Tex.
Ins. Code Section 1205.001
Applicability of Chapter
(1)
provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, including:(A)
an individual, group, blanket, or franchise insurance policy or insurance agreement, a group hospital service contract, or an individual or group evidence of coverage that is offered by:(i)
an insurance company;(ii)
a group hospital service corporation operating under Chapter 842 (Group Hospital Service Corporations);(iii)
a fraternal benefit society operating under Chapter 885 (Fraternal Benefit Societies);(iv)
a stipulated premium company operating under Chapter 884 (Stipulated Premium Insurance Companies); or(v)
a health maintenance organization operating under Chapter 843 (Health Maintenance Organizations); and(B)
to the extent permitted by the Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.), a health benefit plan that is offered by:(i)
a multiple employer welfare arrangement as defined by Section 3 of that Act and operating under Chapter 846 (Multiple Employer Welfare Arrangements); or(ii)
an analogous benefit arrangement;(2)
is offered by an approved nonprofit health corporation that holds a certificate of authority under Chapter 844 (Certification of Certain Nonprofit Health Corporations); or(3)
is offered by any other entity that:(A)
is not authorized under this code or another insurance law of this state; and(B)
contracts directly for health care services on a risk-sharing basis, including a capitation basis.
Source:
Section 1205.001 — Applicability of Chapter, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1205.htm#1205.001 (accessed May 18, 2024).
