reglab/housing_qa huggingface dataset:
TX Ins Code § 1460.006 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle F - Physicians and Health Care Providers|Chapter 1460 - Standards Required Regarding Certain Physician Rankings by Health Benefit Plans|Section 1460.006. Duties of Health Benefit Plan Issuer

Sec. 1460.006.  DUTIES OF HEALTH BENEFIT PLAN ISSUER.  A health benefit plan issuer shall ensure that:(1)  physicians currently in clinical practice are actively involved in the development of the standards used under this chapter; and(2)  the measures and methodology used in the comparison programs described by Section 1460.003 are transparent and valid.|Added by Acts 2009, 81st Leg., R.S., Ch. 652 (H.B. 1888), Sec. 1, eff. September 1, 2009.|
TX Ins Code § 1460.007 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle F - Physicians and Health Care Providers|Chapter 1460 - Standards Required Regarding Certain Physician Rankings by Health Benefit Plans|Section 1460.007. Sanctions; Disciplinary Actions

Sec. 1460.007.  SANCTIONS; DISCIPLINARY ACTIONS.  (a)  A health benefit plan issuer that violates this chapter or a rule adopted under this chapter is subject to sanctions and disciplinary actions under Chapters 82 and 84.(b)  A violation of this chapter by a physician constitutes grounds for disciplinary action by the Texas Medical Board, including imposition of an administrative penalty.|Added by Acts 2009, 81st Leg., R.S., Ch. 652 (H.B. 1888), Sec. 1, eff. September 1, 2009.|
TX Ins Code § 1461.001 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle F - Physicians and Health Care Providers|Chapter 1461 - Discrimination Against Physician Based on Maintenance of Certification|Section 1461.001. Definitions

Sec. 1461.001.  DEFINITIONS.  In this chapter:(1)  "Enrollee" means an individual who is eligible to receive health care services under a managed care plan.(2)  "Maintenance of certification" has the meaning assigned by Section 151.002, Occupations Code.(3)  "Managed care plan" means a health benefit plan under which health care services are provided to enrollees through contracts with physicians and that requires enrollees to use participating physicians or that provides a different level of coverage for enrollees who use participating physicians.  The term includes a health benefit plan issued by:(A)  a health maintenance organization;(B)  a preferred provider benefit plan issuer; or(C)  any other entity that issues a health benefit plan, including an insurance company.(4)  "Participating physician" means a physician who has directly or indirectly contracted with a health benefit plan issuer to provide services to enrollees.(5)  "Physician" means an individual licensed to practice medicine in this state.|Added by Acts 2017, 85th Leg., R.S., Ch. 1121 (S.B. 1148), Sec. 1, eff. January 1, 2018.|
TX Ins Code § 1461.002 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle F - Physicians and Health Care Providers|Chapter 1461 - Discrimination Against Physician Based on Maintenance of Certification|Section 1461.002. Applicability

Sec. 1461.002.  APPLICABILITY.  (a)  This chapter applies to a physician regardless of whether the physician is a participating physician.(b)  This chapter applies to a person with whom a managed care plan issuer contracts to:(1)  process or pay claims;(2)  obtain the services of physicians to provide health care services to enrollees; or(3)  issue verifications or preauthorizations.|Added by Acts 2017, 85th Leg., R.S., Ch. 1121 (S.B. 1148), Sec. 1, eff. January 1, 2018.|
TX Ins Code § 1461.003 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle F - Physicians and Health Care Providers|Chapter 1461 - Discrimination Against Physician Based on Maintenance of Certification|Section 1461.003. Discrimination Based on Maintenance of Certification

Sec. 1461.003.  DISCRIMINATION BASED ON MAINTENANCE OF CERTIFICATION.  (a)  Except as provided by Subsection (b), a managed care plan issuer may not differentiate between physicians based on a physician's maintenance of certification in regard to:(1)  paying the physician;(2)  reimbursing the physician; or(3)  directly or indirectly contracting with the physician to provide services to enrollees.(b)  A managed care plan issuer may differentiate between physicians based on a physician's maintenance of certification only if the designation under law or certification or accreditation by a national certifying or accrediting organization of an entity described by Section 151.0515(a), Occupations Code, is contingent on the entity requiring a specific maintenance of certification by physicians seeking staff privileges or credentialing at the entity.|Added by Acts 2017, 85th Leg., R.S., Ch. 1121 (S.B. 1148), Sec. 1, eff. January 1, 2018.|
TX Ins Code § 1503.001 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1503 - Coverage of Certain Students|Section 1503.001. Applicability of Chapter

