reglab/housing_qa huggingface dataset:
TX Ins Code § 1467.151 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle F - Physicians and Health Care Providers|Chapter 1467 - Out-of-Network Claim Dispute Resolution|Subchapter D. Complaints; Consumer Protection|Section 1467.151. Consumer Protection; Rules

Sec. 1467.151.  CONSUMER PROTECTION; RULES.(a)  The commissioner and the Texas Medical Board or other regulatory agency, as appropriate, shall adopt rules regulating the investigation and review of a complaint filed that relates to the settlement of an out-of-network health benefit claim that is subject to this chapter.  The rules adopted under this section must:(1)  distinguish among complaints for out-of-network coverage or payment and give priority to investigating allegations of delayed health care or medical care;(2)  develop a form for filing a complaint; and(3)  ensure that a complaint is not dismissed without appropriate consideration.(b)  The department and the Texas Medical Board or other appropriate regulatory agency shall maintain information on each complaint filed that concerns a claim, arbitration, or mediation subject to this chapter, including:(1)  the type of services or supplies that gave rise to the dispute;(2)  the type and specialty, if any, of the out-of-network provider who provided the out-of-network service or supply;(3)  the county and metropolitan area in which the health care or medical service or supply was provided;(4)  whether the health care or medical service or supply was for emergency care; and(5)  any other information about:(A)  the health benefit plan issuer or administrator that the commissioner by rule requires; or(B)  the out-of-network provider that the Texas Medical Board or other appropriate regulatory agency by rule requires.(c)  The information collected and maintained under Subsection (b) is public information as defined by Section 552.002, Government Code, and may not include personally identifiable information or health care or medical information.(d)  Repealed by Acts 2019, 86th Leg., R.S., Ch. 1342 (S.B. 1264), Sec. 3.03(11), eff. September 1, 2019.|Added by Acts 2009, 81st Leg., R.S., Ch. 1290 (H.B. 2256), Sec. 1, eff. June 19, 2009.Amended by: Acts 2017, 85th Leg., R.S., Ch. 100 (S.B. 507), Sec. 16, eff. September 1, 2017.Acts 2019, 86th Leg., R.S., Ch. 1342 (S.B. 1264), Sec. 2.17, eff. September 1, 2019.Acts 2019, 86th Leg., R.S., Ch. 1342 (S.B. 1264), Sec. 3.03(11), eff. September 1, 2019.|
TX Ins Code § 1501.001 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter A. General Provisions|Section 1501.001. Short Title

Sec. 1501.001.  SHORT TITLE.  This chapter may be cited as the Health Insurance Portability and Availability Act.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.003 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter A. General Provisions|Section 1501.003. Applicability: Small Employer Health Benefit Plans

Sec. 1501.003.  APPLICABILITY:  SMALL EMPLOYER HEALTH BENEFIT PLANS.  An individual or group health benefit plan is a small employer health benefit plan subject to Subchapters C-H if it provides health care benefits covering two or more employees of a small employer and:(1)  the employer pays a portion of the premium or benefits;(2)  the employer or a covered individual treats the health benefit plan as part of a plan or program for purposes of Section 106 or 162, Internal Revenue Code of 1986 (26 U.S.C. Section 106 or 162); or(3)  the health benefit plan is an employee welfare benefit plan under 29 C.F.R. Section 2510.3-1(j).|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.Amended by: Acts 2013, 83rd Leg., R.S., Ch. 199 (S.B. 1332), Sec. 2, eff. September 1, 2013.|
TX Ins Code § 1501.004 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter A. General Provisions|Section 1501.004. Applicability: Large Employer Health Benefit Plans

Sec. 1501.004.  APPLICABILITY:  LARGE EMPLOYER HEALTH BENEFIT PLANS.  An individual or group health benefit plan is a large employer health benefit plan subject to Subchapters C and M if the plan provides health care benefits to employees of a large employer and:(1)  the employer pays a portion of the premium or benefits;(2)  the employer or a covered individual treats the health benefit plan as part of a plan or program for purposes of Section 106 or 162, Internal Revenue Code of 1986 (26 U.S.C. Section 106 or 162); or(3)  the health benefit plan is an employee welfare benefit plan under 29 C.F.R. Section 2510.3-1(j).|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.Amended by: Acts 2013, 83rd Leg., R.S., Ch. 199 (S.B. 1332), Sec. 3, eff. September 1, 2013.|
TX Ins Code § 1501.005 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter A. General Provisions|Section 1501.005. Exception: Certain Individually Underwritten Policies

