Tex. Ins. Code § 1203.105 · Subchapter C. VISION AND EYE CARE BENEFITS
CERTAIN COORDINATION OF BENEFITS PROVISIONS PROHIBITED.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) A health benefit plan or vision benefit plan subject to this subchapter may not be delivered, issued for delivery, or renewed in this state if:
(1) a provision of the plan excludes or reduces the payment of benefits for eye care expenses to or on behalf of an enrollee;
(2) the reason for the exclusion or reduction is that eye care benefits are payable or have been paid to or on behalf of the enrollee under another plan; and
(3) the exclusion or reduction would apply before the full amount of the eye care expenses incurred by the enrollee and covered by both plans have been paid or reimbursed or the full amount of the applicable coverage limit of the plan containing the exclusion or reduction is reached.
(b) Nothing in this section requires a secondary plan issuer to pay an amount that, when added to a payment amount made by a primary plan issuer, would exceed the usual and customary billed charges of the health care provider.
Notes and commentary — not statutory text
History
Added by Acts 2023, 88th Leg., R.S., Ch. 15 (S.B. 861), Sec. 1, eff. September 1, 2023.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1203.htm
- Text hash
- sha256 e6c164635d9c880e1173be9f5164aba24da8da4b0bae90d6619adbd944ad3264
- Composed by
- compose_tx.py 2026-10-05: the Legislative Council's chapter files read in document order; verify_tx.py's independent reading (lxml DOM walk) agrees character for character
Procedural information only. Not legal advice and not a substitute for the advice of an attorney. Confirm the current text with the official publisher before relying on it.