28 Tex. Admin. Code § 21.2452 - Coordination of Provisions in Insurance Code Chapter 1355, Concerning Benefits for Certain Mental Disorders
(a)
Applicability. This section applies only to a health benefit plan that is
subject to both:
(1) Insurance Code Chapter
1355, Subchapter A, concerning Group Health Benefit Plan Coverage for Certain
Serious Mental Illnesses and Other Disorders; and
(2) Insurance Code Chapter 1355, Subchapter
F, concerning Coverage for Mental Health Conditions and Substance Use
Disorders.
(b) Compliance
requirement. If an issuer's health benefit plan includes a quantitative or
nonquantitative treatment limitation that is permissible under Insurance Code
Chapter 1355, Subchapter A, but does not satisfy Insurance Code §
1355.254, concerning
Coverage for Mental Health Conditions and Substance Use Disorders, the issuer
must modify its plan to ensure that it complies with Insurance Code §
1355.254.
Notes
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