Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 21 - TRADE PRACTICES
Subchapter SS - CONTINUATION AND CONVERSION PROVISIONS
Division 3 - GENERAL PROVISIONS
Section 21.5320 - Offer of Conversion

Universal Citation: 28 TX Admin Code § 21.5320

Current through Reg. 50, No. 13; March 28, 2025

(a) An insurer or group hospital service corporation must offer to any employee, member, or dependent whose insurance under a group policy has been terminated for any reason (except involuntary termination for cause), including discontinuance of the group policy in its entirety or with respect to any insured class, and who has been continuously insured under the group policy (and under any policy providing similar benefits which it replaces) for at least three consecutive months immediately prior to termination:

(1) a conversion policy providing the same coverage and benefits as provided under the group policy or plan, for an insurance policy or evidence of coverage that was delivered, issued for delivery, or renewed prior to June 1, 1996;

(2) a conversion policy providing similar coverage and benefits as provided under the group policy or plan, for an insurance policy or evidence of coverage that was delivered, issued for delivery, or renewed on or after June 1, 1996, and before July 1, 1997.

(b) An insurer or group hospital service corporation may offer a conversion policy for an insurance policy that is delivered, issued for delivery, or renewed on or after July 1, 1997.

(c) If an insurer or group hospital service corporation offers a conversion policy under subsection (a) or (b) of this section, the insurer or group hospital service corporation must issue a conversion policy without evidence of insurability if a written application for the policy and payment of the first premium are made not later than the 31st day after the date of termination.

(d) An insurer or group hospital service corporation may provide the conversion coverage on an individual or group basis as authorized under Insurance Code § 1251.256.

(e) Under Insurance Code § 1271.306, an HMO may offer to each enrollee a conversion contract.

Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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