Sec. 1366.053. APPLICABILITY OF SUBCHAPTER. This subchapter 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;
(ii) an entity not authorized under this code or another insurance law of this state that contracts directly for health care services on a risk-sharing basis, including a capitation basis; or
(iii) another analogous benefit arrangement; or
(2) is offered by an approved nonprofit health corporation that holds a certificate of authority under Chapter 844.
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.
Structure Texas Statutes
Title 8 - Health Insurance and Other Health Coverages
Subtitle E - Benefits Payable Under Health Coverages
Chapter 1366 - Benefits Related to Fertility and Childbirth
Subchapter B. Minimum Inpatient Stay Following Birth of Child and Postdelivery Care
Section 1366.053. Applicability of Subchapter
Section 1366.055. Coverage for Inpatient Care Required
Section 1366.056. Coverage for Postdelivery Care Required
Section 1366.057. Prohibited Conduct