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TITLE 28INSURANCE
PART 1TEXAS DEPARTMENT OF INSURANCE
CHAPTER 21TRADE PRACTICES
SUBCHAPTER LMEDICAL CHILD SUPPORT, UNFAIR PRACTICES
RULE §21.2001Definitions

The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise.

  (1) Actuarial assumptions--The value of a parameter, or other choice, having an impact on an estimate of a future cost or other actuarial item under evaluation.

  (2) Actuarially equivalent--Producing equal actuarial present value, determined as of a given date with each value based on the same set of actuarial assumptions.

  (3) Actuarial present value--The value of an amount or series of amounts payable or receivable at various times, determined as of a given date by the application of a particular set of actuarial assumptions.

  (4) Child--

    (A) a person under 18 years of age who is not and has not been married or who has not had the disabilities of minority removed for general purposes; or

    (B) in the context of child support, "child" includes a person over 18 years of age for whom a person may be obligated to pay child support.

  (5) Child support agency--As defined in Family Code §101.004.

  (6) Custodial parent--

    (A) a managing conservator of a child or a possessory conservator of a child who is a parent of the child; or

    (B) a guardian of the person of a child, or another custodian of a child if the guardian or custodian is designated by a court or administrative agency of this or another state.

  (7) Health insurer--Any insurance company, stipulated premium company, fraternal benefit society, group hospital service corporation, or HMO that delivers or issues for delivery an individual, group, blanket, or franchise insurance policy or insurance agreement, a group hospital service contract, or an evidence of coverage that provides benefits for medical or surgical expenses incurred as a result of an accident or sickness.

  (8) Insurer--

    (A) a health insurer;

    (B) a governmental entity subject to:

      (i) Insurance Code, Articles 3.51-1, 3.51-4, or 3.51-5; or

      (ii) Insurance Code Chapter 1578; Local Government Code, Chapter 177; or Insurance Code §1355.151 or §1364.101;

    (C) a multiple employer welfare arrangement, as that term is defined by Insurance Code §§846.001, 846.002, 846.202, and 846.251; or

    (D) a health insurer that issues coverage for a group health plan, as defined by the Employee Retirement Income Security Act of 1974, §607(1) (29 U.S.C. §1167).

  (9) Medical assistance--Medical assistance under the state Medicaid program.

  (10) Medical support order--A court or administrative judgment, decree, or order whether temporary, final, or subject to modification for the benefit of a child that provides for health coverage of the child.

  (11) Policy--Includes an individual, blanket, or franchise insurance agreement or contract, a certificate issued under a group policy, a group hospital service contract, or evidence of coverage issued by a health maintenance organization.

  (12) Qualified actuary--An actuary who is either:

    (A) a Fellow of the Society of Actuaries, or

    (B) a Member of the American Academy of Actuaries.


Source Note: The provisions of this §21.2001 adopted to be effective May 8, 1997, 22 TexReg 3799; amended to be effective January 31, 1999, 24 TexReg 388; amended to be effective November 7, 2021, 46 TexReg 7408

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