Sec. 1501.005.  EXCEPTION:  CERTAIN INDIVIDUALLY UNDERWRITTEN POLICIES.  Except as provided by Section 1501.003 or 1501.004, this chapter does not apply to an individual health insurance policy that is subject to individual underwriting, even if the premium is paid through a payroll deduction method.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.006 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter A. General Provisions|Section 1501.006. Certification

Sec. 1501.006.  CERTIFICATION.  (a)  In accordance with rules adopted by the commissioner, each health benefit plan issuer shall certify that the issuer is offering, delivering, issuing for delivery, or renewing, or that the issuer intends to offer, deliver, issue for delivery, or renew:(1)  a health benefit plan to or through a small employer in this state that is subject to this chapter;  or(2)  a health benefit plan to or through a large employer in this state that is subject to this chapter.(b)  A health benefit plan issuer must submit a revised certification to the commissioner only if the issuer changes its status as a small or large employer health benefit plan issuer or changes its intent to become a small or large employer health benefit plan issuer to the extent that its previous certification ceases to be accurate.(c)  The certification must include a statement that the health benefit plan issuer is complying with this chapter to the extent it applies to the issuer.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.007 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter A. General Provisions|Section 1501.007. Affiliates

Sec. 1501.007.  AFFILIATES.  (a)  In this section, "affiliate" has the meaning described by Section 823.003.(b)  For purposes of this chapter, health benefit plan issuers that are affiliates or that are eligible to file a consolidated tax return are considered to be one issuer, and a restriction imposed by this chapter applies as if the health benefit plans delivered or issued for delivery to small employers in this state by the affiliates were issued by one issuer.(c)  Notwithstanding Subsection (b), a health maintenance organization that is an affiliate is considered to be a separate health benefit plan issuer for purposes of this chapter.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.008 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter A. General Provisions|Section 1501.008. Late Enrollees

Sec. 1501.008.  LATE ENROLLEES.  (a)  For purposes of this chapter, an employee or dependent eligible for enrollment in a small or large employer's health benefit plan is a late enrollee if the individual requests enrollment after the expiration of:(1)  the initial enrollment period established under the terms of the first plan for which the individual was eligible through the small or large employer;  or(2)  an open enrollment period under Section 1501.156(a) or 1501.606(a).(b)  An employee or dependent eligible for enrollment is not a late enrollee if the individual:(1)  was covered under another health benefit plan or self-funded employer health benefit plan at the time the individual was eligible to enroll;(2)  declined enrollment in writing, at the time of the initial eligibility for enrollment, stating that coverage under another health benefit plan or self-funded employer health benefit plan was the reason for declining enrollment;(3)  has lost coverage under the other health benefit plan or self-funded employer health benefit plan as a result of:(A)  the termination of employment;(B)  a reduction in the number of hours of employment;(C)  the termination of the other plan's coverage;(D)  the termination of contributions toward the premium made by the employer;  or(E)  the death of a spouse or divorce;  and(4)  requests enrollment not later than the 31st day after the date coverage under the other health benefit plan or self-funded employer health benefit plan terminates.(c)  An employee or dependent eligible for enrollment is also not a late enrollee if the individual is:(1)  employed by an employer that offers multiple health benefit plans and the individual elects a different health benefit plan during an open enrollment period;(2)  a spouse for whom a court has ordered coverage under a covered employee's plan and the request for enrollment of the spouse is made not later than the 31st day after the date the court order is issued;(3)  a child for whom a court has ordered coverage under a covered employee's plan and the request for enrollment is made not later than the 31st day after the date the employer receives the court order;  or(4)  a child of a covered employee who has lost coverage under Title XIX of the Social Security Act (42 U.S.C. Section 1396 et seq.), other than coverage consisting solely of benefits under Section 1928 of that Act (42 U.S.C. Section 1396s), or under Chapter 62, Health and Safety Code, and the request for enrollment is made not later than the 31st day after the date on which the child loses coverage.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.009 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter A. General Provisions|Section 1501.009. School District Election

