Texas Accident & Health Insurance Law — Texas Insurance Law — Life & Health Practice Test

This Texas Insurance Law — Life & Health Texas Accident & Health Insurance Law practice set has 27 practice questions based on the official exam materials, each with an instant explanation.

Sample questions

Three questions from the Texas Accident & Health Insurance Law bank with the correct answer and an explanation. The practice quiz above draws 27 questions at random from the same bank.

1. Under the Texas Insurance Code, a group accident and health policy that provides coverage for a policyholder's or member's dependents must:

   • Automatically cover a newborn child from the moment of birth, without requiring advance notice or an additional premium for an initial period — Correct answer
   • Exclude all newborn children until the child is enrolled in writing and a full premium is paid
   • Cover a newborn child only if the child is adopted, not if the child is born to the insured
   • Cover a newborn child only after the child's first pediatric well-visit is completed

   Explanation: Texas law requires that a policy covering a policyholder's dependents automatically cover a newly born child from the moment of birth (Tex. Ins. Code §1367.003; §1551.004; 28 TAC §3.3403).

   Handbook: Texas Accident & Health Insurance Law — Coverage for Newborns

2. Under 28 TAC §3.3403, when a Texas accident and health policy automatically covers a newborn child from birth, the insurer may require the policyholder to:

   • Notify the insurer of the birth and pay any additional premium required within a specified period after the birth in order to continue the newborn's coverage beyond that period — Correct answer
   • Wait 12 months after the birth before any notice or premium is due
   • Provide notice before the child is conceived
   • Never notify the insurer, since notice is expressly prohibited

   Explanation: Coverage begins automatically at birth, but the insurer may require notice of the birth and payment of any additional premium within a specified period to keep the newborn covered beyond that window (28 TAC §3.3403; Tex. Ins. Code §1367.003).

   Handbook: Texas Accident & Health Insurance Law — Newborn Coverage Notice Period

3. Texas Insurance Code §1551.004 addresses newborn coverage requirements specifically for:

   • Group health coverage plans administered under the Texas Employees Group Benefits Act (state employee/retiree group health plans) — Correct answer
   • Only individual life insurance policies with a disability rider
   • Only Medicare Advantage plans sold to Texas seniors
   • Only workers' compensation insurance policies

   Explanation: TIC §1551.004 is part of the Texas Employees Group Benefits Act and extends the newborn-coverage requirement to the state employee/retiree group health benefits program (Tex. Ins. Code §1551.004).

   Handbook: Texas Accident & Health Insurance Law — Employees Retirement System Newborn Coverage