1. (a) This subchapter applies only to a health benefit plan that provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, 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 that is offered by:

   1. (1) an insurance company;
   2. (2) a group hospital service corporation operating under Chapter 842;
   3. (3) a fraternal benefit society operating under Chapter 885;
   4. (4) a stipulated premium company operating under Chapter 884;
   5. (5) a reciprocal exchange operating under Chapter 942;
   6. (6) a health maintenance organization operating under Chapter 843;
   7. (7) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846; or
   8. (8) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844.

2. (b) Notwithstanding any other law, this subchapter applies to coverage under:

   1. (1) the basic coverage plan under Chapter 1551;
   2. (2) the basic plan under Chapter 1575;
   3. (3) the primary care coverage plan under Chapter 1579;
   4. (4) the basic coverage plan under Chapter 1601;
   5. (5) the child health plan program under Chapter 62, Health and Safety Code; and
   6. (6) the medical assistance program under Chapter 32, Human Resources Code.

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

Acts 2009, 81st Leg., R.S., Ch. 1117 (H.B. 1138), Sec. 1, eff. September 1, 2009.