28 Tex. Admin. Code § 21.5320 - Offer of Conversion

(a) An insurer or group hospital service corporation must offer to any employee, member, or dependent whose insurance under a group policy has been terminated for any reason (except involuntary termination for cause), including discontinuance of the group policy in its entirety or with respect to any insured class, and who has been continuously insured under the group policy (and under any policy providing similar benefits which it replaces) for at least three consecutive months immediately prior to termination:

(1) a conversion policy providing the same coverage and benefits as provided under the group policy or plan, for an insurance policy or evidence of coverage that was delivered, issued for delivery, or renewed prior to June 1, 1996;

(2) a conversion policy providing similar coverage and benefits as provided under the group policy or plan, for an insurance policy or evidence of coverage that was delivered, issued for delivery, or renewed on or after June 1, 1996, and before July 1, 1997.

(b) An insurer or group hospital service corporation may offer a conversion policy for an insurance policy that is delivered, issued for delivery, or renewed on or after July 1, 1997.

(c) If an insurer or group hospital service corporation offers a conversion policy under subsection (a) or (b) of this section, the insurer or group hospital service corporation must issue a conversion policy without evidence of insurability if a written application for the policy and payment of the first premium are made not later than the 31st day after the date of termination.

(d) An insurer or group hospital service corporation may provide the conversion coverage on an individual or group basis as authorized under Insurance Code § 1251.256.

(e) Under Insurance Code § 1271.306, an HMO may offer to each enrollee a conversion contract.

Notes

28 Tex. Admin. Code § 21.5320

Adopted by Texas Register, Volume 39, Number 46, November 14, 2014, TexReg 9043, eff. 11/17/2014