Texas Insurance Code
§ 843.112 — DENTAL POINT-OF-SERVICE OPTION
IN § 843.112Title 6. ORGANIZATION OF INSURERS AND RELATED ENTITIES · Part C. LIFE, HEALTH, AND ACCIDENT INSURERS AND RELATED ENTITIES · Ch. 843. HEALTH MAINTENANCE ORGANIZATIONS · Art. D. GENERAL POWERS AND DUTIES OF HEALTH MAINTENANCE ORGANIZATIONS
Statute text
View on source(a)In this section:
(1)"Point-of-service option" means a plan provided through a contractual arrangement under which:
(A)indemnity benefits for the cost of dental care services, other than emergency care or emergency dental care, are provided by an insurer or group hospital service corporation in conjunction with corresponding benefits arranged or provided by a health maintenance organization; and
(B)an enrollee may choose to obtain benefits or services under the indemnity plan or the health maintenance organization plan in accordance with specific provisions of a point-of-service contract.
(2)"Provider panel" means the providers with whom a health maintenance organization contracts to provide dental services to enrollees covered under a dental benefit plan.
(b)This section applies to a dental health maintenance organization or another single service health maintenance organization that provides dental benefits. This section does not apply to a health maintenance organization that has 10,000 or fewer enrollees in this state who are enrolled in dental benefit plans based on a provider panel.
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Legislative history
Added by Acts 2001, 77th Leg., ch. 1419, Sec. 1, eff. June 1, 2003.