Tex. Ins. Code § 1223.001 · Chapter 1223. VERIFICATION OF HEALTH BENEFITS
APPLICABILITY OF CHAPTER.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) This chapter 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 issued by:
(1) an insurance company;
(2) a group hospital service corporation operating under Chapter 842;
(3) a health maintenance organization operating under Chapter 843;
(4) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844;
(5) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846;
(6) a stipulated premium company operating under Chapter 884;
(7) a Lloyd's plan operating under Chapter 941; or
(8) an exchange operating under Chapter 942.
(b) Notwithstanding any other law, this chapter applies to:
(1) a small employer health benefit plan subject to Chapter 1501, including coverage provided through a health group cooperative under Subchapter B of that chapter;
(2) a standard health benefit plan issued under Chapter 1507;
(3) a basic coverage plan under Chapter 1551;
(4) a basic plan under Chapter 1575;
(5) a primary care coverage plan under Chapter 1579;
(6) a plan providing basic coverage under Chapter 1601;
(7) alternative health benefit coverage offered by a subsidiary of the Texas Mutual Insurance Company under Subchapter M, Chapter 2054;
(8) group health coverage made available by a school district in accordance with Section 22.004, Education Code;
(9) a regional or local health care program operated under Section 75.104, Health and Safety Code; and
(10) a self-funded health benefit plan sponsored by a professional employer organization under Chapter 91, Labor Code.
(c) This chapter does not apply to the state Medicaid program, including the Medicaid managed care program operated under Chapter 540 or 540A, Government Code, or the child health plan program operated under Chapter 62, Health and Safety Code.
Notes and commentary — not statutory text
History
Added by Acts 2023, 88th Leg., R.S., Ch. 881 (H.B. 4500), Sec. 1, eff. January 1, 2024.
Amended by:
Acts 2025, 89th Leg., R.S., Ch. 204 (H.B. 1620), Sec. 11.001, eff. September 1, 2025.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1223.htm
- Text hash
- sha256 fe2e0176bfa6d49ce141004b775666b915056949d093a877412838b7d2133b2c
- Composed by
- compose_tx.py 2026-10-05: the Legislative Council's chapter files read in document order; verify_tx.py's independent reading (lxml DOM walk) agrees character for character
This section cites
Provisions in this library that the text above cites, as it prints each citation. A range cited as “ss. 61.13-61.16” links its first and last provisions.
Education Code
Health and Safety Code
Insurance Code
- Tex. Ins. Code ch. 842GROUP HOSPITAL SERVICE CORPORATIONSPrinted as Chapter 842
- Tex. Ins. Code ch. 843HEALTH MAINTENANCE ORGANIZATIONSPrinted as Chapter 843
- Tex. Ins. Code ch. 844CERTIFICATION OF CERTAIN NONPROFIT HEALTH CORPORATIONSPrinted as Chapter 844
- Tex. Ins. Code ch. 846MULTIPLE EMPLOYER WELFARE ARRANGEMENTSPrinted as Chapter 846
- Tex. Ins. Code ch. 884STIPULATED PREMIUM INSURANCE COMPANIESPrinted as Chapter 884
- Tex. Ins. Code ch. 941LLOYD'S PLANPrinted as Chapter 941
- Tex. Ins. Code ch. 1501HEALTH INSURANCE PORTABILITY AND AVAILABILITY ACTPrinted as Chapter 1501
- Tex. Ins. Code ch. 1507CONSUMER CHOICE OF BENEFITS PLANSPrinted as Chapter 1507
- Tex. Ins. Code ch. 1551TEXAS EMPLOYEES GROUP BENEFITS ACTPrinted as Chapter 1551
- Tex. Ins. Code ch. 1575TEXAS PUBLIC SCHOOL EMPLOYEES GROUP BENEFITS PROGRAMPrinted as Chapter 1575
- Tex. Ins. Code ch. 1579TEXAS SCHOOL EMPLOYEES UNIFORM GROUP HEALTH COVERAGEPrinted as Chapter 1579
- Tex. Ins. Code ch. 1601UNIFORM INSURANCE BENEFITS ACT FOR EMPLOYEES OF THE UNIVERSITY OF TEXAS SYSTEM AND THE TEXAS A&M UNIVERSITY SYSTEMPrinted as Chapter 1601
- Tex. Ins. Code ch. 2054, subch. MSUBSIDIARIES AUTHORIZED TO PROVIDE HEALTH BENEFIT COVERAGEPrinted as Subchapter M, Chapter 2054
Procedural information only. Not legal advice and not a substitute for the advice of an attorney. Confirm the current text with the official publisher before relying on it.