Sec. 1367.101. APPLICABILITY OF SUBCHAPTER  


Latest version.
  • (a) This subchapter applies only to a health benefit plan that:

    (1) 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 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;

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

    (F) a multiple employer welfare arrangement subject to regulation under Chapter 846;

    (2) is offered by an approved nonprofit health corporation that holds a certificate of authority under Chapter 844; or

    (3) provides health and accident coverage through a risk pool created under Chapter 172, Local Government Code, notwithstanding Section 172.014, Local Government Code, or any other law.

    (b) This subchapter applies to a health benefit plan described by Subsection (a) that provides coverage to a resident of this state, regardless of whether the plan issuer is located in or outside this state.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.