Section 1661.001 - Definitions In this chapter:
(1) "Health benefit plan" means a 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 that is offered by:(A) an insurance company;(B) a group hospital service corporation operating under Chapter 842;(C) a fraternal benefit society operating under Chapter 885;(D) a stipulated premium company operating under Chapter 884;(E) a Lloyd's plan operating under Chapter 941;(F) an exchange operating under Chapter 942;(G) a health maintenance organization operating under Chapter 843;(H) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846;(I) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844; or(J) an entity not authorized under this code or another insurance law of this state that contracts directly for health care services on a risk-sharing basis, including a capitation basis.(2) "Health benefit plan issuer" means an entity authorized to issue a health benefit plan in this state.(3) "Health care provider" means:(A) an individual who is licensed, certified, or otherwise authorized to provide health care services; or(B) a hospital, emergency clinic, outpatient clinic, or other facility providing health care services.(4) "Participating provider" means a health care provider who has contracted with a health benefit plan issuer to provide services to enrollees.Tex. Ins. Code § 1661.001
Added by Acts 2009, 81st Leg., R.S., Ch. 261, Sec. 1, eff. 5/30/2009.