1. (a) An insurer shall not enforce otherwise applicable policy provisions that would deny, limit, or reduce payment for claims for a covered child who is the subject of a medical support order and lives outside the insurer's service area but inside the United States.
2. (b) An insurer may use alternative delivery systems, such as other indemnity insurers or reciprocal agreements with other health maintenance organizations to provide coverage for a child who is the subject of a medical support order and lives outside the insurer's service area.
3. (c) If an insurer uses an indemnity policy to provide coverage for children who are the subject of a medical support order and live outside the insurer's service area, then the insurer shall file with the following areas of the Texas Department of Insurance, if applicable: Life/Health Group, Filings Intake, Mail Code 106-1E, Texas Department of Insurance, P.O. Box 149104, Austin, Texas 78714-9104 or 333 Guadalupe, Austin, Texas 78701 and the HMO Unit, Mail Code 108-6A, Texas Department of Insurance, P.O. Box 149104, Austin, Texas 78714-9104 or 333 Guadalupe, Austin, Texas 78701 a certification that the provisions of this section and Insurance Code, Article 3.96-8 have been met. A copy of the indemnity policy shall also be filed with the Life/Health Group, Filings Intake, Mail Code 106-1E, Texas Department of Insurance, P.O. Box 149104, Austin, Texas 78714-9104.
4. (d) An insurer whose policy contains preferred provider provisions for the purposes of offering a network of preferred providers as defined in §3.3702 of this title (relating to Definitions) shall provide reimbursement for services for a child who is the subject of a medical support order and lives outside the insurer's service area at the preferred provider level of benefits.

Source Note:The provisions of this §21.2010 adopted to be effective May 8, 1997, 22 TexReg 3799.