Texas § IN.1367.251 - APPLICABILITY OF SUBCHAPTER

§ IN.1367.251. APPLICABILITY OF SUBCHAPTER

APPLICABILITY OF SUBCHAPTER. (a) This subchapter applies only to a health benefit plan, including a small employer health benefit plan written under Chapter 1501 or coverage provided through a health group cooperative under Subchapter B of that chapter, 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 Lloyd's plan operating under Chapter 941 ; (5) a stipulated premium insurance company operating under Chapter 884 ; (6) a reciprocal exchange operating under Chapter 942 ; (7) a health maintenance organization operating under Chapter 843 ; (8) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846 ; or (9) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844 . (b) This subchapter applies to coverage under a group health benefit plan described by Subsection (a) provided to a resident of this state, regardless of whether the group policy, agreement, or contract is delivered, issued for delivery, or renewed within or outside this state. (c) This subchapter applies to a self-funded health benefit plan sponsored by a professional employer organization under Chapter 91 , Labor Code. (d) Notwithstanding Section 22.409 , Business Organizations Code, or any other law, this subchapter applies to health benefits provided by or through a church benefits board under Subchapter I , Chapter 22 , Business Organizations Code. (e) Notwithstanding Section 75.104 , Health and Safety Code, or any other law, this subchapter applies to a regional or local health care program operated under that section. (f) Notwithstanding any other law, a standard health benefit plan provided under Chapter 1507 must provide the coverage required by this subchapter. (g) Notwithstanding any provision in Chapter 1551 , 1575 , 1579 , or 1601 or any other law, this subchapter 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 . Added by Acts 2017, 85th Leg., R.S., Ch. 979 (H.B. 490 ), Sec. 1, eff. September 1, 2017.