Applicability of Chapter

Sec. 1503.001. APPLICABILITY OF CHAPTER. This chapter applies only to a health benefit plan that: (1) provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, including: (A) 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: (i) an insurance company; (ii) a group hospital service corporation operating under Chapter 842; (iii) a fraternal benefit society operating under Chapter 885; (iv) a stipulated premium company operating under Chapter 884; or (v) a health maintenance organization operating under Chapter 843; and (B) to the extent permitted by the Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.), a health benefit plan that is offered by: (i) a multiple employer welfare arrangement as defined by Section 3 of that Act; or (ii) an analogous benefit arrangement; or (2) is offered by: (A) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844; or (B) another entity that: (i) is not authorized under this code or another insurance law of this state; and (ii) contracts directly for health care services on a risk-sharing basis, including a capitation basis. Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.