Tex.
Ins. Code Section 4151.001
Definitions
(1)
“Administrator” means a person who, in connection with annuities or life benefits, health benefits, accident benefits, pharmacy benefits, or workers’ compensation benefits, collects premiums or contributions from or adjusts or settles claims for residents of this state. The term includes a delegated entity under Chapter 1272 (Delegation of Certain Functions by Health Maintenance Organization) and a workers’ compensation health care network authorized under Chapter 1305 (Workers’ Compensation Health Care Networks) that administers a workers’ compensation claim for an insurer, including an insurer that establishes or contracts with the network to provide health care services. The term does not include a person described by Section 4151.002 (Exemptions).(2)
“Insurer” means a person who engages in the business of life, health, accident, or workers’ compensation insurance under the law of this state. For purposes of this chapter only, the term also includes an “insurance carrier,” as defined by Section 401.011 (General Definitions)(27), Labor Code, other than a governmental entity or a workers’ compensation self-insurance group subject to regulation under Chapter 407A (Group Self-insurance Coverage), Labor Code.(3)
“Person” means an individual, partnership, corporation, organization, government or governmental subdivision or agency, business trust, estate trust, association, or any other legal entity.(4)
“Plan” means a plan, fund, or program established, adopted, or maintained by a plan sponsor or insurer to the extent that the plan, fund, or program is established, adopted, or maintained to provide indemnification or expense reimbursement for any type of life, health, or accident benefit.(5)
“Plan sponsor” means a person, other than an insurer, who establishes, adopts, or maintains a plan that covers residents of this state, including a plan established, adopted, or maintained by two or more employers or jointly by one or more employers and one or more employee organizations, an association, a committee, a joint board of trustees, or any similar group of representatives who establish, adopt, or maintain a plan.(6)
“Workers’ compensation benefits” means benefits provided under Title 5, Labor Code, or services provided through a certified workers’ compensation health care network authorized under Chapter 1305 (Workers’ Compensation Health Care Networks).(7)
“Workers’ compensation insurance coverage” means coverage subject to Subtitle E, Title 10. The term includes coverage described by Sections 401.011 (General Definitions)(44)(A) and (B), Labor Code.(8)
“Workers’ compensation self-insurer” means a legal entity subject to regulation under Chapter 407 (Self-insurance Regulation), Labor Code.
Source:
Section 4151.001 — Definitions, https://statutes.capitol.texas.gov/Docs/IN/htm/IN.4151.htm#4151.001 (accessed May 18, 2024).
