Tex. Ins. Code Section 1372.002
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 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 chapter 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)

the state Medicaid program, including the Medicaid managed care program operated under Chapter 533, Government Code;

(8)

the child health plan program under Chapter 62 (Child Health Plan for Certain Low-income Children), Health and Safety Code; and

(9)

a self-funded health benefit plan sponsored by a professional employer organization under Chapter 91 (Professional Employer Organizations), Labor Code.
Added by Acts 2023, 88th Leg., R.S., Ch. 279 (S.B. 989), Sec. 1, eff. September 1, 2023.

Source: Section 1372.002 — Applicability of Chapter, https://statutes.­capitol.­texas.­gov/Docs/IN/htm/IN.­1372.­htm#1372.­002 (accessed Jun. 5, 2024).

Accessed:
Jun. 5, 2024

§ 1372.002’s source at texas​.gov