State RegulationsTX specificDifficulty 2/5
Which of the following best describes the scope of the Texas small employer health benefit plan statute?
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Answer & full 3-part explanation (select an option above, or peek)
Why D is correct
TIC Chapter 1501 governs health benefit plans issued to small employers, covering guaranteed issue, guaranteed renewal, portability and the related rating limits, and it does not reach individual health coverage, life insurance, Medicare supplement policies, or self-funded employee benefit plans, which are regulated elsewhere or lie outside state jurisdiction. An agent should therefore check whether the case in front of the client is truly an insured small employer plan before relying on Chapter 1501 protections.
Why the other options are wrong
- A) Self-funded employee benefit plans are not within the scope of TIC Chapter 1501, whose requirements attach to insured small employer health benefit plans.
- B) Chapter 1501 is a health benefit plan statute; life insurance is governed by other provisions of the Texas Insurance Code.
- C) Medicare supplement coverage issued to individuals has its own regulatory scheme and is outside Chapter 1501.
Memory hook
Chapter 1501 means insured small employer health plans only.