28 Tex. Admin. Code § 3.3039 - Other Mandatory Policy Provisions
(a) Each
individual policy of accident and sickness insurance, including a policy issued
by a company subject to Insurance Code Chapter 842, that is delivered, issued
for delivery, or renewed in Texas on or after January 1, 1988, must contain a
benefit provision which states, "All benefits payable under this policy on
behalf of a dependent child insured by this policy for which benefits for
financial and medical assistance are being provided by the Texas Health and
Human Services Commission will be paid to the Texas Health and Human Services
Commission " whenever:
(1) the Texas Health
and Human Services Commission is paying benefits under Human Resources Code
Chapter 31 or Chapter 32, i.e., financial and medical assistance service
programs administered pursuant to the Human Resources Code; and
(2) the parent who purchased the individual
policy has possession or access to the child pursuant to a court order, or is
not entitled to access or possession of the child and is required by the court
to pay child support.
(b) The insurer or group nonprofit hospital
service company must receive at its home office, written notice affixed to the
insurance claim when the claim is first submitted, and the notice must state
that all benefits paid pursuant to this section must be paid directly to the
Texas Health and Human Services Commission.
(c) With respect to any policy forms approved
by the Texas Department of Insurance prior to January 1, 1988, an insurer is
authorized to achieve compliance with this section by the use of endorsements
or riders, provided such endorsements or riders are approved by the Texas
Department of Insurance as being in compliance with this section and the
provisions of the Insurance Code.
Notes
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