{"data":{"id":"us-tx/tex.-insurance-code-1222.0002","jurisdiction":"us-tx","citation":"Tex. Insurance Code § 1222.0002","heading":"APPLICABILITY OF CHAPTER.","body":"(a) This chapter applies only to a health benefit plan that provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, including an individual, group, blanket, or franchise insurance policy or insurance agreement, a group hospital service contract, or an individual or group evidence of coverage or similar coverage document that is issued by:\n(1) an insurance company;\n(2) a group hospital service corporation operating under Chapter 842;\n(3) a health maintenance organization operating under Chapter 843;\n(4) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844;\n(5) a multiple employer welfare arrangement that holds a certificate of authority under Chapter 846;\n(6) a stipulated premium company operating under Chapter 884;\n(7) a fraternal benefit society operating under Chapter 885;\n(8) a Lloyd's plan operating under Chapter 941; or\n(9) an exchange operating under Chapter 942.\n(b) Notwithstanding any other law, this chapter applies to:\n(1) a small employer health benefit plan subject to Chapter 1501, including coverage provided through a health group cooperative under Subchapter B of that chapter;\n(2) a standard health benefit plan issued under Chapter 1507;\n(3) a basic coverage plan under Chapter 1551;\n(4) a basic plan under Chapter 1575;\n(5) a primary care coverage plan under Chapter 1579;\n(6) a plan providing basic coverage under Chapter 1601;\n(7) health benefits provided by or through a church benefits board under Subchapter I, Chapter 22, Business Organizations Code;\n(8) group health coverage made available by a school district in accordance with Section 22.004, Education Code;\n(9) the state Medicaid program, including the Medicaid managed care program operated under Chapters 540 and 540A, Government Code;\n(10) the child health plan program under Chapter 62, Health and Safety Code;\n(11) a regional or local health care program operated under Section 75.104, Health and Safety Code; and\n(12) a self-funded health benefit plan sponsored by a professional employer organization under Chapter 91, Labor Code.\nAdded by Acts 2019, 86th Leg., R.S., Ch. 488 (H.B. 3041), Sec. 1, eff. September 1, 2019.\nAmended by:\nActs 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 2.121, eff. April 1, 2025.","path":["INSURANCE CODE","TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES","SUBTITLE A. HEALTH COVERAGE IN GENERAL","CHAPTER 1222. PREAUTHORIZATION FOR MEDICAL OR HEALTH CARE SERVICE"],"source_url":"https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1222.htm#1222.0002","current_through":"89th 2nd Called Legislative Session, 2025","vintage":"","retrieved_at":"2026-08-27T01:47:21Z","sha256":"b47b5a42e8ad7f7d1b1b4ab23db08405edfdfca9b1a1f500b6f0328d3b1b52a9","source_id":"us-tx","stale":false,"prev":"us-tx/tex.-insurance-code-1222.0001","next":"us-tx/tex.-insurance-code-1222.0003"},"notice":"GroundRules: Original legal text. Not legal advice."}