Sec. 140.002. APPLICABILITY OF CHAPTER. (a) This chapter applies to an issuer of a health benefit plan that provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, a disability benefit plan, or an employee welfare benefit plan, 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, including: (1) an insurance company; (2) a group hospital service corporation operating under Chapter 842 , Insurance Code; (3) a fraternal benefit society operating under Chapter 885 , Insurance Code; (4) a stipulated premium insurance company operating under Chapter 884 , Insurance Code; (5) a reciprocal exchange operating under Chapter 942 , Insurance Code; (6) a health maintenance organization operating under Chapter 843 , Insurance Code; (7) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846 , Insurance Code; or (8) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844 , Insurance Code. (b) Notwithstanding Section 172.014 , Local Government Code, or any other law, this chapter applies to a risk pool providing health and accident coverage under Chapter 172 , Local Government Code. (c) Notwithstanding any other law, this chapter applies to an issuer of a plan or coverage under Chapter 1551 , 1575 , 1579 , or 1601 , Insurance Code. (d) Notwithstanding any other law, this chapter applies to any self-funded issuer of a plan that provides a benefit described by Subsection (a). (e) This chapter applies to any policy, evidence of coverage, or contract under which a benefit described by Subsection (a) is provided and: (1) that is delivered, issued for delivery, or entered into in this state; or (2) under which an individual or group in this state is entitled to benefits. (f) This chapter does not apply to: (1) a workers' compensation insurance policy or any other source of medical benefits under Title 5, Labor Code; (2) Medicare; (3) the Medicaid program under Chapter 32 , Human Resources Code; (4) a Medicaid managed care program operated under Chapter 540 or Chapter 540A , Government Code, as applicable; (5) the state child health plan or any other program operated under Chapter 62 or 63 , Health and Safety Code; or (6) a self-funded plan that is subject to the Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.).
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