Texas Insurance Code 1213.001 – Definition of Health Benefit Plan
(a) In this chapter, “health benefit plan” means a plan that provides benefits for medical, surgical, or other treatment expenses incurred as a result of a health condition, a mental health condition, an accident, sickness, or substance abuse, 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 fraternal benefit society operating under Chapter 885;
(4) a stipulated premium insurance company operating under Chapter 884;
(5) a Lloyd’s plan operating under Chapter 941;
(6) an exchange operating under Chapter 942;
(7) a health maintenance organization operating under Chapter 843;
(8) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846; or
(9) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844.
(b) The term includes:
(1) a small employer health benefit plan written under Chapter 1501; and
(2) a health benefit plan offered under Chapter 1551, 1575, 1579, or 1601.
Terms Used In Texas Insurance Code 1213.001
- 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.
- Written: includes any representation of words, letters, symbols, or figures. See Texas Government Code 311.005