reglab/housing_qa huggingface dataset:
TX Ins Code § 842.203 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 842 - Group Hospital Service Corporations|Subchapter E. Regulation of Group Hospital Service Corporations|Section 842.203. Final Judgment Deposit

Sec. 842.203.  FINAL JUDGMENT DEPOSIT.  (a)  For each 1,000 members and fraction of 1,000 members, a group hospital service corporation shall deposit $100 with the comptroller through the commissioner.  The total deposit required under this subsection may not exceed $2,000.(b)  The deposit required under Subsection (a) shall be used to pay any judgment entered against the group hospital service corporation and is subject to garnishment after a final judgment is entered.(c)  The group hospital service corporation shall immediately replenish the amount on deposit if the amount is impounded or impaired.  If the amount is not replenished immediately on the demand of the commissioner, the corporation may be regarded as insolvent and treated accordingly.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 842.204 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 842 - Group Hospital Service Corporations|Subchapter E. Regulation of Group Hospital Service Corporations|Section 842.204. Investment Limitations

Sec. 842.204.  INVESTMENT LIMITATIONS.  The investment limitations that apply to a life, health, and accident insurance company apply to the investments of a group hospital service corporation.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 842.205 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 842 - Group Hospital Service Corporations|Subchapter E. Regulation of Group Hospital Service Corporations|Section 842.205. Incurred Expenses

Sec. 842.205.  INCURRED EXPENSES.  (a)  In this section, "general expenses" means expenses incurred by a group hospital service corporation in the operation of its business other than:(1)  a tax;(2)  a license fee;(3)  a commission;  or(4)  an expense incurred in the performance of a contract:(A)  made directly or indirectly with this state or the United States;  and(B)  under which the corporation does not assume an insurance risk.(b)  Subject to Subsection (c), a group hospital service corporation may not incur during a calendar year general expenses that exceed 20 percent of the premiums earned in that calendar year.(c)  For a group hospital service corporation earning $500 million or more in premiums in a calendar year, the maximum percentage of general expenses that may be incurred during a calendar year is reduced by one-half percent for each $50 million of premiums earned to a maximum percentage of 15 percent.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 842.206 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 842 - Group Hospital Service Corporations|Subchapter E. Regulation of Group Hospital Service Corporations|Section 842.206. Minimum Surplus Requirement

Sec. 842.206.  MINIMUM SURPLUS REQUIREMENT.  Each group hospital service corporation shall maintain a surplus of at least $100,000 to meet adverse contingencies.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 842.207 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 842 - Group Hospital Service Corporations|Subchapter E. Regulation of Group Hospital Service Corporations|Section 842.207. Contracts; Reinsurance; Other Agreements

Sec. 842.207.  CONTRACTS;  REINSURANCE;  OTHER AGREEMENTS.  (a)  Subject to Subsection (b), a group hospital service corporation may:(1)  contract with another organization similar in character for joint participation through:(A)  a mutualization contract agreement;(B)  a reinsurance treaty;  or(C)  another arrangement;  and(2)  cede or accept risks from an insurer on all or part of a risk.(b)  Each document used for a purpose described by Subsection (a) must be filed with the department and approved by the commissioner for use in that purpose.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 842.208 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 842 - Group Hospital Service Corporations|Subchapter E. Regulation of Group Hospital Service Corporations|Section 842.208. Books and Records

Sec. 842.208.  BOOKS AND RECORDS.  Each group hospital service corporation shall keep complete books and records.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 842.209 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 842 - Group Hospital Service Corporations|Subchapter E. Regulation of Group Hospital Service Corporations|Section 842.209. Examinations

Sec. 842.209.  EXAMINATIONS.  The following laws apply to a group hospital service corporation:(1)  Subchapter A, Chapter 86; and(2)  Sections 401.051, 401.052, 401.054-401.062, 401.151, 401.152, 401.155, and 401.156.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.Amended by: Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2E.026, eff. April 1, 2009.|
TX Ins Code § 842.210 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 842 - Group Hospital Service Corporations|Subchapter E. Regulation of Group Hospital Service Corporations|Section 842.210. Liquidation, Rehabilitation, or Conservation of Group Hospital Service Corporation

