Texas Insurance Code 1255.107 – Permissible Limitations, Exclusions, or Reductions
(a) A group family leave insurance policy that limits, excludes, or reduces eligibility for family leave benefits under this chapter must state the limit, exclusion, or reduction in the policy.
(b) Permissible limitations, exclusions, or reductions in the policy include a limitation, exclusion, or reduction for:
(1) a period of family leave for which the required notice and medical certification have not been provided as prescribed by the policy;
(2) family leave related to a serious health condition or other harm to a family member brought about by the wilful intention of the insured;
(3) a period of family leave during which the insured performed work for compensation or profit;
(4) a period of family leave for which the insured is eligible to receive money from the insured’s employer or from a fund to which the employer has contributed;
(5) a period of family leave in which the insured is eligible to receive benefits under another statutory program or employer-sponsored program, including unemployment insurance benefits, workers’ compensation benefits, statutory disability benefits, statutory paid leave benefits, or paid time off from the employer’s paid leave policy;
(6) a period of family leave beginning before the insured becomes eligible for family leave benefits under the policy; or
(7) periods of family leave during which more than one person covered under the policy seeks family leave for the same family member.
Terms Used In Texas Insurance Code 1255.107
- Person: includes corporation, organization, government or governmental subdivision or agency, business trust, estate, trust, partnership, association, and any other legal entity. See Texas Government Code 311.005