Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES
Subchapter S - MINIMUM STANDARDS AND BENEFITS AND READABILITY FOR INDIVIDUAL ACCIDENT AND HEALTH INSURANCE POLICIES
Section 3.3079 - Minimum Standards for Limited Benefit Coverage

Universal Citation: 28 TX Admin Code § 3.3079

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

(a) Limited benefit coverage is a policy of accident and sickness insurance providing the types of coverage set forth in § 3.3071 of this title (relating to Minimum Standards for Basic Hospital Expense Coverage), § 3.3072 of this title (relating to Minimum Standards for Basic Medical-Surgical Expense Coverage), and § 3.3075 of this title (relating to Minimum Standards for Disability Income Protection Coverage), but the types and/or amounts of benefits are less than those prescribed in such sections. Such policies delivered or issued for delivery in this state in addition to meeting all other applicable requirements of these sections must prominently display at the top of the outline of coverage and on the face page of the policy in no less than 14 point type the notice set out in § 3.3091 of this title (relating to Notice Requirements for Outline of Coverage of Limited Benefit, Supplemental and Nonconventional Coverages).

(b) Any limited benefit basic hospital expense coverage or limited benefit basic medical-surgical expense coverage offered pursuant to this section must be guaranteed renewable in accordance with § 3.3020 of this title (relating to Policy Definition of Guaranteed Renewable and Limited Guarantee of Renewability) and § 3.3038 of this title (relating to Mandatory Guaranteed Renewability Provisions for Individual Hospital, Medical or Surgical Coverage; Exceptions) of this subchapter, unless such insurance constitutes short-term limited duration coverage, as defined in § 3.3002(b)(18) of this title (relating to Definitions).

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