2021 Texas Statutes
Insurance Code
Title 5 - Protection of Consumer Interests
Subtitle C - Deceptive, Unfair, and Prohibited Practices
Chapter 562 - Unfair Methods of Competition and Unfair or Deceptive Acts or Practices Regarding Discount Health Care Programs
Subchapter A. General Provisions
Section 562.002. Definitions
Sec. 562.002. DEFINITIONS. In this chapter:
(1) "Advertisement, solicitation, or marketing material" means material that is made, published, disseminated, circulated, or placed before the public:
(A) in a newspaper, magazine, or other publication;
(B) in a notice, circular, pamphlet, letter, or poster;
(C) over a radio or television station;
(D) through the Internet;
(E) in a telephone sales script; or
(F) in any other manner.
(2) "Discount health care program" means a business arrangement or contract in which an entity, in exchange for fees, dues, charges, or other consideration, offers its members access to discounts on health care services provided by health care providers. The term does not include an insurance policy, certificate of coverage, or other product otherwise regulated by the department or a self-funded or self-insured employee benefit plan.
(3) "Discount health care program operator" means a person who, in exchange for fees, dues, charges, or other consideration, operates a discount health care program and contracts with providers, provider networks, or other discount health care program operators to offer access to health care services at a discount and determines the charge to members.
(4) "Health care services" includes physician care, inpatient care, hospital surgical services, emergency services, ambulance services, laboratory services, audiology services, dental services, vision services, mental health services, substance abuse services, chiropractic services, and podiatry services, and the provision of medical equipment and supplies, including prescription drugs.
(5) "Marketer" means a person who sells or distributes, or offers to sell or distribute, a discount health care program, including a private label entity that places its name on and markets or distributes a discount health care program, but does not operate a discount health care program.
(6) "Member" means a person who pays fees, dues, charges, or other consideration for the right to participate in a discount health care program.
(7) "Person" means an individual, corporation, association, partnership, or other legal entity.
(8) "Program operator" means a discount health plan program operator.
(9) "Provider" means a person who is licensed or otherwise authorized to provide health care services in this state.
Added by Acts 2009, 81st Leg., R.S., Ch. 1331 (H.B. 4341), Sec. 1, eff. September 1, 2009.
