Question 13003 of 324 · Texas Life, Accident and Health Agent Exam
An HMO may cancel or refuse to renew an enrollee's coverage only for specific reasons such as
Exactly one answer is correct.
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Correct answer to question 13003
- B: nonpayment of premium, fraud, or loss of eligibility
Explanation
Section 843.208 allows an HMO to cancel or refuse to renew an enrollee's coverage only for failure to pay the charges or another reason set by commissioner rule. The rule lists grounds such as nonpayment, fraud or intentional misrepresentation, and loss of eligibility, each with a minimum written notice period.
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