Tex.
Civ. Practice & Remedies Code Section 140.002
Applicability of Chapter
(a)
This chapter applies to an issuer of a health benefit plan that provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, a disability benefit plan, or an employee welfare benefit plan, 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, including:(1)
an insurance company;(2)
a group hospital service corporation operating under Chapter 842 (Group Hospital Service Corporations), Insurance Code;(3)
a fraternal benefit society operating under Chapter 885 (Fraternal Benefit Societies), Insurance Code;(4)
a stipulated premium insurance company operating under Chapter 884 (Stipulated Premium Insurance Companies), Insurance Code;(5)
a reciprocal exchange operating under Chapter 942 (Reciprocal and Interinsurance Exchanges), Insurance Code;(6)
a health maintenance organization operating under Chapter 843 (Health Maintenance Organizations), Insurance Code;(7)
a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846 (Multiple Employer Welfare Arrangements), Insurance Code; or(8)
an approved nonprofit health corporation that holds a certificate of authority under Chapter 844 (Certification of Certain Nonprofit Health Corporations), Insurance Code.(b)
Notwithstanding Section 172.014 (Application of Certain Laws), Local Government Code, or any other law, this chapter applies to a risk pool providing health and accident coverage under Chapter 172 (Texas Political Subdivisions Uniform Group Benefits Program), Local Government Code.(c)
Notwithstanding any other law, this chapter applies to an issuer of a plan or coverage under Chapter 1551 (Texas Employees Group Benefits Act), 1575 (Texas Public School Employees Group Benefits Program), 1579 (Texas School Employees Uniform Group Health Coverage), or 1601 (Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System), Insurance Code.(d)
Notwithstanding any other law, this chapter applies to any self-funded issuer of a plan that provides a benefit described by Subsection (a).(e)
This chapter applies to any policy, evidence of coverage, or contract under which a benefit described by Subsection (a) is provided and:(1)
that is delivered, issued for delivery, or entered into in this state; or(2)
under which an individual or group in this state is entitled to benefits.(f)
This chapter does not apply to:(1)
a workers’ compensation insurance policy or any other source of medical benefits under Title 5, Labor Code;(2)
Medicare;(3)
the Medicaid program under Chapter 32 (Medical Assistance Program), Human Resources Code;(4)
a Medicaid managed care program operated under Chapter 533, Government Code;(5)
the state child health plan or any other program operated under Chapter 62 (Child Health Plan for Certain Low-income Children) or 63 (Health Benefits Plan for Certain Children), Health and Safety Code; or(6)
a self-funded plan that is subject to the Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.).(f)
This chapter does not apply to:(1)
a workers’ compensation insurance policy or any other source of medical benefits under Title 5, Labor Code;(2)
Medicare;(3)
the Medicaid program under Chapter 32 (Medical Assistance Program), Human Resources Code;(4)
a Medicaid managed care program operated under Chapter 540 (Medicaid Managed Care Program) or Chapter 540A (Medicaid Managed Transportation Services), Government Code, as applicable;(5)
the state child health plan or any other program operated under Chapter 62 (Child Health Plan for Certain Low-income Children) or 63 (Health Benefits Plan for Certain Children), Health and Safety Code; or(6)
a self-funded plan that is subject to the Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.).
Source:
Section 140.002 — Applicability of Chapter, https://statutes.capitol.texas.gov/Docs/CP/htm/CP.140.htm#140.002 (accessed Jun. 5, 2024).
