Tex. Ins. Code § 843.051 · Subchapter B. APPLICABILITY OF AND CONSTRUCTION WITH OTHER LAWS
APPLICABILITY OF INSURANCE AND GROUP HOSPITAL SERVICE CORPORATION LAWS.
Text — Current through the 89th 2nd Called Legislative Session, 2025
(a) Except to the extent that the commissioner determines that the nature of health maintenance organizations, health care plans, or evidences of coverage renders a provision of the following laws clearly inappropriate, Subchapter A, Chapter 542, Subchapters D and E, Chapter 544, and Chapters 541, 543, and 547 apply to:
(1) health maintenance organizations that offer basic, limited, and single health care coverages;
(2) basic, limited, and single health care plans; and
(3) evidences of coverage under basic, limited, and single health care plans.
(b) A health maintenance organization is subject to:
(1) Chapter 402;
(2) Chapter 827 and is an authorized insurer for purposes of that chapter; and
(3) Subchapter G, Chapter 1251, and Section 1551.064.
(c) Except as otherwise provided by this chapter or other law, insurance laws and group hospital service corporation laws do not apply to a health maintenance organization that holds a certificate of authority under this chapter. This subsection applies to an insurer or a group hospital service corporation only with respect to the health maintenance organization activities of the insurer or corporation.
(d) Activities permitted under other chapters of this code are not subject to this chapter.
(e) Except for Chapter 251, as applicable to a third-party administrator, and Chapters 259, 4151, and 4201, insurance laws and group hospital service corporation laws do not apply to a physician or provider. Notwithstanding this subsection, a physician or provider who conducts a utilization review during the ordinary course of treatment of patients under a joint or delegated review agreement with a health maintenance organization on services provided by the physician or provider is not required to obtain certification under Subchapter C, Chapter 4201.
(f) A health maintenance organization is subject to Chapter 823 as if the health maintenance organization were an insurer under that chapter.
(g) The merger of a health maintenance organization with another health maintenance organization is subject to Chapter 824 as if the health maintenance organizations were insurance corporations under that chapter. The commissioner may adopt rules as necessary to implement this subsection in a way that reflects the nature of health maintenance organizations, health care plans, or evidences of coverage.
Notes and commentary — not statutory text
History
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.
Amended by:
Acts 2005, 79th Leg., Ch. 364 (S.B. 1284), Sec. 1, eff. September 1, 2005.
Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2E.033, eff. April 1, 2009.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/IN/htm/IN.843.htm
- Text hash
- sha256 cf36b65823e13ab76dd7ad73826beafdda99561363e94c872dc6323104d18b57
- 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.
Insurance Code
- Tex. Ins. Code ch. 251GENERAL PROVISIONSPrinted as Chapter 251
- Tex. Ins. Code ch. 402DISCLOSURE OF MATERIAL TRANSACTIONSPrinted as Chapter 402
- Tex. Ins. Code ch. 542, subch. AUNFAIR CLAIM SETTLEMENT PRACTICESPrinted as Subchapter A, Chapter 542
- Tex. Ins. Code ch. 544PROHIBITED DISCRIMINATIONPrinted as Chapter 544
- Tex. Ins. Code ch. 823INSURANCE HOLDING COMPANY SYSTEMSPrinted as Chapter 823
- Tex. Ins. Code ch. 824MERGER AND CONSOLIDATION OF STOCK INSURANCE CORPORATIONSPrinted as Chapter 824
- Tex. Ins. Code ch. 827WITHDRAWAL AND RESTRICTION PLANSPrinted as Chapter 827
- Tex. Ins. Code ch. 1251, subch. GCONTINUATION OF GROUP COVERAGE FOR CERTAIN FAMILY MEMBERS AND DEPENDENTSPrinted as Subchapter G, Chapter 1251
- Tex. Ins. Code § 1551.064CERTAIN GROUP HEALTH AND ACCIDENT POLICIES OR CONTRACTS.Printed as Section 1551.064
Cited by 1 provision
Provisions in this library whose text cites Tex. Ins. Code § 843.051. Each shows the citation as that text prints it.
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