Tex. Ins. Code § 847.003 · Chapter 847. HEALTH CARE QUALITY ASSURANCE
DEFINITIONS.
Text — Current through the 89th 2nd Called Legislative Session, 2025
In this chapter:
(1) "Commission" means the Health and Human Services Commission.
(2) "Health benefit plan" means an individual, group, blanket, or franchise insurance policy, a certificate issued under a group policy, a group hospital service contract, or an individual or group subscriber contract or evidence of coverage issued by a health maintenance organization that provides benefits for health care services. The term does not include:
(A) accident-only or disability income insurance coverage or a combination of accident-only and disability income insurance coverage;
(B) credit-only insurance coverage;
(C) disability insurance coverage;
(D) Medicare services under a federal contract;
(E) Medicare supplement and Medicare Select benefit plans regulated in accordance with federal law;
(F) long-term care coverage or benefits, nursing home care coverage or benefits, home health care coverage or benefits, community-based care coverage or benefits, or any combination of those coverages or benefits;
(G) workers' compensation insurance coverage or similar insurance coverage;
(H) coverage provided through a jointly managed trust authorized under 29 U.S.C. Section 141 et seq. that contains a plan of benefits for employees that is negotiated in a collective bargaining agreement governing wages, hours, and working conditions of the employees that is authorized under 29 U.S.C. Section 157;
(I) hospital indemnity or other fixed indemnity insurance coverage;
(J) reinsurance contracts issued on a stop-loss, quota-share, or similar basis;
(K) short-term major medical contracts;
(L) liability insurance coverage, including general liability insurance coverage and automobile liability insurance coverage, and coverage issued as a supplement to liability insurance coverage, including automobile medical payment insurance coverage;
(M) coverage for on-site medical clinics;
(N) coverage that provides other limited benefits specified by federal regulations;
(O) coverage that provides limited scope dental or vision benefits; or
(P) other coverage that:
(i) is similar to the coverage described by this subdivision under which benefits for medical care are secondary or incidental to other coverage benefits; and
(ii) is specified by federal regulations.
(3) "National accreditation organization" means:
(A) the Accreditation Association for Ambulatory Health Care;
(B) the Joint Commission on Accreditation of Healthcare Organizations;
(C) the National Committee for Quality Assurance;
(D) the American Accreditation HealthCare Commission ("URAC"); or
(E) any other national accreditation entity recognized by rules jointly adopted by the commissioner of insurance and the executive commissioner of the commission.
Notes and commentary — not statutory text
History
Added by Acts 2005, 79th Leg., Ch. 789 (S.B. 155), Sec. 1, eff. June 17, 2005.
Source of truth
- Edition
- Current through the 89th 2nd Called Legislative Session, 2025
- Official file
- https://statutes.capitol.texas.gov/Docs/IN/htm/IN.847.htm
- Text hash
- sha256 b31591a4a19fe42287697a5a43096c6f88de06de211c955cb8a5d0169b348994
- 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
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.