Texas Insurance Code 1355.252 – Applicability of Subchapter
(a) This subchapter applies only to a health benefit plan that provides benefits or coverage for medical or surgical expenses incurred as a result of a health condition, accident, or sickness and for treatment expenses incurred as a result of a mental health condition or substance use disorder, including an individual, group, blanket, or franchise insurance policy or insurance agreement, a group hospital service contract, an individual or group evidence of coverage, or a 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 stipulated premium company operating under Chapter 884;
(5) a health maintenance organization operating under Chapter 843;
(6) a reciprocal exchange operating under Chapter 942;
(7) a Lloyd’s plan operating under Chapter 941;
(8) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844; or
(9) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846.
(b) Notwithstanding § 1501.251 or any other law, this subchapter applies to coverage under a small employer health benefit plan subject to Chapter 1501.
Terms Used In Texas Insurance Code 1355.252
- Contract: A legal written agreement that becomes binding when signed.
- Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
(c) This subchapter applies to a standard health benefit plan issued under Chapter 1507.