28 Tex. Admin. Code § 7.1802 - Definitions
The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise.
(1) Annual
Statement--Annual statement most recently filed by the insurer or HMO with the
Texas Department of Insurance.
(2)
Association coverage--Coverage under a health benefit plan issued to an
association or bona fide association as those terms are defined in §
21.2702 of this title (relating to
Association Plans).
(3)
Commissioner--Commissioner of Insurance.
(4) Department--Texas Department of
Insurance.
(5) Individual
coverage--Coverage issued by an HMO that provides an individual health care
plan as defined in Insurance Code §
1271.004.
(6) Large employer coverage--Coverage under a
health benefit plan issued to a large employer as those terms are defined in §
26.4 of this title (relating to
Definitions).
(7) Line of
insurance--Each line of business as specified in §
7.1803 of this title (relating to
What Constitutes a Line of Insurance).
(8) HMO--A health maintenance organization
licensed under Insurance Code Chapter 843.
(9) Medicaid--The Medicaid program under
Title XIX of the Social Security Act of 1965.
(10) Medicare--Has the same meaning as
specified in §
3.3303 of this title (relating to
Definitions).
(11) Medicare+Choice
plan--Has the same meaning as specified in §
3.3303 of this title.
(12) Small employer coverage--Coverage under
a health benefit plan issued to a small employer as those terms are defined in
§
26.4 of this title.
(13) Enrollees of special circumstances--As
described in Insurance Code §§
1301.152 -
1301.154 and §
843.362.
(14) CHIP--The Texas Children's Health
Insurance Program under Texas Health and Safety Code Chapter 62.
(15) Withdrawal--The event that occurs when
the actions of an insurer or HMO meets the criteria under Insurance Code §
827.003.
(16) Rating territory--A county in
Texas.
Notes
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