SECTION 3.3093. Prescribed Outlines of Coverage  


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  • An outline of coverage in the following prescribed form and drafted in accordance with the instructions set forth in §3.3092 of this title (relating to Format, Content, and Readability for Outline of Coverage) shall be issued in connection with policies meeting the standards of §§3.3071-3.3080 of this title (relating to Minimum Standards and Benefits and Readability for Accident and Health Insurance Policies). The items included in the outline of coverage shall appear in the following prescribed sequence.

    (1) Basic hospital expense coverage policies shall be accompanied by an outline of coverage in the following form.

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    (2) Basic medical-surgical expense coverage policies shall be accompanied by an outline of coverage in the following form.

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    (3) Hospital confinement indemnity coverage policies shall be accompanied by an outline of coverage in the following form.

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    (4) Major medical expense coverage policies shall be accompanied by an outline of coverage in the following form.

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    (5) Disability income protection coverage policies shall be accompanied by an outline of coverage in the following form.

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    (6) Accident only coverage policies shall be accompanied by an outline of coverage in the following form.

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    (7) Specified disease or specified accident coverage policies shall be accompanied by an outline of coverage in either of the following forms as specified in subparagraphs (A) or (B) of this paragraph, whichever is appropriate.

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    (8) Limited benefit coverage policies shall be accompanied by an outline of coverage in the following form.

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    (9) Supplemental coverage policies shall be accompanied by an outline of coverage in the following form.

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Source Note: The provisions of this §3.3093 adopted to be effective January 26, 1977, 2 TexReg 159; amended to be effective December 7, 1983, 8 TexReg 4858