Tex.
Ins. Code Section 1355.252
Applicability of Subchapter
(a)
This subchapter applies only to a health benefit plan that provides benefits or coverage for medical or surgical expenses incurred as a result of a health condition, accident, or sickness and for treatment expenses incurred as a result of a mental health condition or substance use disorder, including an individual, group, blanket, or franchise insurance policy or insurance agreement, a group hospital service contract, an individual or group evidence of coverage, or a 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)
a health maintenance organization operating under Chapter 843 (Health Maintenance Organizations);(6)
a reciprocal exchange operating under Chapter 942 (Reciprocal and Interinsurance Exchanges);(7)
a Lloyd’s plan operating under Chapter 941 (Lloyd’s Plan);(8)
an approved nonprofit health corporation that holds a certificate of authority under Chapter 844 (Certification of Certain Nonprofit Health Corporations); or(9)
a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846 (Multiple Employer Welfare Arrangements).(b)
Notwithstanding Section 1501.251 (Exception from Certain Mandated Benefit Requirements) or any other law, this subchapter applies to coverage under a small employer health benefit plan subject to Chapter 1501 (Health Insurance Portability and Availability Act).(c)
This subchapter applies to a standard health benefit plan issued under Chapter 1507 (Consumer Choice of Benefits Plans).
Source:
Section 1355.252 — Applicability of Subchapter, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1355.htm#1355.252 (accessed Jun. 5, 2024).
