Tex. Ins. Code § 1273.004
Current with legislation from the 2023 Regular and Special Sessions signed by the Governor as of November 21, 2023.
Indemnity benefits and services provided under a point-of-service plan may be limited to those services described by the blended contract and may be subject to different cost-sharing provisions. The cost-sharing provisions for indemnity benefits may be higher than the cost-sharing provisions for in-network health maintenance organization coverage. For an enrollee in a limited provider network, higher cost-sharing may be imposed only when the enrollee obtains benefits or services outside the health maintenance organization delivery network.
Tex. Ins. Code § 1273.004