Tex. Ins. Code § 38.353 · Subchapter H. HEALTH CARE REIMBURSEMENT RATE INFORMATION
APPLICABILITY OF SUBCHAPTER.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) This subchapter applies to the issuer of a group health benefit plan, including:
(1) an insurance company;
(2) a group hospital service corporation;
(3) a fraternal benefit society;
(4) a stipulated premium company;
(5) a reciprocal or interinsurance exchange; or
(6) a health maintenance organization.
(b) Notwithstanding any provision in Chapter 1551, 1575, 1579, or 1601 or any other law, and except as provided by Subsection (e), this subchapter applies to:
(1) a basic coverage plan under Chapter 1551;
(2) a basic plan under Chapter 1575;
(3) a primary care coverage plan under Chapter 1579; and
(4) basic coverage under Chapter 1601.
(c) Except as provided by Subsection (d), this subchapter applies to a small employer health benefit plan provided under Chapter 1501.
(d) This subchapter does not apply to:
(1) standard health benefit plans provided under Chapter 1507;
(2) children's health benefit plans provided under Chapter 1502;
(3) health care benefits provided under a workers' compensation insurance policy;
(4) Medicaid managed care programs operated under Chapter 540 or 540A, Government Code, as applicable;
(5) Medicaid programs operated under Chapter 32, Human Resources Code; or
(6) the state child health plan operated under Chapter 62 or 63, Health and Safety Code.
(e) The commissioner by rule may exclude a type of health benefit plan from the requirements of this subchapter if the commissioner finds that data collected in relation to the health benefit plan would not be relevant to accomplishing the purposes of this subchapter.
Notes and commentary — not statutory text
History
Added by Acts 2007, 80th Leg., R.S., Ch. 997 (S.B. 1731), Sec. 8, eff. September 1, 2007.
Amended by:
Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 2.116, eff. April 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.38.htm
- Text hash
- sha256 833215551d7ee1de1e0fe84f453845ff6d2d25399de0ba1240aca7d05c4e831e
- 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.
Human Resources Code
Insurance Code
- Tex. Ins. Code ch. 1502HEALTH BENEFIT PLANS FOR CHILDRENPrinted as Chapter 1502
- 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
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.