Tex.
Ins. Code Section 1369.151
Applicability of Subchapter
(a)
This subchapter 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)
a reciprocal 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)
Notwithstanding any other law, this subchapter applies to coverage under:(1)
the basic coverage plan under Chapter 1551 (Texas Employees Group Benefits Act);(2)
the basic plan under Chapter 1575 (Texas Public School Employees Group Benefits Program);(3)
the primary care coverage plan under Chapter 1579 (Texas School Employees Uniform Group Health Coverage);(4)
the basic coverage plan under Chapter 1601 (Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System);(5)
the child health plan program under Chapter 62 (Child Health Plan for Certain Low-income Children), Health and Safety Code; and(6)
the medical assistance program under Chapter 32 (Medical Assistance Program), Human Resources Code.
Source:
Section 1369.151 — Applicability of Subchapter, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1369.htm#1369.151 (accessed Jun. 5, 2024).
