State RegulationsTX specificDifficulty 1/5
Under the Texas chemical dependency coverage statute, what must a health benefit plan that is subject to that statute provide?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Under TIC 1368.005 the chemical dependency requirement is a mandated benefit, not an optional rider: a health benefit plan subject to the statute must provide coverage for the treatment of chemical dependency, meaning treatment for alcoholism and for drug dependency. The practical consequence for a Texas agent is that a plan which pays only for an initial evaluation, or only for care delivered inside a general hospital, has not discharged the statutory obligation, and the agent cannot describe such a plan as satisfying the Texas mandate.
Why the other options are wrong
- B) The Texas mandate reaches treatment, not merely detection; a plan that pays only for screening and assessment leaves the required benefit unpaid.
- C) Nothing in TIC 1368.005 confines required chemical dependency treatment to a general hospital setting, so limiting the benefit that way understates the mandate.
- D) The mandate is not conditioned on how the policy is underwritten; recasting a benefit requirement as an underwriting condition gets the rule backwards.
Memory hook
Texas says treat it, not just detect it - chemical dependency care is a mandated benefit under TIC 1368.005.