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Texas Insurance Code - Not Codified - Article 29.03. Scope Of Chapter

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Art. 29.03. SCOPE OF CHAPTER.                                                  

Text of article effective until September 1, 2007
	(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 20 of this code;
	(3)  a fraternal benefit society operating under Chapter 10 
of this code;    
	(4)  a stipulated premium insurance company operating under 
Chapter 22 of this code;
	(5)  a reciprocal exchange operating under Chapter 19 of this 
code;          
	(6)  a health maintenance organization operating under the 
Texas Health Maintenance Organization Act (Chapter 20A, Vernon's 
Texas Insurance Code);  or
	(7)  a multiple employer welfare agreement that holds a 
certificate of authority under Article 3.95-2 of this code.
	(b)  This chapter does not apply to:                                           
	(1)  a plan that provides coverage:                                            
	(A)  only for a specified disease or other limited benefit;                    
	(B)  only for accidental death or dismemberment;                               
	(C)  for wages or payments in lieu of wages for a period 
during which an employee is absent from work because of sickness or 
injury;
	(D)  as a supplement to liability insurance;                                   
	(E)  for credit insurance;                                                     
	(F)  only for dental or vision care;                                           
	(G)  only for hospital expenses;  or                                           
	(H)  only for indemnity for hospital confinement;                              
	(2)  a small employer health benefit plan written under 
Chapter 26 of this code;
	(3)  a Medicare supplemental policy as defined by Section 
1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss), as 
amended;
	(4)  workers' compensation insurance coverage;                                 
	(5)  medical payment insurance coverage issued as part of a 
motor vehicle insurance policy;  or
	(6)  a long-term care policy, including a nursing home 
indemnity policy, unless the attorney general determines that the 
policy provides benefit coverage so comprehensive that the policy 
is a health benefit plan as described by Subsection (a) of this 
article.

Added by Acts 1999, 76th Leg., ch. 1586, Sec. 1, eff. Sept. 1, 1999.          

Last modified: August 11, 2007