Applicability of Subchapter

Sec. 1369.151. APPLICABILITY OF SUBCHAPTER. (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 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 reciprocal exchange operating under Chapter 942; (6) a health maintenance organization operating under Chapter 843; (7) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846; or (8) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844. (b) Notwithstanding any other law, this subchapter applies to coverage under: (1) the basic coverage plan under Chapter 1551; (2) the basic plan under Chapter 1575; (3) the primary care coverage plan under Chapter 1579; (4) the basic coverage plan under Chapter 1601; (5) the child health plan program under Chapter 62, Health and Safety Code; and (6) the medical assistance program under Chapter 32, Human Resources Code. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005. Amended by: Acts 2009, 81st Leg., R.S., Ch. 1117 (H.B. 1138), Sec. 1, eff. September 1, 2009.