{"data":{"id":"us-tx/tex.-insurance-code-1273.055","jurisdiction":"us-tx","citation":"Tex. Insurance Code § 1273.055","heading":"COST-SHARING PROVISIONS.","body":"(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.\n(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.\nAdded by Acts 2003, 78th Leg., ch. 1274, Sec. 3, eff. April 1, 2005.","path":["INSURANCE CODE","TITLE 8. HEALTH INSURANCE AND OTHER HEALTH COVERAGES","SUBTITLE C. MANAGED CARE","CHAPTER 1273. POINT-OF-SERVICE PLANS","SUBCHAPTER B. AVAILABILITY OF HEALTH BENEFIT COVERAGE OPTIONS"],"source_url":"https://statutes.capitol.texas.gov/Docs/IN/htm/IN.1273.htm#1273.055","current_through":"89th 2nd Called Legislative Session, 2025","vintage":"","retrieved_at":"2026-08-27T01:47:21Z","sha256":"bdd46ddedd6f0b22190d975f01a34baf9599c3527fbfc28114de20a978cf58ce","source_id":"us-tx","stale":false,"prev":"us-tx/tex.-insurance-code-1273.054","next":"us-tx/tex.-insurance-code-1273.056"},"notice":"GroundRules: Original legal text. Not legal advice."}