Coordination of Provisions in Insurance Code Chapter 1355, Concerning Benefits for Certain Mental Disorders

(a) Applicability. This section applies only to a health benefit plan that is subject to both:

(1) Insurance Code Chapter 1355, Subchapter A, concerning Group Health Benefit Plan Coverage for Certain Serious Mental Illnesses and Other Disorders; and

(2) Insurance Code Chapter 1355, Subchapter F, concerning Coverage for Mental Health Conditions and Substance Use Disorders.

(b) Compliance requirement. If an issuer's health benefit plan includes a quantitative or nonquantitative treatment limitation that is permissible under Insurance Code Chapter 1355, Subchapter A, but does not satisfy Insurance Code §1355.254, concerning Coverage for Mental Health Conditions and Substance Use Disorders, the issuer must modify its plan to ensure that it complies with Insurance Code §1355.254.

Source Note: The provisions of this §21.2452 adopted to be effective September 7, 2021, 46 TexReg 5571.