Universal Citation: 28 TX Admin Code § 21.2452
Current through Reg. 50, No. 13; March 28, 2025
(a) Applicability. This section applies only to a health benefit plan that is subject to both:
(1) Insurance Code Chapter
1355, Subchapter A, concerning Group Health Benefit Plan Coverage for Certain
Serious Mental Illnesses and Other Disorders; and
(2) Insurance Code Chapter 1355, Subchapter
F, concerning Coverage for Mental Health Conditions and Substance Use
Disorders.
(b) Compliance requirement. If an issuer's health benefit plan includes a quantitative or nonquantitative treatment limitation that is permissible under Insurance Code Chapter 1355, Subchapter A, but does not satisfy Insurance Code § 1355.254, concerning Coverage for Mental Health Conditions and Substance Use Disorders, the issuer must modify its plan to ensure that it complies with Insurance Code § 1355.254.
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