Tex.
Ins. Code Section 1660.003
Applicability
(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 fraternal benefit society operating under Chapter 885 (Fraternal Benefit Societies);(4)
a stipulated premium insurance 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)
This chapter does not apply to:(1)
a Medicaid managed care program operated under Chapter 533, Government Code;(2)
a Medicaid program operated under Chapter 32 (Medical Assistance Program), Human Resources Code;(3)
the state child health plan or any similar plan operated under Chapter 62 (Child Health Plan for Certain Low-income Children) or 63 (Health Benefits Plan for Certain Children), Health and Safety Code; or(4)
a health benefit plan offered by an insurer or health maintenance organization that provides coverage only for dental services.(b)
This chapter does not apply to:(1)
a Medicaid managed care program operated under Chapter 540 (Medicaid Managed Care Program) or 540A (Medicaid Managed Transportation Services), Government Code, as applicable;(2)
a Medicaid program operated under Chapter 32 (Medical Assistance Program), Human Resources Code;(3)
the state child health plan or any similar plan operated under Chapter 62 (Child Health Plan for Certain Low-income Children) or 63 (Health Benefits Plan for Certain Children), Health and Safety Code; or(4)
a health benefit plan offered by an insurer or health maintenance organization that provides coverage only for dental services.
Source:
Section 1660.003 — Applicability, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1660.htm#1660.003 (accessed Jun. 5, 2024).
