Sec. 1501.212. RESTRICTED PROVIDER NETWORK. (a) A small employer health benefit plan may use a restricted provider network to provide benefits under the plan.
(b) A small employer health benefit plan that uses a restricted provider network does not provide similar coverage to a plan that does not use a restricted provider network if the use of the network results in reduced premium rates charged to the small employer or substantial differences in claim costs.
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 G - Health Coverage Availability
Chapter 1501 - Health Insurance Portability and Availability Act
Subchapter E. Underwriting and Rating of Small Employer Health Benefit Plans
Section 1501.202. Establishment of Classes of Business
Section 1501.203. Establishment of Classes of Business on Certain Bases Prohibited
Section 1501.205. Premium Rates: Establishment
Section 1501.206. Premium Rates: Adjustments
Section 1501.207. Premium Rate Adjustment in Closed Plan
Section 1501.208. Premium Rates: Industry Classification
Section 1501.209. Premium Rates: Number of Employees
Section 1501.210. Premium Rates: Nondiscrimination
Section 1501.211. Rules Concerning Premium Rates
Section 1501.212. Restricted Provider Network
Section 1501.213. Premium Rates: Health Maintenance Organization Health Benefit Plan