Sec. 1355.002. APPLICABILITY OF SUBCHAPTER  


Latest version.
  • (a) This subchapter applies only to a group health benefit plan that provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, including:

    (1) a group insurance policy, group insurance agreement, group hospital service contract, or group evidence of coverage that is offered by:

    (A) an insurance company;

    (B) a group hospital service corporation operating under Chapter 842;

    (C) a fraternal benefit society operating under Chapter 885;

    (D) a stipulated premium company operating under Chapter 884; or

    (E) a health maintenance organization operating under Chapter 843; and

    (2) to the extent permitted by the Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.), a plan offered under:

    (A) a multiple employer welfare arrangement as defined by Section 3 of that Act; or

    (B) another analogous benefit arrangement.

    (b) Notwithstanding any provision in Chapter 1575 or 1579 or any other law, Section 1355.015 applies to:

    (1) a basic plan under Chapter 1575; and

    (2) a primary care coverage plan under Chapter 1579.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005. Amended by: Acts 2009, 81st Leg., R.S., Ch. 1107 , Sec. 1, eff. September 1, 2009.