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Texas · Through 89th 2nd Called Legislative Session, 2025

Tex. Insurance Code § 1273.055: COST-SHARING PROVISIONS.

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Where this section sits in the code
  1. INSURANCE CODE
  2. TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES
  3. SUBTITLE C. MANAGED CARE
  4. CHAPTER 1273. POINT-OF-SERVICE PLANS
  5. SUBCHAPTER B. AVAILABILITY OF HEALTH BENEFIT COVERAGE OPTIONS

(a) Different cost-sharing provisions may be imposed for a point-of-service plan offered under this subchapter, and those provisions may be higher than the cost-sharing provisions for in-network health maintenance organization coverage. For an enrollee in a limited provider network, higher cost-sharing may be imposed only when the enrollee obtains benefits or services outside the health maintenance organization delivery network.

(b) An employee who chooses the non-network plan is responsible for any additional costs for the non-network plan, and the employer may impose a reasonable administrative fee for providing the non-network plan.

Added by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.

Collected 2026-08-27T01:47:21Z. Source file · JSON

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