79th Texas Legislature, Regular Session, House Bill 1286, Chapter 63 Page: 5 of 11
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H.B. No. 1286
1 SECTION 9. Section 1304.152, Occupations Code, is amended
2 by amending Subsections (a)-(c) and adding Subsections (a-1),
3 (b-l) , and (e) to read as follows:
4 (a) A reimbursement insurance policy that a provider uses to
5 comply with Sections 1304.1025 and [Sec-ti] 1304.151(a)(1) must
6 state that:
7 (1) the insurer that issued the policy shall:
8 (A) reimburse or pay on behalf of the provider
9 any covered amount the provider is legally obligated to pay; or
10 (B) provide the service that the provider is
11 legally obligated to perform according to the provider 's
12 contractual obligations under the insured service contract; [ae4]
13 (2) if the covered service is not provided to a service
14 contract holder not later than the 60th day after the date of proof
15 of loss, the insurer shall pay the covered amount directly to the
16 service contract holder or provide the required service; and
17 (3) if a refund is not paid to the service contract
18 holder or credited to the service contract holder's account as
19 required by Section 1304.158, the insurer, after receiving written
20 notice, shall pay the refund amount directly to the service
21 contract holder.
22 (a-l) For a reimbursement insurance policy to comply with
23 Section 1304.151(a) (1), the insurer issuing the policy must:
24 (1) maintain surplus as to policyholders and paid-in
25 capital of at least $15 million and annually file with the executive
26 director copies of the insurer's audited financial statements,
27 National Association of Insurance Commissioners annual statement.5
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Texas. Legislature. House of Representatives. 79th Texas Legislature, Regular Session, House Bill 1286, Chapter 63, legislative document, May 17, 2005; [Austin, Texas]. (https://texashistory.unt.edu/ark:/67531/metapth156475/m1/5/: accessed April 23, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.