28 Tex. Admin. Code § 3.3055 - Standards for Probationary or Waiting Period Provision
A probationary or waiting period, if one is specified in the policy, is that period of time commencing with the date a person is initially insured under the policy to the date the coverage or coverages of the policy shall become effective as to such person.
(1) A probationary or waiting period shall
not apply to any loss resulting from accidental injuries as defined in the
policy; however, a policy may specify a probationary or waiting period for
coverage of sickness which shall not exceed 30 days except as follows:
(A) for pregnancy, childbirth, miscarriage,
or complications of pregnancy, the probationary or waiting period when
expressed in terms of the inception of the pregnancy shall be no more than 30
days;
(B) six months for losses
resulting from hernia, disorder of reproductive organs, varicose veins,
hemorrhoids, appendix, tonsils, adenoids, and gall bladder;
(C) 120 days for coverages under specified
disease insurance.
(2)
The limitations set out in this section do not apply to benefits for dental or
vision care.
(3) Probationary
waiting periods do not affect limitations for pre-existing
conditions.
Notes
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