Sec. 1503.001.  APPLICABILITY OF CHAPTER.  This chapter applies only to a health benefit plan that:(1)  provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, including:(A)  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:(i)  an insurance company;(ii)  a group hospital service corporation operating under Chapter 842;(iii)  a fraternal benefit society operating under Chapter 885;(iv)  a stipulated premium company operating under Chapter 884;  or(v)  a health maintenance organization operating under Chapter 843;  and(B)  to the extent permitted by the Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.), a health benefit plan that is offered by:(i)  a multiple employer welfare arrangement as defined by Section 3 of that Act;  or(ii)  an analogous benefit arrangement;  or(2)  is offered by:(A)  an approved nonprofit health corporation that holds a certificate of authority under Chapter 844;  or(B)  another entity that:(i)  is not authorized under this code or another insurance law of this state;  and(ii)  contracts directly for health care services on a risk-sharing basis, including a capitation basis.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1503.002 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1503 - Coverage of Certain Students|Section 1503.002. Exception

Sec. 1503.002.  EXCEPTION.  This chapter does not apply to:(1)  a plan that provides coverage:(A)  only for a specified disease;(B)  only for accidental death or dismemberment;(C)  for wages or payments in lieu of wages for a period during which an employee is absent from work because of sickness or injury;  or(D)  as a supplement to a liability insurance policy;(2)  a small employer health benefit plan written under Chapter 1501;(3)  a Medicare supplemental policy as defined by Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss), as amended;(4)  a workers' compensation insurance policy;(5)  medical payment insurance coverage provided under a motor vehicle insurance policy;  or(6)  a long-term care insurance policy, including a nursing home fixed indemnity policy, unless the commissioner determines that the policy provides benefit coverage so comprehensive that the policy is a health benefit plan as described by Section 1503.001.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1503.003 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1503 - Coverage of Certain Students|Section 1503.003. Coverage of Certain Students

Sec. 1503.003.  COVERAGE OF CERTAIN STUDENTS.  (a)  A health benefit plan may not condition coverage for a child younger than 25 years of age on the child's being enrolled at an educational institution.(b)  A health benefit plan that requires as a condition of coverage for a child 25 years of age or older that the child be a full-time student at an educational institution must provide the coverage:(1)  for the entire academic term during which the child begins as a full-time student and remains enrolled, regardless of whether the number of hours of instruction for which the child is enrolled is reduced to a level that changes the child's academic status to less than that of a full-time student; and(2)  continuously until the 10th day of instruction of the subsequent academic term, on which date the health benefit plan may terminate coverage for the child if the child does not return to full-time student status before that date.(c)  For purposes of this section, determination of the full-time student status of a child is made in the manner provided by the educational institution at which the child is enrolled.|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. 11.063(a), eff. September 1, 2005.|
TX Ins Code § 1505.001 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1505 - Group Health Insurance Plans for Persons 65 Years of Age or Older|Section 1505.001. Definition

Sec. 1505.001.  DEFINITION.  In this chapter, "health insurer" means an insurance company authorized to provide a hospital, surgical, and medical expense insurance plan in this state, including:(1)  a stock insurance company;(2)  a reciprocal or interinsurance exchange;(3)  a Lloyd's plan;(4)  a fraternal benefit society;(5)  a stipulated premium company;  and(6)  a mutual insurance company, including a statewide mutual assessment company or a local mutual aid association.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1505.002 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1505 - Group Health Insurance Plans for Persons 65 Years of Age or Older|Section 1505.002. Plans for Certain Persons 65 Years of Age or Older

Sec. 1505.002.  PLANS FOR CERTAIN PERSONS 65 YEARS OF AGE OR OLDER.  (a)  Two or more health insurers may provide a hospital, surgical, and medical expense insurance plan under a group insurance policy that covers residents of this state who are at least 65 years of age and the spouses of those residents.(b)  The participating health insurers may enter into agreements regarding matters within the scope of this chapter, including:(1)  premium rates;(2)  policy provisions;  and(3)  sales, administrative, technical, and accounting procedures.(c)  Each participating health insurer is subject to regulation under the laws of this state and is severally liable on a group insurance policy issued under this chapter.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1505.003 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1505 - Group Health Insurance Plans for Persons 65 Years of Age or Older|Section 1505.003. Application and Other Evidence of Insurance Forms

