Tex. Ins. Code Section 1273.055
Cost-sharing Provisions

(a)

Different cost-sharing provisions may be imposed for a point-of-service plan offered under this subchapter, and those provisions may be higher than the cost-sharing provisions for in-network health maintenance organization coverage. For an enrollee in a limited provider network, higher cost-sharing may be imposed only when the enrollee obtains benefits or services outside the health maintenance organization delivery network.

(b)

An employee who chooses the non-network plan is responsible for any additional costs for the non-network plan, and the employer may impose a reasonable administrative fee for providing the non-network plan.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.

Source: Section 1273.055 — Cost-sharing Provisions, https://statutes.­capitol.­texas.­gov/Docs/IN/htm/IN.­1273.­htm#1273.­055 (accessed May 18, 2024).

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Accessed:
May 18, 2024

§ 1273.055’s source at texas​.gov