Purpose and Scope

(a) General purpose. This subchapter implements provisions of the Health Care Quality Assurance Act (Act), codified as the Insurance Code Chapter 847. The general purpose of the Act and this subchapter is to provide standards for the appropriate recognition of accreditation of health benefit plan issuers by nationally recognized accreditation organizations. These standards will facilitate increased affordability of health benefit plan coverage for consumers and eliminate the duplication of effort by both health benefit plan issuers and state agencies.

(b) Applicability. This subchapter applies to an entity that:

(1) issues a health benefit plan as defined in the Insurance Code §847.003(2);

(2) holds a license or certificate of authority issued by the commissioner; and

(3) provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, including those entities listed in the Insurance Code §847.004.

Source Note: The provisions of this §21.4101 adopted to be effective May 3, 2007, 32 TexReg 2364.