Sec. 1505.003.  APPLICATION AND OTHER EVIDENCE OF INSURANCE FORMS.  An application, policy, certificate, or other evidence of insurance form for an insurance plan under this chapter is subject to Chapter 1701.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1505.004 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1505 - Group Health Insurance Plans for Persons 65 Years of Age or Older|Section 1505.004. Execution of Policy

Sec. 1505.004.  EXECUTION OF POLICY.  An authorized person may execute an insurance policy subject to this chapter on behalf of the participating health insurers.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1505.005 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1505 - Group Health Insurance Plans for Persons 65 Years of Age or Older|Section 1505.005. Use of Unincorporated Entity

Sec. 1505.005.  USE OF UNINCORPORATED ENTITY.  (a)  The participating health insurers may issue the group insurance policy in their own names or in the name of an unincorporated association, trust, or other organization formed for the sole purposes of this chapter and evidenced by a written contract executed by the insurers.  An unincorporated association, trust, or other organization formed under this subsection may sue and be sued in the name of the association, trust, or organization.(b)  A person licensed as a general life, accident, and health agent under Chapter 4054, as a general property and casualty agent under Chapter 4051 authorized to write health and accident insurance under Section 4051.053, or as a personal lines property and casualty agent authorized to write health and accident insurance under Section 4051.402, may act in the licensed capacity in connection with an insurance policy or a certificate of insurance issued by an unincorporated association, trust, or other organization formed under Subsection (a).  The agent is not required to notify the department that the person has been appointed to act for that purpose.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.Amended by: Acts 2007, 80th Leg., R.S., Ch. 548 (S.B. 1263), Sec. 2.12, eff. September 1, 2007.|
TX Ins Code § 1505.006 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1505 - Group Health Insurance Plans for Persons 65 Years of Age or Older|Section 1505.006. Required Filings; Department Approval

Sec. 1505.006.  REQUIRED FILINGS;  DEPARTMENT APPROVAL.  (a)  The participating health insurers shall provide for the filing with the department on behalf of the insurers of:(1)  a copy of any contract of association or organization or trust agreement entered into by the insurers under this chapter;(2)  the schedule of premium rates to be charged for the insurance coverage;  and(3)  the plan for operating and marketing the insurance.(b)  Except as provided by Subsection (c), a contract, schedule, or plan described by Subsection (a) may not be effective until approved by the commissioner.(c)  A contract, schedule, or plan described by Subsection (a) that is not approved or disapproved in a written order of the commissioner on or before the 30th day after the date on which the document is filed with the department is considered approved on the 31st day after the date of filing.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1505.007 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1505 - Group Health Insurance Plans for Persons 65 Years of Age or Older|Section 1505.007. Effect of Commissioner Disapproval

Sec. 1505.007.  EFFECT OF COMMISSIONER DISAPPROVAL.  If, after notice and public hearing, the commissioner determines under reasonable assumptions that a premium rate charged for the insurance coverage offered under this chapter or the plan for operating and marketing that insurance is excessive, inadequate, or contrary to the public interest or that any activity or practice performed in connection with the insurance is unfair, unreasonable, or contrary to the public interest, the commissioner shall:(1)  enter an order containing the commissioner's determination and disapproving the premium rate or plan or the activity or practice;  and(2)  require the discontinuance of the premium rate, plan, activity, or practice within a period that is not less than 30 days after the date of the commissioner's order containing the determination.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1505.008 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1505 - Group Health Insurance Plans for Persons 65 Years of Age or Older|Section 1505.008. Exemption From Premium Taxes

Sec. 1505.008.  EXEMPTION FROM PREMIUM TAXES.  Each premium received for group insurance coverage authorized by this chapter is exempt from any premium tax imposed by any other law of this state.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1505.009 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1505 - Group Health Insurance Plans for Persons 65 Years of Age or Older|Section 1505.009. Exemption From Certain Antitrust Requirements

Sec. 1505.009.  EXEMPTION FROM CERTAIN ANTITRUST REQUIREMENTS.  An association, trust, or other organization formed and operated in accordance with this chapter or an insurance business conducted in accordance with this chapter is not considered a combination in restraint of trade, an illegal monopoly, or an attempt to lessen competition or fix prices arbitrarily and does not otherwise violate the antitrust laws of this state.|Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.|
TX Ins Code § 1509.001 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1509 - Short-Term Limited-Duration Insurance|Section 1509.001. Definition

