Sec. 1379.002. APPLICABILITY OF CHAPTER  


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  • (a) This chapter 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 fraternal benefit society operating under Chapter 885;

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

    (5) an exchange operating under Chapter 942;

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

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

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

    (b) This chapter applies to group health coverage made available by a school district in accordance with Section 22.004, Education Code.

    (c) Notwithstanding any provision in Chapter 1551, 1575, 1579, or 1601 or any other law, this chapter applies to:

    (1) a basic coverage plan under Chapter 1551;

    (2) a basic plan under Chapter 1575;

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

    (4) basic coverage under Chapter 1601.

    (d) Notwithstanding Section 1501.251 or any other law, this chapter applies to coverage under a small employer health benefit plan subject to Chapter 1501.

Added by Acts 2009, 81st Leg., R.S., Ch. 719 , Sec. 1, eff. September 1, 2009.