Section 1380.002 - Applicability Of Chapter(a) This chapter 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 health maintenance organization operating under Chapter 843; (4) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844; (5) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846; (6) a stipulated premium company operating under Chapter 884; (7) a fraternal benefit society operating under Chapter 885; (8) a Lloyd's plan operating under Chapter 941; or (9) an exchange operating under Chapter 942. (b) Notwithstanding any other law, this chapter applies to: (1) a small employer health benefit plan subject to Chapter 1501, including coverage provided through a health group cooperative under Subchapter B of that chapter; (2) a standard health benefit plan issued under Chapter 1507; (3) a basic coverage plan under Chapter 1551; (4) a basic plan under Chapter 1575; (5) a primary care coverage plan under Chapter 1579; (6) a plan providing basic coverage under Chapter 1601; (7) health benefits provided by or through a church benefits board under Subchapter I, Chapter 22, Business Organizations Code; (8) the state Medicaid program, including the Medicaid managed care program operated under Chapter 533, Government Code; (9) the child health plan program under Chapter 62, Health and Safety Code; (10) a regional or local health care program operated under Section 75.104, Health and Safety Code; (11) a self-funded health benefit plan sponsored by a professional employer organization under Chapter 91, Labor Code; (12) county employee group health benefits provided under Chapter 157, Local Government Code; and (13) health and accident coverage provided by a risk pool created under Chapter 172, Local Government Code. Tex. Ins. Code § 1380.002
Added by Acts 2023, Texas Acts of the 88th Leg.- Regular Session, ch. 1155,Sec. 1, eff. 9/1/2023, app. to a health benefit plan delivered, issued for delivery, or renewed on or after January 1, 2024.