Sec. 1352.001. APPLICABILITY OF CHAPTER  


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  • (a) This chapter applies only to a health benefit plan, including, subject to this chapter, a small employer health benefit plan written under Chapter 1501, 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 fraternal benefit society operating under Chapter 885;

    (4) a stipulated premium company operating under Chapter 884;

    (5) a reciprocal exchange operating under Chapter 942;

    (6) a Lloyd's plan operating under Chapter 941;

    (7) a health maintenance organization operating under Chapter 843;

    (8) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846; or

    (9) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844.

    (b) Notwithstanding any provision in Chapter 1575, 1579, or 1601 or any other law, this chapter applies to:

    (1) a basic plan under Chapter 1575;

    (2) a primary care coverage plan under Chapter 1579; and

    (3) basic coverage under Chapter 1601.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005. Amended by: Acts 2007, 80th Leg., R.S., Ch. 877 , Sec. 1, eff. September 1, 2007.