INSURANCE CODE

TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES

SUBTITLE E. BENEFITS PAYABLE UNDER HEALTH COVERAGES

CHAPTER 1364. COVERAGE PROVISIONS RELATING TO HIV, AIDS, OR HIV-RELATED ILLNESSES

SUBCHAPTER A. EXCLUSION FROM OR DENIAL OF COVERAGE PROHIBITED

Sec. 1364.001.  APPLICABILITY OF SUBCHAPTER.  This subchapter applies only to a group health benefit plan that is delivered, issued for delivery, or renewed and that is:
(1)  a group accident and health insurance policy;
(2)  a group contract issued by a group hospital service corporation operating under Chapter 842;  or
(3)  a group evidence of coverage issued by a health maintenance organization operating under Chapter 843.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.

Sec. 1364.002.  EXCEPTION.  This subchapter does not apply to:
(1)  a credit accident and health insurance policy subject to Chapter 1153;
(2)  any group specifically provided for or authorized by law in existence and covered under a policy filed with the State Board of Insurance before April 1, 1975;
(3)  accident or health coverage that is incidental to any form of a group automobile, casualty, property, workers' compensation, or employers' liability policy approved by the department;  or
(4)  any policy or contract of insurance with a state agency, department, or board providing health services:
(A)  to eligible individuals under Chapter 32, Human Resources Code;  or
(B)  under a state plan adopted in accordance with 42 U.S.C. Sections 1396-1396g, as amended, or 42 U.S.C. Section 1397aa et seq., as amended.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.

Sec. 1364.003.  PROHIBITION.  A group health benefit plan may not exclude or deny coverage for:
(1)  human immunodeficiency virus (HIV);
(2)  acquired immune deficiency syndrome (AIDS);  or
(3)  an HIV-related illness.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.

Sec. 1364.004.  RULES.  The commissioner may adopt rules necessary to administer this subchapter.  A rule adopted under this section is subject to notice and hearing as provided by Section 1201.007 for a rule adopted under Chapter 1201.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.

SUBCHAPTER B. CANCELLATION OF GROUP COVERAGE PROHIBITED

Sec. 1364.051.  DEFINITIONS.  In this subchapter, "AIDS" and "HIV" have the meanings assigned by Section 81.101, Health and Safety Code.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.

Sec. 1364.052.  APPLICABILITY OF SUBCHAPTER.  This subchapter applies to an insurer that delivers or issues for delivery a group health insurance policy or contract in this state, including a group hospital service corporation operating under Chapter 842.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.

Sec. 1364.053.  PROHIBITION.  (a)  Except as provided by Subsection (b), an insurer may not cancel during the term of a group health insurance policy or contract an individual's coverage provided by the policy or contract because the individual:
(1)  has been diagnosed as having AIDS or HIV;
(2)  has been treated for AIDS or HIV;  or
(3)  is being treated for AIDS or HIV.
(b)  The insurer may cancel the coverage provided by the policy or contract for fraud or misrepresentation in the obtaining of coverage by failure to disclose a diagnosis of AIDS or an HIV-related condition.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.

SUBCHAPTER C. CERTAIN COVERAGES PROVIDED BY LOCAL GOVERNMENTS

Sec. 1364.101.  PROHIBITION ON EXCLUSION OR LIMITATION OF COVERAGES.  A political subdivision that provides group health insurance coverage, health maintenance organization coverage, or self-insured health care coverage to the political subdivision's officers or employees may not contract for or provide coverage that excludes or limits coverage or services for:
(1)  acquired immune deficiency syndrome, as defined by the Centers for Disease Control and Prevention of the United States Public Health Service;  or
(2)  human immunodeficiency virus infection.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.