In this chapter:

1. (1) "Health benefit plan" means a 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 that is offered by:

   1. (A) an insurance company;
   2. (B) a group hospital service corporation operating under Chapter 842;
   3. (C) a fraternal benefit society operating under Chapter 885;
   4. (D) a stipulated premium company operating under Chapter 884;
   5. (E) a Lloyd's plan operating under Chapter 941;
   6. (F) an exchange operating under Chapter 942;
   7. (G) a health maintenance organization operating under Chapter 843;
   8. (H) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846;
   9. (I) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844; or
   10. (J) 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.
2. (2) "Health benefit plan issuer" means an entity authorized to issue a health benefit plan in this state.

3. (3) "Health care provider" means:

   1. (A) an individual who is licensed, certified, or otherwise authorized to provide health care services; or
   2. (B) a hospital, emergency clinic, outpatient clinic, or other facility providing health care services.
4. (4) "Participating provider" means a health care provider who has contracted with a health benefit plan issuer to provide services to enrollees.

Added by Acts 2009, 81st Leg., R.S., Ch. 261 (H.B. 1342), Sec. 1, eff. May 30, 2009.