Common use of General Requirements for All Insurance Coverage Clause in Contracts

General Requirements for All Insurance Coverage. (1) Except as provided herein, all exceptions to the Contract’s insurance requirements must be approved in writing by HHSC. HHSC’s written approval is not required in the following situations: (i) An MCO or a Network Provider is not required to obtain the insurance coverage described in Section 17.01 if the MCO or Network Provider qualifies as a state governmental unit or municipality under the Texas Tort Claims Act, and is required to comply with, and subject to the provisions of, the Texas Tort Claims Act. (ii) An MCO may waive the Professional Liability Insurance requirement described in Section 17.01(b)(1) for a Network Provider of Community-based Long-term Services and Supports. An MCO may not waive this requirement if the Network Provider provides other Covered Services in addition to Community-based Long Term Services and Supports, or if a Texas licensing entity requires the Network Provider to carry such Professional Liability coverage. An MCO that waives the Professional Liability Insurance requirement for a Network Provider pursuant to this provision is not required to obtain such coverage on behalf of the Network Provider. (2) MCO or the Network Provider is responsible for any and all deductibles stated in the insurance policies. (3) Insurance coverage must be issued by insurance companies authorized to conduct business in the State of Texas. (4) With the exception of Professional Liability Insurance maintained by Network Providers, all insurance coverage must name HHSC as an additional insured. In addition, with the exception of Professional Liability Insurance maintained by Network Providers and Business Automobile Liability Insurance, all insurance coverage must name HHSC as a loss payee. (5) Insurance coverage kept by the MCO must be maintained in full force at all times during the Term of the Contract, and until HHSC’s final acceptance of all Services and Deliverables. Failure to maintain such insurance coverage will constitute a material breach of this Contract. (6) With the exception of Professional Liability Insurance maintained by Network Providers, the insurance policies described in this Section must have extended reporting periods of two (2) years. When policies are renewed or replaced, the policy retroactive date must coincide with, or precede, the Contract Effective Date. (7) With the exception of Professional Liability Insurance maintained by Network Providers, the insurance policies described in this Section must provide that prior written notice be given to HHSC at least 30 calendar days before coverage is reduced below minimum HHSC contractual requirements, canceled, or non-renewed. MCO must submit a new coverage binder to HHSC to ensure no break in coverage. (8) The Parties expressly understand and agree that any insurance coverages and limits furnished by MCO will in no way expand or limit MCO’s liabilities and responsibilities specified within the Contract documents or by applicable law. (9) MCO expressly understands and agrees that any insurance maintained by HHSC will apply in excess of and not contribute to insurance provided by MCO under the Contract. (10) If MCO, or its Network Providers, desire additional coverage, higher limits of liability, or other modifications for its own protection, MCO or its Network Providers will be responsible for the acquisition and cost of such additional protection. Such additional protection will not be an Allowable Expense under this Contract. (11) MCO will require all insurers to waive their rights of subrogation against HHSC for claims arising from or relating to this Contract.

