Section 1273.055 - Cost-Sharing Provisions(a) Different cost-sharing provisions may be imposed for a point-of-service plan offered under this subchapter, and those provisions may be higher than the cost-sharing provisions for in-network health maintenance organization coverage. For an enrollee in a limited provider network, higher cost-sharing may be imposed only when the enrollee obtains benefits or services outside the health maintenance organization delivery network.(b) An employee who chooses the non-network plan is responsible for any additional costs for the non-network plan, and the employer may impose a reasonable administrative fee for providing the non-network plan.Tex. Ins. Code § 1273.055
Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. 4/1/2005.