Sec. 842.210.  LIQUIDATION, REHABILITATION, OR CONSERVATION OF GROUP HOSPITAL SERVICE CORPORATION.  The dissolution, liquidation, rehabilitation, or conservation of a group hospital service corporation is subject to Chapters 441 and 443.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.Amended by: Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2E.027, eff. April 1, 2009.|
TX Ins Code § 842.251 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 842 - Group Hospital Service Corporations|Subchapter F. Plan of Operation; Provision of Benefits to Members|Section 842.251. Plan of Operation

Sec. 842.251.  PLAN OF OPERATION.  (a)  Before accepting applications for membership in its hospital service plan, a group hospital service corporation must submit to the commissioner a plan of operation.  The plan of operation must be accompanied by a schedule of the dues to be charged to members and a statement of the amount of hospital services that the corporation contracts to provide.(b)  The commissioner must approve the plan of operation as fair and reasonable before the corporation may engage in business.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 842.252 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 842 - Group Hospital Service Corporations|Subchapter F. Plan of Operation; Provision of Benefits to Members|Section 842.252. Membership Certificate; Contract

Sec. 842.252.  MEMBERSHIP CERTIFICATE;  CONTRACT.  (a)  A group hospital service corporation shall issue to each member a membership certificate that states the benefits to which the member is or may become entitled.(b)  The department must approve the form of:(1)  the membership certificate;  and(2)  any contract made between the group hospital service corporation and the member's employer or group representative.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 842.253 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 842 - Group Hospital Service Corporations|Subchapter F. Plan of Operation; Provision of Benefits to Members|Section 842.253. Policy, Certificate, and Application Forms

Sec. 842.253.  POLICY, CERTIFICATE, AND APPLICATION FORMS.  A policy, certificate, or application form used by a group hospital service corporation is subject to Chapter 1701.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.Amended by: Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2E.028, eff. April 1, 2009.|
TX Ins Code § 842.254 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 842 - Group Hospital Service Corporations|Subchapter F. Plan of Operation; Provision of Benefits to Members|Section 842.254. Deposit Requirements

Sec. 842.254.  DEPOSIT REQUIREMENTS.  A group hospital service corporation shall deposit in the account of the corporation in a bank money collected by the corporation from a member or subscriber.  The bank must be a state depository.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 842.255 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 842 - Group Hospital Service Corporations|Subchapter F. Plan of Operation; Provision of Benefits to Members|Section 842.255. Advance Payments to Hospital Prohibited

Sec. 842.255.  ADVANCE PAYMENTS TO HOSPITAL PROHIBITED.  A group hospital service corporation may not pay to a hospital any money collected by the corporation from a member or subscriber before the hospital provides necessary care to that member or subscriber.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 842.256 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 842 - Group Hospital Service Corporations|Subchapter F. Plan of Operation; Provision of Benefits to Members|Section 842.256. Contracts With Health Care Providers

Sec. 842.256.  CONTRACTS WITH HEALTH CARE PROVIDERS.  (a)  A group hospital service corporation may contract with health care providers as necessary to ensure to each member or subscriber the provision of services and supplies covered by the membership certificate or policy of the corporation.(b)  A group hospital service corporation may not be required to contract with any particular health care provider.(c)  This section does not authorize a group hospital service corporation to contract with a health care provider in a manner prohibited by a licensing law of this state under which that health care provider operates.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 842.257 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 842 - Group Hospital Service Corporations|Subchapter F. Plan of Operation; Provision of Benefits to Members|Section 842.257. May Limit Benefits

Sec. 842.257.  MAY LIMIT BENEFITS.  A policy or certificate issued by a group hospital service corporation may limit the types of disease for which benefits are provided.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 842.258 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 842 - Group Hospital Service Corporations|Subchapter F. Plan of Operation; Provision of Benefits to Members|Section 842.258. Limitations on Contracts for Medical Services

