1. (a) Each limited service HMO shall provide uniquely-described services with any corresponding copayments for each covered service and benefit and shall provide a limited health care service plan as defined under Insurance Code §843.002. Each limited service HMO must comply with all requirements for a limited health care service plan specified in this subchapter.
2. (b) Each limited service HMO schedule of enrollee copayments shall specify an appropriate description of covered services and benefits and may specify recognized procedure codes or other information used for maintaining a statistical reporting system, as required under §11.1902 of this title (relating to Quality Improvement Program for Basic and Limited Services HMOs).
3. (c) Each limited HMO evidence of coverage shall include a glossary of terminology, including such terms used in the evidence of coverage required by §11.501 of this title (relating to Forms Which Must be Approved Prior to Use). Such glossary shall be included in the information to prospective and current group contract holders and enrollees, as required under Insurance Code §843.201.
4. (d) In the event of a conflict between the provisions of this subchapter and other provisions of Chapter 11 of this title (relating to Health Maintenance Organizations), this subchapter prevails with regard to limited service HMOs. It is not considered a conflict if a topic that is not addressed in this subchapter appears elsewhere in Chapter 11 of this title.

Source Note:The provisions of this §11.2402 adopted to be effective February 14, 1999, 24 TexReg 726; amended to be effective February 24, 2005, 30 TexReg 854.