General Requirements for All Insurance Coverage. (1) Except as provided herein, all exceptions to the Contract’s insurance requirements must be approved in writing by HHSC. HHSC’s written approval is not required in the following situations: (iA) An MCO HMO or a Network Provider is not required to obtain the insurance coverage described in Section 17.01 if the MCO HMO or Network Provider qualifies as a state governmental unit or municipality under the Texas Tort Claims Act, and is required to comply with, and subject to the provisions of, the Texas Tort Claims Act. (iiB) An MCO HMO may waive the Professional Liability Insurance requirement described in Section 17.01(b)(1) for a Network Provider of Community-based Long-term Services and SupportsLong Term Care Services. An MCO HMO may not waive this requirement if the Network Provider provides other Covered Services in addition to Community-based Long Term Services and SupportsCare Services, or if a Texas licensing entity requires the Network Provider to carry such Professional Liability coverage. An MCO HMO that waives the Professional Liability Insurance requirement for a Network Provider pursuant to this provision is not required to obtain such coverage on behalf of the Network Provider. (2) MCO HMO or the Network Provider is responsible for any and all deductibles stated in the insurance policies. (3) Insurance coverage must be issued by insurance companies authorized to conduct business in the State of Texas. (4) With Insurance coverage must name HHSC as an additional insured with the exception of following exceptions: Standard Workers’ Compensation Insurance maintained by the HMO, and Professional Liability Insurance maintained by Network Providers, all insurance coverage must name HHSC as an additional insured. In addition, with the exception of Professional Liability Insurance maintained by Network Providers and Business Automobile Liability Insurance, all insurance coverage must name HHSC as a loss payee. (5) Insurance coverage kept by the MCO HMO must be maintained in full force at all times during throughout the Term of the Contract, and until HHSC’s final acceptance of all Services and Deliverables. Failure to maintain such insurance coverage will constitute a material breach of this Contract. (6) With the exception of Professional Liability Insurance maintained by Network Providers, the insurance policies described in this Section must have extended reporting periods of two (2) years. When policies are renewed or replaced, the policy retroactive date must coincide with, or precede, the Contract Effective Date. (7) With the exception of Professional Liability Insurance maintained by Network Providers, the insurance policies described in this Section must provide that prior written notice to be given to HHSC at least 30 thirty (30) calendar days before coverage is reduced below minimum HHSC contractual requirementssubstantially changed, canceled, or non-renewed. MCO HMO must submit a new coverage binder to HHSC to ensure no break in coverage. (8) The Parties expressly understand and agree that any insurance coverages and limits furnished by MCO HMO will in no way expand or limit MCOHMO’s liabilities and responsibilities specified within the Contract documents or by applicable law. (9) MCO HMO expressly understands and agrees that any insurance maintained by HHSC will apply in excess of and not contribute to insurance provided by MCO HMO under the Contract. (10) If MCOHMO, or its Network Providers, desire additional coverage, higher limits of liability, or other modifications for its own protection, MCO HMO or its Network Providers will be responsible for the acquisition and cost of such additional protection. Such additional protection will not be an Allowable Expense under this Contract. (11) MCO will require all insurers to waive their rights of subrogation against HHSC for claims arising from or relating to this Contract.

General Requirements for All Insurance Coverage. (1) Except as provided herein, all exceptions to the Contract’s insurance requirements must be approved in writing by HHSC. HHSC’s written approval is not required in the following situations: (i) An MCO or a Network Provider is not required to obtain the insurance coverage described in Section 17.01 if the MCO or Network Provider qualifies as a state governmental unit or municipality under the Texas Tort Claims Act, and is required to comply with, and subject to the provisions of, the Texas Tort Claims Act. (ii) An MCO may waive the Professional Liability Insurance requirement described in Section 17.01(b)(1) for a Network Provider of Community-based Long-term Services and Supports. An MCO may not waive this requirement if the Network Provider provides other Covered Services in addition to Community-based Long Term Services and Supports, or if a Texas licensing entity requires the Network Provider to carry such Professional Liability coverage. An MCO that waives the Professional Liability Insurance requirement for a Network Provider pursuant to this provision is not required to obtain such coverage on behalf of the Network Provider. (iii) The Professional Liability Insurance requirements described in Section 17.01(b)(1) do not apply to Nursing Facility Providers. (2) MCO or the Network Provider is responsible for any and all deductibles stated in the insurance policies. (3) Insurance coverage must be issued by insurance companies authorized to conduct business in the State of Texas. (4) With the exception of Professional Liability Insurance maintained by Network Providers, all insurance coverage must name HHSC as an additional insured. In addition, with the exception of Professional Liability Insurance maintained by Network Providers and Business Automobile Liability Insurance, all insurance coverage must name HHSC as a loss payee. (5) Insurance coverage kept by the MCO must be maintained in full force at all times during the Term of the Contract, and until HHSC’s final acceptance of all Services and Deliverables. Failure to maintain such insurance coverage will constitute a material breach of this Contract. (6) With the exception of Professional Liability Insurance maintained by Network Providers, the insurance policies described in this Section must have extended reporting periods of two (2) years. When policies are renewed or replaced, the policy retroactive date must coincide with, or precede, the Contract Effective Date. (7) With the exception of Professional Liability Insurance maintained by Network Providers, the insurance policies described in this Section must provide that prior written notice be given to HHSC at least 30 calendar days before coverage is reduced below minimum HHSC contractual requirements, canceled, or non-renewed. MCO must submit a new coverage binder to HHSC to ensure no break in coverage. (8) The Parties expressly understand and agree that any insurance coverages and limits furnished by MCO will in no way expand or limit MCO’s liabilities and responsibilities specified within the Contract documents or by applicable law. (9) MCO expressly understands and agrees that any insurance maintained by HHSC will apply in excess of and not contribute to insurance provided by MCO under the Contract. (10) If MCO, or its Network Providers, desire additional coverage, higher limits of liability, or other modifications for its own protection, MCO or its Network Providers will be responsible for the acquisition and cost of such additional protection. Such additional protection will not be an Allowable Expense under this Contract. (11) MCO will require all insurers to waive their rights of subrogation against HHSC for claims arising from or relating to this Contract.

