Section 1253.001 - Limitation of Services and Benefits on Contract Renegotiation(a) In this section, "health benefit contract" means a contract providing group health care coverage for employees that is delivered, issued for delivery, or renewed in this state by:(1) an insurance company;(2) a group hospital service corporation operating under Chapter 842; or(3) a health maintenance organization operating under Chapter 843.(b) Subject to Subsection (c), if an employer in this state agrees to renegotiate a health benefit contract, a change in the renegotiated contract may not operate solely to terminate eligibility with respect to any member of the group who, before the contract was renegotiated: (1) was covered under the contract; and(2) had a sickness or injury for which a service was being provided or a benefit was being paid under the contract.(c) A renegotiated health benefit contract may include a different durational or dollar limit or a different deductible amount or amount of coinsurance applicable to a sickness or injury for which a service was being provided or benefit was being paid before the contract was renegotiated if that same or a similar limit or amount applies to a service provided or benefit paid for a similar sickness or a related condition or injury covered by the contract.Tex. Ins. Code § 1253.001
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. 4/1/2005.