Texas Insurance Code 1216.002 – Applicability of Chapter
(a) This chapter applies only to a health benefit plan that provides benefits for health care services, including medical or surgical expenses, incurred as a result of a health condition, accident, or sickness, including:
(1) an individual, group, blanket, or franchise insurance policy or insurance agreement, a group hospital service contract, or an individual or group evidence of coverage that is offered by:
(A) an insurance company;
(B) a group hospital service corporation operating under Chapter 842;
(C) a fraternal benefit society operating under Chapter 885;
(D) a stipulated premium company operating under Chapter 884; or
(E) a health maintenance organization operating under Chapter 843; and
(2) to the extent permitted by the Employee Retirement Income Security Act of 1974 (29 U.S.C. § 1001 et seq.), a health benefit plan that is offered by:
(A) a multiple employer welfare arrangement as defined by Section 3 of that Act; or
(B) another analogous benefit arrangement.
(b) For purposes of Subsection (a), a health benefit plan includes a consumer choice of benefits plan issued under Chapter 1507.
Terms Used In Texas Insurance Code 1216.002
- 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.