General Requirements for All Insurance Coverage. (1) Except as provided herein, all exceptions to the Contract’s insurance requirements must be approved in writing by HHSC. HHSC’s written approval is not required in the following situations: (iA) An MCO HMO or a Network Provider is not required to obtain the insurance coverage described in Section 17.01 if the MCO HMO or Network Provider qualifies as a state governmental unit or municipality under the Texas Tort Claims Act, and is required to comply with, and subject to the provisions of, the Texas Tort Claims Act. (iiB) An MCO HMO may waive the Professional Liability Insurance requirement described in Section 17.01(b)(1) for a Network Provider of Community-based Long-term Services and SupportsLong Term Care Services. An MCO HMO may not waive this requirement if the Network Provider provides other Covered Services in addition to Community-based Long Term Services and SupportsCare Services, or if a Texas licensing entity requires the Network Provider to carry such Professional Liability coverage. An MCO HMO that waives the Professional Liability Insurance requirement for a Network Provider pursuant to this provision is not required to obtain such coverage on behalf of the Network Provider. (2) MCO HMO or the Network Provider is responsible for any and all deductibles stated in the insurance policies. (3) Insurance coverage must be issued by insurance companies authorized to conduct business in the State of Texas. (4) With Insurance coverage must name HHSC as an additional insured with the exception of following exceptions: Standard Workers’ Compensation Insurance maintained by the HMO, and Professional Liability Insurance maintained by Network Providers, all insurance coverage must name HHSC as an additional insured. In addition, with the exception of Professional Liability Insurance maintained by Network Providers and Business Automobile Liability Insurance, all insurance coverage must name HHSC as a loss payee. (5) Insurance coverage kept by the MCO HMO must be maintained in full force at all times during throughout the Term of the Contract, and until HHSC’s final acceptance of all Services and Deliverables. Failure to maintain such insurance coverage will constitute a material breach of this Contract. (6) With the exception of Professional Liability Insurance maintained by Network Providers, the insurance policies described in this Section must have extended reporting periods of two (2) years. When policies are renewed or replaced, the policy retroactive date must coincide with, or precede, the Contract Effective Date. (7) With the exception of Professional Liability Insurance maintained by Network Providers, the insurance policies described in this Section must provide that prior written notice to be given to HHSC at least 30 thirty (30) calendar days before coverage is reduced below minimum HHSC contractual requirementssubstantially changed, canceled, or non-renewed. MCO HMO must submit a new coverage binder to HHSC to ensure no break in coverage. (8) The Parties expressly understand and agree that any insurance coverages and limits furnished by MCO HMO will in no way expand or limit MCOHMO’s liabilities and responsibilities specified within the Contract documents or by applicable law. (9) MCO HMO expressly understands and agrees that any insurance maintained by HHSC will apply in excess of and not contribute to insurance provided by MCO HMO under the Contract. (10) If MCO, or its Network Providers, desire additional coverage, higher limits of liability, or other modifications for its own protection, MCO or its Network Providers will be responsible for the acquisition and cost of such additional protection. Such additional protection will not be an Allowable Expense under this Contract. (11) MCO will require all insurers to waive their rights of subrogation against HHSC for claims arising from or relating to this Contract.