SECTION 7.1803. What Constitutes a Line of Insurance  


Latest version.
  • (a) For purposes of this subchapter, a line of insurance is defined as each line of business as specified in paragraphs (1)(A)-(P), (2)(A)-(PP), and (3)(A)-(K) of this subsection, and including any line written in by the insurer or HMO on the annual statement pages specified in this section, for which financial data was reported by the individual withdrawing insurer or HMO filing any of the annual statement pages specified in this section, or any duly promulgated equivalent pages, of the annual statement forms specified in this section, or any duly promulgated equivalent forms, and including any line of business that is duly promulgated to be added to the annual statement pages specified in this section or to any duly promulgated equivalent page.

    (1) For an insurer that is required to file the Life and Accident and Health Annual Statement, Texas State Page 21, Reporting Direct Business in the State of Texas During the Year, or the Health Statement, Exhibit of Premiums, Enrollment and Utilization, reporting direct business in the State of Texas (page 34 of the Health Statement), in addition to any line of insurance written in by the insurer, each of the following is a line of insurance:

    (A) ordinary life;

    (B) group and individual credit life;

    (C) group life;

    (D) industrial life;

    (E) ordinary annuity;

    (F) group annuity;

    (G) ordinary annuity and other fund deposits;

    (H) group annuity and other fund deposits;

    (I) small employer coverage;

    (J) group and individual credit accident and health;

    (K) individual accident and health coverage including collectively renewable accident and health, noncancellable accident and health, guaranteed renewable accident and health, non-renewable for stated reasons only accident and health, and other accident only;

    (L) group accident and health other than association, large employer or small employer coverage;

    (M) Medicare+Choice plan;

    (N) CHIP coverage;

    (O) association coverage; or

    (P) large employer coverage.

    (2) For an insurer that is required to file the Property and Casualty Annual Statement, Exhibit of Premiums and Losses, page 15, (coded "Statutory Page 14"), in addition to any line written in by the insurer, each of the following is a line of insurance:

    (A) fire;

    (B) allied lines;

    (C) earthquake;

    (D) flood;

    (E) farmowners multiple peril;

    (F) homeowners multiple peril;

    (G) Texas commercial multiple peril (non-liability portion);

    (H) growing crops (all other);

    (I) multiple peril crop;

    (J) inland marine;

    (K) ocean marine;

    (L) small employer coverage;

    (M) group and individual credit accident and health;

    (N) individual accident and health coverage including collectively renewable accident and health, noncancellable accident and health, guaranteed renewable accident and health, non-renewable for stated reasons only accident and health, and other accident only;

    (O) group accident and health other than association, large employer or small employer coverage;

    (P) Medicare+Choice plans;

    (Q) CHIP coverage;

    (R) association coverage;

    (S) large employer coverage;

    (T) workers compensation;

    (U) Texas commercial multiple peril (liability portion);

    (V) financial guaranty;

    (W) medical malpractice liability (physicians--including surgeons and osteopaths);

    (X) medical malpractice liability (all other health care professionals);

    (Y) medical malpractice liability--hospitals;

    (Z) medical malpractice liability (all other health care facilities);

    (AA) product liability;

    (BB) other general liability;

    (CC) fidelity;

    (DD) surety;

    (EE) glass;

    (FF) burglary and theft;

    (GG) boiler and machinery;

    (HH) credit guaranty;

    (II) mortgage guaranty;

    (JJ) aircraft (all perils);

    (KK) private passenger auto no-fault personal injury protection;

    (LL) other private passenger auto liability;

    (MM) commercial auto no-fault personal injury protection;

    (NN) other commercial auto liability;

    (OO) private passenger auto physical damage; or

    (PP) commercial auto physical damage.

    (3) For an HMO that is required to file the Health Statement, Exhibit of Premiums, Enrollment and Utilization, reporting direct business in the State of Texas (page 34 of the Health Statement), in addition to any line of insurance written in by the HMO, each of the following is a line of insurance for the purposes of this subchapter:

    (A) small employer coverage;

    (B) large employer coverage;

    (C) health care services for Medicaid delivered under a contract with the Texas Health and Human Services Commission;

    (D) health care services for Medicare or a Medicare+Choice plan delivered under a contract with the federal Centers for Medicare and Medicaid Service;

    (E) CHIP coverage;

    (F) individual coverage;

    (G) association coverage;

    (H) limited service group coverage;

    (I) limited service individual coverage;

    (J) single service group coverage; and

    (K) single service individual coverage.

    (b) Nothing in this section authorizes or allows an insurer or HMO to cancel or non-renew any coverage that would violate any law or provisions contained in a contract or evidence of coverage or a policy or certificate of insurance itself.

Source Note: The provisions of this §7.1803 adopted to be effective July 22, 1993, 18 TexReg 4504; amended to be effective January 30, 2002, 27 TexReg 610