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Details Title: Texas Life and Health Description: Texas Statutes and Rules Pertinent to Accident and Health Only Total Flash Cards: 19 Created: 08/06/2004 15:12:55	To study from this set of flash cards, or to create your own your own study flash cards, register HERE. If you are already a registered user, CLICK HERE.
Cards Term family member;newborn child Definition All individual and group health policies that provide coverage for a _______________________________ of the insured shall also provide coverage for a __________________________________. Term chemical dependency Definition Group Health insurance policies must cover the treatment of________________________________ Term HIV infection Definition All individual or group policies that provide accident and health benefits must cover the testing and treatment of _______________. Term company's expense Definition When required by the insurance company, medical examinations will be conducted at the __________________. Term discriminatory Definition Underwriting for HIV or AIDS is permitted as long as it is not unfairly _________________________ Term strict confidentiality;test results or diagnosis Definition Insurance companies must maintain ________________________________ regarding HIV-related ________________. Term MIB;identified Definition Test results may not be provided to the __________ if the individual is ________________________ Term deny;6 months;preexisting condition Definition MSPs cannot ____________ a claim for losses incurred more than _________________ from the effective date of coverage because it involved a _____________________________ Term 3;25 Definition A Small Employer employees not less that _______ nor more than _________ eligible employees. Term 75%;eligible Definition Small employers are required to pay at least _______ of the premium for each __________________ employee. Term basic coverage benefit plan;catastrophic care benefit plan Definition Every small employer carrier (except HMO's) shall offer the _______________________________________ and the _____________________. Term catastrophic care benefit plan Definition The ____________________ must provide necessary coverage in the event of catastrophic illness or injury. Term basic hospital, medical; surgical Definition Basic Coverage Benefit Plan covers _______________ and ______________ procedures. Term option to renew Definition The small employer has the __________________ the medical plan except in certain cases. Term limit;exclude;newborn child Definition A small employer plan may not _______________ or _____________ initial coverage for a _________________ of a covered employee. Term exclude;pregnancy;effective date Definition A small employer plan may ____________ coverage for a ________________ existing on the ____________ of the coverage. Term Texas insurance risk pool;unable Definition The ____________ was developed to assist Texans who are _____________ to get health insurance because of their medical history. Term two medical plans;deductable;out of pocket Definition The pool offers ______________ that differ only in their ____________ amounts and ________________ maximums. Term 20%;40% Definition Co-payments for both Plan I and Plan II are _______ when using the preferred providers and _______ when using out-of-network providers.