(a) This subchapter 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 issued in this state 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 subchapter 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; and
(2) a standard health benefit plan issued under Chapter 1507.

Terms Used In Texas Insurance Code 1366.102

  • 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.