Section 140.002 - [Effective 4/1/2025] Applicability of Chapter(a) This chapter applies to an issuer of a health benefit plan that provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, a disability benefit plan, or an employee welfare benefit plan, 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, including:(1) an insurance company;(2) a group hospital service corporation operating under Chapter 842, Insurance Code;(3) a fraternal benefit society operating under Chapter 885, Insurance Code;(4) a stipulated premium insurance company operating under Chapter 884, Insurance Code;(5) a reciprocal exchange operating under Chapter 942, Insurance Code;(6) a health maintenance organization operating under Chapter 843, Insurance Code;(7) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846, Insurance Code; or(8) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844, Insurance Code.(b) Notwithstanding Section 172.014, Local Government Code, or any other law, this chapter applies to a risk pool providing health and accident coverage under Chapter 172, Local Government Code.(c) Notwithstanding any other law, this chapter applies to an issuer of a plan or coverage under Chapter 1551, 1575, 1579, or 1601, Insurance Code.(d) Notwithstanding any other law, this chapter applies to any self-funded issuer of a plan that provides a benefit described by Subsection (a).(e) This chapter applies to any policy, evidence of coverage, or contract under which a benefit described by Subsection (a) is provided and: (1) that is delivered, issued for delivery, or entered into in this state; or(2) under which an individual or group in this state is entitled to benefits.(f) This chapter does not apply to:(1) a workers' compensation insurance policy or any other source of medical benefits under Title 5, Labor Code;(3) the Medicaid program under Chapter 32, Human Resources Code;(4) a Medicaid managed care program operated under Chapter 540 or Chapter 540A , Government Code, as applicable;(5) the state child health plan or any other program operated under Chapter 62 or 63, Health and Safety Code; or(6) a self-funded plan that is subject to the Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.).Tex. Civ. Prac. and Rem. Code § 140.002
Amended by Acts 2023, Texas Acts of the 88th Leg.- Regular Session, ch. 769,Sec. 2.02, eff. 4/1/2025.Added by Acts 2013, 83rd Leg. - Regular Session, ch. 180,Sec. 1, eff. 1/1/2014.This section is set out more than once due to postponed, multiple, or conflicting amendments.