Ins. Code Section 1369.652
Applicability of Subchapter
(a)This subchapter applies only to a health benefit plan that provides benefits for medical, surgical, or prescription drug 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 issued by:
(1)an insurance company;
(2)a group hospital service corporation operating under Chapter 842 (Group Hospital Service Corporations);
(3)a health maintenance organization operating under Chapter 843 (Health Maintenance Organizations);
(4)an approved nonprofit health corporation that holds a certificate of authority under Chapter 844 (Certification of Certain Nonprofit Health Corporations);
(5)a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846 (Multiple Employer Welfare Arrangements);
(6)a stipulated premium company operating under Chapter 884 (Stipulated Premium Insurance Companies);
(7)a fraternal benefit society operating under Chapter 885 (Fraternal Benefit Societies);
(8)a Lloyd’s plan operating under Chapter 941 (Lloyd’s Plan); or
(9)an exchange operating under Chapter 942 (Reciprocal and Interinsurance Exchanges).
(b)Notwithstanding any other law, this subchapter applies to:
(1)a small employer health benefit plan subject to Chapter 1501 (Health Insurance Portability and Availability Act), including coverage provided through a health group cooperative under Subchapter B of that chapter;
(2)a standard health benefit plan issued under Chapter 1507 (Consumer Choice of Benefits Plans);
(3)a basic coverage plan under Chapter 1551 (Texas Employees Group Benefits Act);
(4)a basic plan under Chapter 1575 (Texas Public School Employees Group Benefits Program);
(5)a primary care coverage plan under Chapter 1579 (Texas School Employees Uniform Group Health Coverage);
(6)a plan providing basic coverage under Chapter 1601 (Uniform Insurance Benefits Act for Employees of the University of Texas System and the Texas A&m University System);
(7)group health coverage made available by a school district in accordance with Section 22.004 (Group Health Benefits for School Employees), Education Code; and
(8)a self-funded health benefit plan sponsored by a professional employer organization under Chapter 91 (Professional Employer Organizations), Labor Code.
(c)This subchapter applies to coverage under a group health benefit plan provided to a resident of this state regardless of whether the group policy, agreement, or contract is delivered, issued for delivery, or renewed in this state.
Section 1369.652 — Applicability of Subchapter,
https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1369.htm#1369.652 (accessed Nov. 25, 2023).