Sec. 1369.602. 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 ; (8) a Lloyd's plan operating under Chapter 941 ; or (9) an exchange operating under Chapter 942 . (b) Notwithstanding any other law, this subchapter applies to: (1) a small employer health benefit plan subject to Chapter 1501 , including coverage provided through a health group cooperative under Subchapter B of that chapter; (2) a standard health benefit plan issued under Chapter 1507 ; (3) health benefits provided by or through a church benefits board under Subchapter I , Chapter 22 , Business Organizations Code; (4) group health coverage made available by a school district in accordance with Section 22.004 , Education Code; (5) a regional or local health care program operated under Section 75.104 , Health and Safety Code; and (6) a self-funded health benefit plan sponsored by a professional employer organization under Chapter 91 , Labor Code. (c) This subchapter does not apply to an issuer or provider of health benefits under or a pharmacy benefit manager administering pharmacy benefits under a workers' compensation insurance policy or other form of providing medical benefits under Title 5, Labor Code.
‹ 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.