SB 527

relating to health benefit coverage for general anesthesia in
connection with certain pediatric dental services.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1.  Chapter 1367, Insurance Code, is amended by
adding Subchapter G to read as follows:
SUBCHAPTER G. PEDIATRIC DENTISTRY
Sec. 1367.301.  APPLICABILITY OF SUBCHAPTER.  (a)  This
subchapter applies only to a health benefit plan that provides
benefits for medical or surgical expenses incurred as a result of a
health condition, accident, or sickness, including an individual,
group, blanket, or franchise insurance policy or insurance
agreement, a group hospital service contract, or an individual or
group evidence of coverage or similar coverage document that is
(2)  a group hospital service corporation operating
(3)  a health maintenance organization operating under
(4)  an approved nonprofit health corporation that
holds a certificate of authority under Chapter 844;
(5)  a multiple employer welfare arrangement that holds
a certificate of authority under Chapter 846;
(6)  a stipulated premium insurance company operating
(7)  a fraternal benefit society operating under
(8)  a Lloyd's plan operating under Chapter 941; or
(9)  an exchange operating under Chapter 942.
(b)  Notwithstanding any other law, this subchapter applies
(1)  a small employer health benefit plan subject to
Chapter 1501, including coverage provided through a health group
cooperative under Subchapter B of that chapter;
(2)  a standard health benefit plan issued under
(3)  a basic coverage plan under Chapter 1551;
(4)  a basic plan under Chapter 1575;
(5)  a primary care coverage plan under Chapter 1579;
(6)  a plan providing basic coverage under Chapter
(7)  a regional or local health care program operated
under Section 75.104, Health and Safety Code; and
(8)  a self-funded health benefit plan sponsored by a
professional employer organization under Chapter 91, Labor Code.
Sec. 1367.302.  COVERAGE FOR GENERAL ANESTHESIA.  Subject to
Section 1360.005, a health benefit plan that provides coverage for
general anesthesia may not exclude from coverage medically
necessary general anesthesia services in connection with dental
services provided to a covered individual if:
(A)  younger than 13 years of age; and
(B)  unable to undergo the dental service without
general anesthesia due to a documented physical, mental, or medical
(2)  the anesthesia is performed by a qualified
provider of anesthesia services.
Sec. 1367.303.  COVERAGE NOT REQUIRED.  This subchapter does
not require a health benefit plan to provide coverage for dental
SECTION 2.  Subchapter G, Chapter 1367, Insurance Code, as
added by this Act, applies only to a health benefit plan that is
delivered, issued for delivery, or renewed on or after January 1,
SECTION 3.  This Act takes effect September 1, 2025.