Sec. 842.258.  LIMITATIONS ON CONTRACTS FOR MEDICAL SERVICES.  (a)  A group hospital service corporation may not:(1)  contract to provide to a member a physician or any medical services;(2)  contract to practice medicine in any manner;(3)  control or attempt to control the relations existing between a member and the member's physician;  or(4)  restrict the right of a patient to obtain the services of any licensed physician.(b)  This section does not prohibit a group hospital service corporation from contracting with:(1)  a health organization certified under Chapter 162, Occupations Code;  or(2)  a physician or other health care provider under rules adopted for preferred provider plans.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 842.259 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 842 - Group Hospital Service Corporations|Subchapter F. Plan of Operation; Provision of Benefits to Members|Section 842.259. Use of Indemnity Plan Authorized

Sec. 842.259.  USE OF INDEMNITY PLAN AUTHORIZED.  A group hospital service corporation may provide benefits for medical care, surgical care, or both medical and surgical care on the basis of indemnity payments for incurred expenses.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 842.260 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 842 - Group Hospital Service Corporations|Subchapter F. Plan of Operation; Provision of Benefits to Members|Section 842.260. Payment of Claim; Proof of Claim

Sec. 842.260.  PAYMENT OF CLAIM;  PROOF OF CLAIM.  (a)  After receipt of due proof of claim, a group hospital service corporation shall pay each claim presented under a membership certificate in full not later than the 60th day after the date on which the applicable services prescribed in the certificate have been provided.(b)  Written notice of a claim given to a group hospital service corporation is considered due proof of claim under this section if the corporation does not provide the claimant with the forms usually provided by the corporation for filing a claim before the 16th day after the date notice is received.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 842.261 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 842 - Group Hospital Service Corporations|Subchapter F. Plan of Operation; Provision of Benefits to Members|Section 842.261. Information Available Through Internet Site

Sec. 842.261.  INFORMATION AVAILABLE THROUGH INTERNET SITE.  (a)  A group hospital service corporation that maintains an Internet site shall list on the Internet site the physicians and health care providers, including, if appropriate, mental health providers and substance abuse treatment providers, that may be used by members in accordance with the terms of the policy or certificate applicable to the member.  The listing must identify those physicians and health care providers who continue to be available to provide services to new patients or clients.(b)  The group hospital service corporation shall update at least quarterly an Internet site subject to this section.(c)  The commissioner may adopt rules as necessary to implement this section.  The rules may govern the form and content of the information required to be provided under Subsection (a).|Acts 2003, 78th Leg., ch. 1177, Sec. 2, eff. Sept. 1, 2003.|
TX Ins Code § 842.301 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 842 - Group Hospital Service Corporations|Subchapter G. Disciplinary Procedures|Section 842.301. Revocation of Certificate of Authority

Sec. 842.301.  REVOCATION OF CERTIFICATE OF AUTHORITY.  The commissioner shall revoke the certificate of authority of a group hospital service corporation that:(1)  is determined to be:(A)  operating fraudulently;  or(B)  improperly contesting claims;  or(2)  fails to pay valid claims in accordance with this chapter.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 843.001 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 843 - Health Maintenance Organizations|Subchapter A. General Provisions|Section 843.001. Short Title

Sec. 843.001.  SHORT TITLE.  This chapter may be cited as the Texas Health Maintenance Organization Act.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 843.003 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 843 - Health Maintenance Organizations|Subchapter A. General Provisions|Section 843.003. Powers of Insurers and Group Hospital Service Corporations

Sec. 843.003.  POWERS OF INSURERS AND GROUP HOSPITAL SERVICE CORPORATIONS.  (a)  An insurer authorized to engage in the business of insurance in this state under Chapter 822, 841, or 883, an accident insurance company, health insurance company, or life insurance company authorized to engage in the business of insurance in this state under Chapter 982, or a group hospital service corporation may, either directly or through a subsidiary or affiliate, organize and operate a health maintenance organization under this chapter.(b)  Any two or more insurers or group hospital service corporations described by Subsection (a), or their subsidiaries or affiliates, may jointly organize and operate a health maintenance organization under this chapter.(c)  An insurer or group hospital service corporation may contract with a health maintenance organization to provide:(1)  insurance or similar protection against the cost of care provided by the health maintenance organization;  and(2)  coverage if the health maintenance organization does not meet its obligations.(d)  The authority of an insurer or group hospital service corporation under a contract described by Subsection (c) may include the authority to make benefit payments to a health maintenance organization for health care services provided by physicians or providers under a health care plan.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 843.004 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 843 - Health Maintenance Organizations|Subchapter A. General Provisions|Section 843.004. Governing Body of Health Maintenance Organization