Sec. 1509.001.  DEFINITION.  In this chapter, "short-term limited-duration insurance" has the meaning assigned by 26 C.F.R. Section 54.9801-2.|Added by Acts 2019, 86th Leg., R.S., Ch. 657 (S.B. 1852), Sec. 3, eff. September 1, 2019.|
TX Ins Code § 1509.002 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1509 - Short-Term Limited-Duration Insurance|Section 1509.002. Policy Disclosure Form

Sec. 1509.002.  POLICY DISCLOSURE FORM.  (a)  The commissioner by rule shall prescribe a disclosure form to be provided with a short-term limited-duration insurance policy and application.(b)  The disclosure form must be in an easily readable font at least 14-point in size and include:(1)  the duration of coverage;(2)  a statement:(A)  of the number of times the policy may be renewed or that the policy may not be renewed, as applicable;(B)  that the expiration of short-term coverage is not a qualifying life event that would make a person eligible for a special enrollment period; and(C)  that the policy may expire outside of the open enrollment period;(3)  to the extent the information is available, the dates of the next three open enrollment periods under the Patient Protection and Affordable Care Act (Pub. L. No. 111-148) following the date the policy expires;(4)  whether the policy contains any limitations or exclusions to preexisting conditions;(5)  the maximum dollar amount payable under the policy;(6)  the deductibles under the policy and the health care services to which the deductibles apply;(7)  whether the following health care services are covered, including:(A)  prescription drug coverage;(B)  mental health services;(C)  substance abuse treatment;(D)  maternity care;(E)  hospitalization;(F)  surgery;(G)  emergency health care; and(H)  preventive health care; and(8)  any other information the commissioner determines is important for a purchaser of a short-term limited-duration insurance policy.(c)  An insurer issuing a short-term limited-duration insurance policy shall adopt procedures in accordance with commissioner rule to obtain a signed form from the insured acknowledging receipt of the disclosure form described by this section.  The rule must allow for electronic acknowledgment.  The insurer shall retain an acknowledgment form until the fifth anniversary of the date the insurer receives the form, and the insurer shall make the form available to the department on request.|Added by Acts 2019, 86th Leg., R.S., Ch. 657 (S.B. 1852), Sec. 3, eff. September 1, 2019.|
TX Ins Code § 1510.001 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1510 - Temporary Health Insurance Risk Pool|Section 1510.001. Definition

Sec. 1510.001.  DEFINITION.  In this chapter, "pool" means a temporary health insurance risk pool that is established and administered by the commissioner under this chapter.|Added by Acts 2017, 85th Leg., R.S., Ch. 765 (S.B. 2087), Sec. 1, eff. June 12, 2017.|
TX Ins Code § 1510.002 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1510 - Temporary Health Insurance Risk Pool|Section 1510.002. Establishment of Temporary Health Insurance Risk Pool

Sec. 1510.002.  ESTABLISHMENT OF TEMPORARY HEALTH INSURANCE RISK POOL.  To the extent that federal funds are available under federal law, the commissioner may:(1)  apply for such funds; and(2)  use such funds to establish and administer a temporary health insurance risk pool for the purposes of this chapter.|Added by Acts 2017, 85th Leg., R.S., Ch. 765 (S.B. 2087), Sec. 1, eff. June 12, 2017.Amended by: Acts 2019, 86th Leg., R.S., Ch. 662 (S.B. 1940), Sec. 1, eff. June 10, 2019.|
TX Ins Code § 1510.003 (2021)
2021 Texas Statutes|Insurance Code|Title 8 - Health Insurance and Other Health Coverages|Subtitle G - Health Coverage Availability|Chapter 1510 - Temporary Health Insurance Risk Pool|Section 1510.003. Purpose of Pool

Sec. 1510.003.  PURPOSE OF POOL.  (a)  The exclusive purpose of the pool is to provide a temporary mechanism to assist residents of this state in obtaining access to quality, guaranteed issue health coverage at minimum cost to the public.(b)  The pool may not be used to expand the Medicaid program, including the program administered under Chapter 32, Human Resources Code, and the program administered under Chapter 533, Government Code.(c)  The pool may not be used in a manner that requires this state to assume functions currently performed by the United States Department of Health and Human Services or the United States Internal Revenue Service under the Patient Protection and Affordable Care Act (Pub. L. No. 111-148), including establishing an exchange or administering premium tax credits.|Added by Acts 2017, 85th Leg., R.S., Ch. 765 (S.B. 2087), Sec. 1, eff. June 12, 2017.Amended by: Acts 2019, 86th Leg., R.S., Ch. 662 (S.B. 1940), Sec. 2, eff. June 10, 2019.|