SECTION 3.3039. Other Mandatory Policy Provisions

(a) Each individual policy of accident and sickness insurance, including a policy issued by a company subject to Insurance Code Chapter 842, that is delivered, issued for delivery, or renewed in Texas on or after January 1, 1988, must contain a benefit provision which states, "All benefits payable under this policy on behalf of a dependent child insured by this policy for which benefits for financial and medical assistance are being provided by the Texas Health and Human Services Commission will be paid to the Texas Health and Human Services Commission" whenever:

(1) the Texas Health and Human Services Commission is paying benefits under Human Resources Code Chapter 31 or Chapter 32, i.e., financial and medical assistance service programs administered pursuant to the Human Resources Code; and

(2) the parent who purchased the individual policy has possession or access to the child pursuant to a court order, or is not entitled to access or possession of the child and is required by the court to pay child support.

(b) The insurer or group nonprofit hospital service company must receive at its home office, written notice affixed to the insurance claim when the claim is first submitted, and the notice must state that all benefits paid pursuant to this section must be paid directly to the Texas Health and Human Services Commission.

(c) With respect to any policy forms approved by the Texas Department of Insurance prior to January 1, 1988, an insurer is authorized to achieve compliance with this section by the use of endorsements or riders, provided such endorsements or riders are approved by the Texas Department of Insurance as being in compliance with this section and the provisions of the Insurance Code.

Source Note: The provisions of this §3.3039 adopted to be effective November 22, 1988, 13 TexReg 5647; amended to be effective December 22, 1997, 22 TexReg 12503; amended to be effective May 11, 2022, 47 TexReg 2758