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TITLE 28INSURANCE
PART 1TEXAS DEPARTMENT OF INSURANCE
CHAPTER 19LICENSING AND REGULATION OF INSURANCE PROFESSIONALS
SUBCHAPTER SFORMS TO REQUEST PRIOR AUTHORIZATION
DIVISION 1TEXAS STANDARD PRIOR AUTHORIZATION REQUEST FORMS
RULE §19.1802Exception

This subchapter does not apply to:

  (1) a health benefit plan that provides coverage:

    (A) only for a specified disease or for another single benefit;

    (B) only for accidental death or dismemberment;

    (C) only for wages or payments to replace wages for a period during which an employee is absent from work because of sickness or injury;

    (D) as a supplement to a liability insurance policy;

    (E) for credit insurance;

    (F) only for dental or vision care;

    (G) only for hospital expenses; or

    (H) only for indemnity for hospital confinement;

  (2) a Medicare supplemental policy as defined by §1882, Social Security Act (42 U.S.C. §1395ss);

  (3) medical payment insurance coverage provided under a motor vehicle insurance policy;

  (4) a long-term care insurance policy, including a nursing home fixed indemnity policy, unless the commissioner determines that the policy provides benefit coverage so comprehensive that the policy is a health benefit plan as described by §1217.002 or §1369.252; or

  (5) a workers' compensation insurance policy.


Source Note: The provisions of this §19.1802 adopted to be effective September 1, 2015, 39 TexReg 9699; amended to be effective September 1, 2015, 40 TexReg 2193

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