Sec. 1501.009.  SCHOOL DISTRICT ELECTION.  (a)  An independent school district may elect to participate as a small employer without regard to the number of employees in the district.  An independent school district that makes the election is treated as a small employer under this chapter for all purposes.(b)  An independent school district that is participating in the uniform group coverage program established under Chapter 1579 may not participate in the small employer market under this section for health insurance coverage and may not renew a health insurance contract obtained in accordance with this section after the date on which the program of coverages provided under Chapter 1579 is implemented.  This subsection does not affect a contract for the provision of optional coverages not included in a health benefit plan under this chapter.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.Amended by: Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2G.014, eff. April 1, 2009.Acts 2013, 83rd Leg., R.S., Ch. 199 (S.B. 1332), Sec. 4, eff. September 1, 2013.|
TX Ins Code § 1501.0095 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter A. General Provisions|Section 1501.0095. School District Employee Election

Sec. 1501.0095.  SCHOOL DISTRICT EMPLOYEE ELECTION.  (a)  Notwithstanding any other provision of this chapter, a school district employee who is eligible for coverage under a large or small employer health benefit plan providing coverage to the school district's employees and who is the spouse of another school district employee covered under the plan may elect whether to be treated under the plan as:(1)  an employee; or(2)  the dependent of the other employee.(b)  The commissioner shall adopt rules under Section 1501.010 governing the manner in which an election under this section must be made.|Added by Acts 2005, 79th Leg., Ch. 998 (H.B. 407), Sec. 1, eff. June 18, 2005.|
TX Ins Code § 1501.010 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter A. General Provisions|Section 1501.010. General Rules

Sec. 1501.010.  GENERAL RULES.  The commissioner shall adopt rules necessary to:(1)  implement this chapter;  and(2)  meet the minimum requirements of federal law, including regulations.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.011 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter A. General Provisions|Section 1501.011. Determination of Employer Status for Certain Employers

Sec. 1501.011.  DETERMINATION OF EMPLOYER STATUS FOR CERTAIN EMPLOYERS.  (a)  For an employer that did not exist throughout the calendar year preceding the year in which the determination of whether the employer is a small employer is made, the determination is based on the average number of employees the employer reasonably expects to employ on business days in the calendar year in which the determination is made.(b)  For an employer that did not exist throughout the calendar year preceding the year in which the determination of whether the employer is a large employer is made, the determination is based on the average number of employees the employer reasonably expects to employ on business days in the calendar year in which the determination is made.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.Amended by: Acts 2013, 83rd Leg., R.S., Ch. 199 (S.B. 1332), Sec. 5, eff. September 1, 2013.|
TX Ins Code § 1501.051 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter B. Coalitions and Cooperatives|Section 1501.051. Definitions

Sec. 1501.051.  DEFINITIONS.  In this subchapter:(1)  "Board of directors" means the board of directors elected by a private purchasing cooperative or a health group cooperative.(2)  "Board of trustees" means the board of trustees of the Texas cooperative.(3)  "Cooperative" means a private purchasing cooperative or a health group cooperative established under this subchapter.(3-a)  "Eligible single-employee business" means a business entity that:(A)  is owned and operated by a sole proprietor;(B)  employed an average of fewer than two employees on business days during the preceding calendar year; and(C)  is eligible to participate in a cooperative under this subchapter in accordance with Section 1501.066.(3-b)  "Expanded service area" means any area larger than one county in which a health group cooperative offers coverage.(4)  "Texas cooperative" means the Texas Health Benefits Purchasing Cooperative established under Section 1501.052.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.Amended by: Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.048(a), eff. September 1, 2005.Acts 2011, 82nd Leg., R.S., Ch. 1067 (S.B. 859), Sec. 1, eff. June 17, 2011.|
TX Ins Code § 1501.052 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter B. Coalitions and Cooperatives|Section 1501.052. Texas Health Benefits Purchasing Cooperative; Board of Trustees

Sec. 1501.052.  TEXAS HEALTH BENEFITS PURCHASING COOPERATIVE;  BOARD OF TRUSTEES.  (a)  The Texas Health Benefits Purchasing Cooperative is a nonprofit corporation established to make health care coverage available to small and large employers and their eligible employees and the eligible employees' dependents.(b)  The Texas cooperative is administered by a board of trustees of five members appointed by the governor with the advice and consent of the senate.  Two members must represent employers, two members must represent employees, and one member must represent the public.(c)  Members of the board of trustees serve staggered six-year terms, with the terms of one or two members expiring February 1 of each odd-numbered year.(d)  A member of the board of trustees may not be compensated for serving on the board but is entitled to reimbursement for actual expenses incurred in performing functions as a member of the board as provided by the General Appropriations Act.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.Amended by: Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.049(a), eff. September 1, 2005.|
TX Ins Code § 1501.053 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter B. Coalitions and Cooperatives|Section 1501.053. Texas Health Benefits Purchasing Cooperative: Executive Director and Other Employees

