™Your Policy Risk Impact Agent
386 chapters · 7,822 sections in this title.
Tex. Insurance Code § 1275.001 Definitions
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Sec. 1275.001. DEFINITIONS. In this chapter: (1) "Enrollee" means an individual enrolled in a health benefit plan to which this chapter applies. (2) "Usual and customary rate" means the relevant allowable amount as described by the applicable master benefit plan document. Added b…
Tex. Insurance Code § 1275.002 Applicability of Chapter
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Sec. 1275.002. APPLICABILITY OF CHAPTER. This chapter applies only to: (1) a health benefit plan offered by a nonprofit agricultural organization under Chapter 1682; (2) a health benefit plan: (A) that is a self-insured or self-funded plan established by an employer for the benef…
Tex. Insurance Code § 1275.003 Balance Billing Prohibition Notice
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Sec. 1275.003. BALANCE BILLING PROHIBITION NOTICE. (a) The administrator of a health benefit plan to which this chapter applies shall provide written notice in accordance with this section in an explanation of benefits provided to the enrollee and the physician or health care pro…
Tex. Insurance Code § 1275.004 Out-of-Network Claim Dispute Resolution
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Sec. 1275.004. OUT-OF-NETWORK CLAIM DISPUTE RESOLUTION. Chapter 1467 applies to a health benefit plan to which this chapter applies, and the administrator of a health benefit plan to which this chapter applies is an administrator for purposes of that chapter. Added by Acts 2021, …