Tex. Ins. Code §§ 1271.051 through 1271.057: Benefits Provided By Health Maintenance Organizations; Evidence of Coverage; Charges – Texas

Status: Enacted
Year Enacted: 2003
File: Download

An evidence of coverage that is a contract must contain a clear and complete statement of the information required by Sections 1271.052, 1271.053, and 1271.054. It is also a certification. The EOC must contain a provision about out of network services. If medically necessary covered services are not available through network physicians or providers, the health maintenance organization, on the request of a network physician or provider and within a reasonable period allow coverage through out of network providers.

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