Texas Insurance Code 1204.051 – Definitions
Terms Used In Texas Insurance Code 1204.051
- 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.
- Dependent: A person dependent for support upon another.
- 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.
- Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
- Person: includes corporation, organization, government or governmental subdivision or agency, business trust, estate, trust, partnership, association, and any other legal entity. See Texas Government Code 311.005
- United States: includes a department, bureau, or other agency of the United States of America. See Texas Government Code 311.005
In this subchapter:
(1) “Covered person” means a person who is insured or covered by a health insurance policy or is a participant in an employee benefit plan. The term includes:
(A) a person covered by a health insurance policy because the person is an eligible dependent; and
(B) an eligible dependent of a participant in an employee benefit plan.
(2) “Employee benefit plan” or “plan” means a plan, fund, or program established or maintained by an employer, an employee organization, or both, to the extent that it provides, through the purchase of insurance or otherwise, health care services to employees, participants, or the dependents of employees or participants.
(3) “Health care provider” means a person who provides health care services under a license, certificate, registration, or other similar evidence of regulation issued by this or another state of the United States.
(4) “Health care service” means a service to diagnose, prevent, alleviate, cure, or heal a human illness or injury that is provided to a covered person by a physician or other health care provider.
(5) “Health insurance policy” means an individual, group, blanket, or franchise insurance policy, or an insurance agreement, that provides reimbursement or indemnity for health care expenses incurred as a result of an accident or sickness.
(6) “Insurer” means an insurance company, association, or organization authorized to engage in business in this state under Chapter 841, 861, 881, 882, 883, 884, 885, 886, 887, 888, 941, 942, or 982.
(7) “Person” means an individual, association, partnership, corporation, or other legal entity.
(8) “Physician” means an individual licensed to practice medicine in this or another state of the United States.