Sec. 1501.053.  TEXAS HEALTH BENEFITS PURCHASING COOPERATIVE:  EXECUTIVE DIRECTOR AND OTHER EMPLOYEES.  (a)  The board of trustees shall employ an executive director.  The executive director may hire other employees of the Texas cooperative as necessary.(b)  Salaries for employees of the Texas cooperative and related costs may be paid from administrative fees collected from employers and participating health benefit plan issuers or other sources of funding arranged by the Texas cooperative.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.054 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter B. Coalitions and Cooperatives|Section 1501.054. Regional Subdivisions of Texas Health Benefits Purchasing Cooperative

Sec. 1501.054.  REGIONAL SUBDIVISIONS OF TEXAS HEALTH BENEFITS PURCHASING COOPERATIVE.  The board of trustees may:(1)  develop regional subdivisions of the Texas cooperative;  and(2)  authorize each subdivision to separately exercise the powers and duties of a cooperative.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.055 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter B. Coalitions and Cooperatives|Section 1501.055. Applicability of Public Information Law to Texas Health Benefits Purchasing Cooperative

Sec. 1501.055.  APPLICABILITY OF PUBLIC INFORMATION LAW TO TEXAS HEALTH BENEFITS PURCHASING COOPERATIVE.  The Texas cooperative is subject to the public information law, Chapter 552, Government Code.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1501.056 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter B. Coalitions and Cooperatives|Section 1501.056. Private Purchasing Cooperatives and Health Group Cooperatives

Sec. 1501.056.  PRIVATE PURCHASING COOPERATIVES AND HEALTH GROUP COOPERATIVES.  (a)  Two or more small or large employers may form a private purchasing cooperative to purchase small or large employer health benefit plans.  Subject to Subsection (d), a person may form a health group cooperative to purchase employer health benefit plans.  A cooperative must be organized as a nonprofit corporation and has the rights and duties provided by the Texas Non-Profit Corporation Act (Article 1396-1.01 et seq., Vernon's Texas Civil Statutes).(b)  On receipt of a certificate of incorporation or certificate of authority from the secretary of state, the cooperative shall file written notice of the receipt of the certificate and a copy of the cooperative's organizational documents with the commissioner.(c)  Repealed by Acts 2015, 84th Leg., R.S., Ch. 42 , Sec. 3.01(5), eff. September 1, 2015.(d)  A health benefit plan issuer may not form, or be a member of, a health group cooperative.  A health benefit plan issuer may associate with a sponsoring entity, such as a business association, chamber of commerce, or other organization representing employers or serving an analogous function, to assist the sponsoring entity in forming a health group cooperative.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.Amended by: Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.050(a), eff. September 1, 2005.Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.050(b), eff. September 1, 2005.Acts 2015, 84th Leg., R.S., Ch. 42 (S.B. 784), Sec. 3.01(5), eff. September 1, 2015.|
TX Ins Code § 1501.057 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1501 - Health Insurance Portability and Availability Act|Subchapter B. Coalitions and Cooperatives|Section 1501.057. Immunity

Sec. 1501.057.  IMMUNITY.  (a)  The Texas cooperative or a member of the board of trustees, the executive director, or an employee or agent of the Texas cooperative is not liable for:(1)  an act performed in good faith in the execution of duties in connection with the cooperative;  or(2)  an independent action of a small employer health benefit plan issuer or a person who provides health care services under a health benefit plan.(b)  A private purchasing cooperative, a health group cooperative, or a member of the board of directors, the executive director, or an employee or agent of the private purchasing or health group cooperative is not liable for:(1)  an act performed in good faith in the execution of duties in connection with the private purchasing or health group cooperative; or(2)  an independent action of a small or large employer health benefit plan issuer or a person who provides health care services under a health benefit plan.(c)  A health group cooperative or a member of the board of directors, the executive director, or an employee or agent of the health group cooperative is not liable for failure to arrange for coverage of any particular illness, disease, or health condition.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.Amended by: Acts 2005, 79th Leg., Ch. 728 (H.B. 2018), Sec. 11.050(c), eff. September 1, 2005.|