This chapter applies only to a health benefit plan, including a small employer health benefit plan written under Chapter 1501 or coverage that is provided by a health group cooperative under Subchapter B of that chapter, that:

1. (1) provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, including:

   1. (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:

      1. (i) an insurance company;
      2. (ii) a group hospital service corporation operating under Chapter 842;
      3. (iii) a fraternal benefit society operating under Chapter 885;
      4. (iv) a Lloyd's plan operating under Chapter 941;
      5. (v) a stipulated premium company operating under Chapter 884;
      6. (vi) a health maintenance organization operating under Chapter 843; or
      7. (vii) a reciprocal or interinsurance exchange operating under Chapter 942; and

   2. (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:

      1. (i) a multiple employer welfare arrangement as defined by Section 3 of that Act; or
      2. (ii) another analogous benefit arrangement;
2. (2) is offered by an approved nonprofit health corporation operating under Chapter 844; or
3. (3) provides health and accident coverage through a risk pool created under Chapter 172, Local Government Code, notwithstanding Section 172.014, Local Government Code, or any other law.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.

Acts 2021, 87th Leg., R.S., Ch. 308 (S.B. 1028), Sec. 1, eff. September 1, 2021.