Tex.
Ins. Code Section 1218.002
Applicability of Chapter
(a)
This chapter 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 offered by:(1)
an insurance company;(2)
a group hospital service corporation operating under Chapter 842 (Group Hospital Service Corporations);(3)
a fraternal benefit society operating under Chapter 885 (Fraternal Benefit Societies);(4)
a stipulated premium company operating under Chapter 884 (Stipulated Premium Insurance Companies);(5)
an exchange operating under Chapter 942 (Reciprocal and Interinsurance Exchanges);(6)
a health maintenance organization operating under Chapter 843 (Health Maintenance Organizations);(7)
a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846 (Multiple Employer Welfare Arrangements); or(8)
an approved nonprofit health corporation that holds a certificate of authority under Chapter 844 (Certification of Certain Nonprofit Health Corporations).(b)
This chapter applies to group health coverage made available by a school district in accordance with Section 22.004 (Group Health Benefits for School Employees), Education Code.(c)
Notwithstanding any provision in 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) or any other law, this chapter applies to:(1)
a basic coverage plan under Chapter 1551 (Texas Employees Group Benefits Act);(2)
a basic plan under Chapter 1575 (Texas Public School Employees Group Benefits Program);(3)
a primary care coverage plan under Chapter 1579 (Texas School Employees Uniform Group Health Coverage); and(4)
basic coverage under Chapter 1601 (Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System).(d)
Notwithstanding Section 1501.251 (Exception from Certain Mandated Benefit Requirements) or any other law, this chapter applies to coverage under a small or large employer health benefit plan subject to Chapter 1501 (Health Insurance Portability and Availability Act).(e)
Notwithstanding Section 1507.003 (State-mandated Health Benefits) or 1507.053 (State-mandated Health Benefits) or any other law, this chapter applies to a standard health benefit plan provided under Chapter 1507 (Consumer Choice of Benefits Plans).
Source:
Section 1218.002 — Applicability of Chapter, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1218.htm#1218.002 (accessed Jun. 5, 2024).
