Texas § 1273.001 DEFINITIONS.

Texas Statutes

§ 1273.001 — DEFINITIONS.

Texas § 1273.001

Code INInsurance Code

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Bluebook

Tex. Insurance Code Code Ann. § 1273.001 (2026).

Text

Sec. 1273.001. DEFINITIONS. In this subchapter:

(1)"Blended contract" means a single document, including a single contract policy, certificate, or evidence of coverage, that provides a combination of indemnity and health maintenance organization benefits.

(2)"Health maintenance organization" has the meaning assigned by Section 843.002 .

(3)"Insurer" means an insurance company, association, or organization authorized to engage in business in this state under Chapter 841 , 842 , 861 , 881 , 882 , 883 , 884 , 885 , 886 , 887 , 888 , 941 , 942 , or 982 .

(4)"Point-of-service plan" means an arrangement under which:

(A)an enrollee chooses to obtain benefits or services through:

(i)a health maintenance organization delivery network, including a limited provider network; or

(ii)a non-networ

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Sec. 1273.001. DEFINITIONS. In this subchapter:
(1) "Blended contract" means a single document, including a single contract policy, certificate, or evidence of coverage, that provides a combination of indemnity and health maintenance organization benefits.
(2) "Health maintenance organization" has the meaning assigned by Section 843.002 .
(3) "Insurer" means an insurance company, association, or organization authorized to engage in business in this state under Chapter 841 , 842 , 861 , 881 , 882 , 883 , 884 , 885 , 886 , 887 , 888 , 941 , 942 , or 982 .
(4) "Point-of-service plan" means an arrangement under which:
(A) an enrollee chooses to obtain benefits or services through:
(i) a health maintenance organization delivery network, including a limited provider network; or
(ii) a non-network delivery system outside the health maintenance organization delivery network, including an exclusive provider benefit plan under Chapter 1301 or a limited provider network, that is administered under an indemnity benefit arrangement for the cost of health care services; or
(B) indemnity benefits for the cost of health care services are provided by an insurer or group hospital service corporation in conjunction with network benefits arranged or provided by a health maintenance organization.

Legislative History

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005. Amended by: Acts 2011, 82nd Leg., R.S., Ch. 288 (H.B. 1772 ), Sec. 1, eff. September 1, 2011.