Texas § IN.1204.051 - DEFINITIONS

§ IN.1204.051. DEFINITIONS

DEFINITIONS. In this subchapter: (1) "Covered person" means a person who is insured or covered by a health insurance policy or is a participant in an employee benefit plan. The term includes: (A) a person covered by a health insurance policy because the person is an eligible dependent; and (B) an eligible dependent of a participant in an employee benefit plan. (2) "Employee benefit plan" or "plan" means a plan, fund, or program established or maintained by an employer, an employee organization, or both, to the extent that it provides, through the purchase of insurance or otherwise, health care services to employees, participants, or the dependents of employees or participants. (3) "Health care provider" means a person who provides health care services under a license, certificate, registration, or other similar evidence of regulation issued by this or another state of the United States. (4) "Health care service" means a service to diagnose, prevent, alleviate, cure, or heal a human illness or injury that is provided to a covered person by a physician or other health care provider. (5) "Health insurance policy" means an individual, group, blanket, or franchise insurance policy, or an insurance agreement, that provides reimbursement or indemnity for health care expenses incurred as a result of an accident or sickness. (6) "Insurer" means an insurance company, association, or organization authorized to engage in business in this state under Chapter 841 , 861 , 881 , 882 , 883 , 884 , 885 , 886 , 887 , 888 , 941 , 942 , or 982 . (7) "Person" means an individual, association, partnership, corporation, or other legal entity. (8) "Physician" means an individual licensed to practice medicine in this or another state of the United States. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.