Sec. 843.004.  GOVERNING BODY OF HEALTH MAINTENANCE ORGANIZATION.  The governing body of a health maintenance organization may include physicians, providers, or other individuals, or any combination of physicians, providers, and other individuals.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 843.005 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 843 - Health Maintenance Organizations|Subchapter A. General Provisions|Section 843.005. Use of Insurance-Related Terms by Health Maintenance Organization

Sec. 843.005.  USE OF INSURANCE-RELATED TERMS BY HEALTH MAINTENANCE ORGANIZATION.  A health maintenance organization that is not authorized as an insurer may not use in its name, contracts, or literature the word "insurance," "casualty," "surety," or "mutual," or any other words that are:(1)  descriptive of the insurance, casualty, or surety business;  or(2)  deceptively similar to the name or description of an insurer or surety corporation engaging in business in this state.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.|
TX Ins Code § 843.006 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 843 - Health Maintenance Organizations|Subchapter A. General Provisions|Section 843.006. Public Documents

Sec. 843.006.  PUBLIC DOCUMENTS.  (a)  Except as provided by Subsection (b), each application, filing, and report required under this chapter, Section 1367.053, Subchapter A, Chapter 1452, Subchapter B, Chapter 1507, Chapter 222, 251, or 258, as applicable to a health maintenance organization, or Chapter 1271 or 1272 is a public document.(b)  An examination report is confidential but may be released if, in the opinion of the commissioner, the release is in the public interest.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.Amended by: Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2E.030, eff. April 1, 2009.|
TX Ins Code § 843.007 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 843 - Health Maintenance Organizations|Subchapter A. General Provisions|Section 843.007. Confidentiality of Medical and Health Information

Sec. 843.007.  CONFIDENTIALITY OF MEDICAL AND HEALTH INFORMATION.  (a)  Any information relating to the diagnosis, treatment, or health of an enrollee or applicant obtained by a health maintenance organization from the enrollee or applicant or from a physician or provider shall be held in confidence and may not be disclosed to any person except:(1)  to the extent necessary to accomplish the purposes of this chapter or:(A)  Section 1367.053;(B)  Subchapter A, Chapter 1452;(C)  Subchapter B, Chapter 1507;(D)  Chapter 222, 251, or 258, as applicable to a health maintenance organization; or(E)  Chapter 1271 or 1272;(2)  with the express consent of the enrollee or applicant;(3)  in compliance with a statute or court order for the production or discovery of evidence; or(4)  in the event of a claim or litigation between the enrollee or applicant and the health maintenance organization in which the information is pertinent.(b)  A health maintenance organization is entitled to claim the statutory privilege against disclosure that the physician or provider who provides the information to the health maintenance organization is entitled to claim.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.Amended by: Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2E.031, eff. April 1, 2009.|
TX Ins Code § 843.008 (2021)
2021 Texas Statutes|Insurance Code|Title 6 - Organization of Insurers and Related Entities|Subtitle C - Life, Health, and Accident Insurers and Related Entities|Chapter 843 - Health Maintenance Organizations|Subchapter A. General Provisions|Section 843.008. Costs of Administering Health Maintenance Organization Laws

Sec. 843.008.  COSTS OF ADMINISTERING HEALTH MAINTENANCE ORGANIZATION LAWS.  Money collected under this chapter and Chapters 222, 251, and 258, as applicable to a health maintenance organization, must be sufficient to administer this chapter and:(1)  Section 1367.053;(2)  Subchapter A, Chapter 1452;(3)  Subchapter B, Chapter 1507;(4)  Chapters 222, 251, and 258, as applicable to a health maintenance organization; and(5)  Chapters 1271 and 1272.|Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.Amended by: Acts 2007, 80th Leg., R.S., Ch. 730 (H.B. 2636), Sec. 2E.032, eff. April 1, 2009.|