Texas Code § 1369.452

APPLICABILITY OF SUBCHAPTER
Open in Lexace · Ask the AI about this section
Sec. 1369.452. 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 ;
(3) a health maintenance organization operating under Chapter 843 ;
(4) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844 ;
(5) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846 ;
(6) a stipulated premium company operating under Chapter 884 ;
(7) a fraternal benefit society operating under Chapter 885 ; or
(8) an exchange operating under Chapter 942 .
(b) This subchapter applies to group health coverage made available by a school district in accordance with Section 22.004 , Education Code.
(c) Notwithstanding any provision in Chapter 1551 , 1575 , 1579 , or 1601 or any other law, this subchapter applies to health benefit plan coverage provided under:
(1) Chapter 1551 ;
(2) Chapter 1575 ;
(3) Chapter 1579 ; and
(4) Chapter 1601 .
(d) Notwithstanding Section 1501.251 or any other law, this subchapter applies to coverage under a small employer health benefit plan subject to Chapter 1501 .
(e) This subchapter applies to a standard health benefit plan issued under Chapter 1507 .
(f) To the extent allowed by federal law, the child health plan program operated under Chapter 62 , Health and Safety Code, and the state Medicaid program, including the Medicaid managed care program operated under Chapters 540 and 540A , Government Code, shall provide the coverage required under this subchapter to a recipient.

‹ Prev All Texas sections Next ›


Lexace provides legal information, not legal advice, and no attorney–client relationship is created. Statute text is provided for general information and may not reflect the most recent amendments; verify against the official state code.