2005 Texas Insurance Code CHAPTER 1370. CERTAIN TESTS FOR DETECTION OF HUMAN PAPILLOMAVIRUS AND CERVICAL CANCER

INSURANCE CODE

CHAPTER 1370. CERTAIN TESTS FOR DETECTION OF HUMAN PAPILLOMAVIRUS 
AND CERVICAL CANCER


	§ 1370.001. APPLICABILITY OF CHAPTER.  (a) This chapter 
applies only to a health benefit plan that provides benefits for 
medical or surgical expenses incurred as a result of a health 
condition, accident, or sickness, including an individual, group, 
blanket, or franchise insurance policy or insurance agreement, a 
group hospital service contract, an individual or group evidence of 
coverage, or a similar coverage document, that is offered by:
		(1)  an insurance company;                                                    
		(2)  a group hospital service corporation operating 
under Chapter 842;      
		(3)  a fraternal benefit society operating under 
Chapter 885;               
		(4)  a stipulated premium company operating under 
Chapter 884;              
		(5)  a health maintenance organization operating under 
Chapter 843;         
		(6)  a reciprocal exchange operating under Chapter 942;                       
		(7)  a Lloyd's plan operating under Chapter 941;                              
		(8)  an approved nonprofit health corporation that 
holds a certificate of authority under Chapter 844;  or
		(9)  a multiple employer welfare arrangement that holds 
a certificate of authority under Chapter 846.
	(b)  This chapter applies to a small employer health benefit 
plan written under Chapter 1501.

Added by Acts 2005, 79th Leg., ch. 577, § 1, eff. Sept. 1, 2005.           


	§ 1370.002. EXCEPTION.  This chapter does not apply to:                     
		(1)  a plan that provides coverage:                                           
			(A)  only for benefits for a specified disease or 
for another limited benefit, other than a plan that provides 
benefits for cancer treatment or similar services;
			(B)  only for accidental death or dismemberment;                             
			(C)  for wages or payments in lieu of wages for a 
period during which an employee is absent from work because of 
sickness or injury;
			(D)  as a supplement to a liability insurance 
policy;                      
			(E)  only for dental or vision care;  or                                     
			(F)  only for indemnity for hospital confinement;                            
		(2)  a Medicare supplemental policy as defined by 
Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);
		(3)  a workers' compensation insurance policy;                                
		(4)  medical payment insurance coverage provided under 
an automobile insurance policy;
		(5)  a credit insurance policy;                                               
		(6)  a limited benefit policy that does not provide 
coverage for physical examinations or wellness exams;  or
		(7)  a long-term care insurance policy, including a 
nursing home fixed indemnity policy, unless the commissioner 
determines that the policy provides benefit coverage so 
comprehensive that the policy is a health benefit plan as described 
by Section 1370.001.

Added by Acts 2005, 79th Leg., ch. 577, § 1, eff. Sept. 1, 2005.           


	§ 1370.003. COVERAGE REQUIRED.  (a) A health benefit plan 
that provides coverage for diagnostic medical procedures must 
provide to each woman 18 years of age or older enrolled in the plan 
coverage for expenses for an annual medically recognized diagnostic 
examination for the early detection of cervical cancer.
	(b)  Coverage required under this section includes at a 
minimum a conventional Pap smear screening or a screening using 
liquid-based cytology methods, as approved by the United States 
Food and Drug Administration, alone or in combination with a test 
approved by the United States Food and Drug Administration for the 
detection of the human papillomavirus.
	(c)  A screening test required under this section must be 
performed in accordance with the guidelines adopted by:
		(1)  the American College of Obstetricians and 
Gynecologists;  or           
		(2)  another similar national organization of medical 
professionals recognized by the commissioner.

Added by Acts 2005, 79th Leg., ch. 577, § 1, eff. Sept. 1, 2005.           


	§ 1370.004. NOTICE OF COVERAGE.  (a) A health benefit 
plan issuer shall provide to each woman 18 years of age or older 
enrolled in the plan written notice of the coverage required under 
this chapter.
	(b)  The notice must be provided in accordance with rules 
adopted by the commissioner.

Added by Acts 2005, 79th Leg., ch. 577, § 1, eff. Sept. 1, 2005.