# Tex. Insurance Code § 1451.252: APPLICABILITY OF SUBCHAPTER

> Texas · Statutes · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1451_S1451.252

## Section

- **Citation:** Tex. Insurance Code § 1451.252
- **Heading:** APPLICABILITY OF SUBCHAPTER
- **Jurisdiction:** Texas
- **Kind:** Statutes
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** TX Code / Code in / Chapter 1451 / Section 1451.252

## Text

This subchapter applies only to a health benefit plan that requires an enrollee to obtain certain specialty health care services through a referral made by a primary care physician or other gatekeeper and that:

(1) provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness, including:

(A) an individual, group, blanket, or franchise insurance policy or insurance agreement, a group hospital service contract, or an individual or group evidence of coverage that is offered by:

(i) an insurance company;

(ii) a group hospital service corporation operating under Chapter 842;

(iii) a fraternal benefit society operating under Chapter 885;

(iv) a stipulated premium company operating under Chapter 884; or

(v) a health maintenance organization operating under Chapter 843; and

(B) to the extent permitted by the Employee Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.), a health benefit plan that is offered by:

(i) a multiple employer welfare arrangement as defined by Section 3 of that Act; or

(ii) another analogous benefit arrangement;

(2) is offered by:

(A) an approved nonprofit health corporation that holds a certificate of authority under Chapter 844; or

(B) an entity that is not authorized under this code or another insurance law of this state that contracts directly for health care services on a risk-sharing basis, including a capitation basis; or

(3) provides health and accident coverage through a risk pool created under Chapter 172, Local Government Code, notwithstanding Section 172.014, Local Government Code, or any other law.

## Nearby sections

- [Tex. Insurance Code § 1451.001 § 1451.001. DEFINITIONS; HEALTH CARE PRACTITIONERS.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1451_S1451.001.md)
- [Tex. Insurance Code § 1451.051 § 1451.051. APPLICABILITY OF SUBCHAPTER.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1451_S1451.051.md)
- [Tex. Insurance Code § 1451.052 § 1451.052. APPLICABILITY OF GENERAL PROVISIONS OF OTHER LAW.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1451_S1451.052.md)
- [Tex. Insurance Code § 1451.053 § 1451.053. PRACTITIONER DESIGNATION.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1451_S1451.053.md)
- [Tex. Insurance Code § 1451.054 § 1451.054. TERMS USED TO DESIGNATE HEALTH CARE PRACTITIONERS.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1451_S1451.054.md)
- [Tex. Insurance Code § 1451.101 § 1451.101. DEFINITIONS.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1451_S1451.101.md)
- [Tex. Insurance Code § 1451.102 § 1451.102. APPLICABILITY OF SUBCHAPTER.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1451_S1451.102.md)
- [Tex. Insurance Code § 1451.103 § 1451.103. CONFLICTING PROVISIONS VOID.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1451_S1451.103.md)
- [Tex. Insurance Code § 1451.104 § 1451.104. NONDISCRIMINATORY PAYMENT OR REIMBURSEMENT; EXCEPTION.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1451_S1451.104.md)
- [Tex. Insurance Code § 1451.105 § 1451.105. SELECTION OF ACUPUNCTURIST.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1451_S1451.105.md)
- [Tex. Insurance Code § 1451.106 § 1451.106. SELECTION OF ADVANCED PRACTICE NURSE.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1451_S1451.106.md)
- [Tex. Insurance Code § 1451.107 § 1451.107. SELECTION OF AUDIOLOGIST.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1451_S1451.107.md)
- [Tex. Insurance Code § 1451.108 § 1451.108. SELECTION OF CHEMICAL DEPENDENCY COUNSELOR.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1451_S1451.108.md)
- [Tex. Insurance Code § 1451.109 § 1451.109. SELECTION OF CHIROPRACTOR.](https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1451_S1451.109.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_TX_Cin_C1451_S1451.252. Check the current official text before relying on it. Not legal advice.