Texas § IN.1362.001 - APPLICABILITY OF CHAPTER

§ IN.1362.001. APPLICABILITY OF CHAPTER

APPLICABILITY OF CHAPTER. This chapter 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: (A) 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: (i) an insurance company; (ii) a group hospital service corporation operating under Chapter 842 ; (iii) a fraternal benefit society operating under Chapter 885 ; (iv) a stipulated premium company operating under Chapter 884 ; or (v) a health maintenance organization operating under Chapter 843 ; and (B) to the extent permitted by the Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.), a health benefit plan that is offered by: (i) a multiple employer welfare arrangement as defined by Section 3 of that Act; or (ii) another analogous benefit arrangement; (2) is offered by: (A) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844 ; or (B) an entity not authorized under this code or another insurance law of this state that contracts directly for health care services on a risk-sharing basis, including a capitation basis; 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. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.