Sec. 1369.151. APPLICABILITY OF SUBCHAPTER. (a) This subchapter 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) a reciprocal 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) Notwithstanding any other law, this subchapter applies to coverage under:
(1) the basic coverage plan under Chapter 1551;
(2) the basic plan under Chapter 1575;
(3) the primary care coverage plan under Chapter 1579;
(4) the basic coverage plan under Chapter 1601;
(5) the child health plan program under Chapter 62, Health and Safety Code; and
(6) the medical assistance program under Chapter 32, Human Resources Code.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Amended by:
Acts 2009, 81st Leg., R.S., Ch. 1117 (H.B. 1138), Sec. 1, eff. September 1, 2009.
Section: Previous 1369.103 1369.104 1369.105 1369.106 1369.107 1369.108 1369.109 1369.151 1369.152 1369.153 1369.154 1369.201 1369.202 1369.203 1369.204 NextLast modified: September 28, 2016