Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES
Subchapter BB - PHARMACEUTICAL SERVICES
Section 3.4202 - Definitions
Current through Reg. 50, No. 13; March 28, 2025
The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise.
(1) Health insurance policy--An individual, group, blanket, or franchise insurance policy, insurance policy or agreement, or group hospital service contract that provides benefits for pharmaceutical services that are necessary as a result of or to prevent an accident or sickness. The term does not include evidence of coverage provided by a health maintenance organization under the Health Maintenance Organization Act (the Insurance Code, Chapter 20A). The term includes a health insurance policy that incorporates a preferred provider benefit plan.
(2) Insurer--Any life, health and accident; health and accident; or health insurance company or company operating pursuant to the Insurance Code, Chapters 3, 10, 20, 22 and 26 authorized to issue, deliver, issue for delivery or renew in this state health insurance policies approved under the Insurance Code, Article 3.42.
(3) Pharmaceutical services--Services, including dispensing prescription drugs as defined in the Pharmacy Act, Texas Civil Statutes, Article 4542a-1, §5, that are ordinarily and customarily rendered by a pharmacy or pharmacist licensed to practice pharmacy under the Pharmacy Act, Texas Civil Statutes, Article 4542a-1. The term does not include mail order services.
(4) Pharmacist--A person licensed to practice pharmacy under the Pharmacy Act, Texas Civil Statutes, Article 4542a-1.
(5) Pharmacy--A facility licensed under the Pharmacy Act, Texas Civil Statutes, Article 4542a-1, §29.
