| (a) Each single service HMO must provide uniquely described
services with any corresponding copayments for each covered service
and benefit and must provide a single health care service plan as
defined in Insurance Code §843.002 (concerning Definitions).
Each single service HMO must comply with all requirements for a single
health care service plan specified in this subchapter.
(b) Each single service HMO schedule of enrollee copayments
must specify an appropriate description of covered services and benefits,
as required by §11.506 of this title (relating to Mandatory Contractual
Provisions: Group, Individual, and Conversion Agreement and Group
Certificate), and may specify recognized procedures or other information
used for the purpose of maintaining a statistical reporting system.
(c) Each single service HMO evidence of coverage must
include a glossary of terminology, including the terms used in the
evidence of coverage required by §11.501 of this title (relating
to Contents of the Evidence of Coverage). The glossary must be included
in the information to prospective and current group contract holders
and enrollees, as required by Insurance Code §843.201 (concerning
Disclosure of Information About Health Care Plan Terms).
(d) In the event of a conflict between the provisions
of this subchapter and other provisions of this chapter, this subchapter
prevails with regard to single service HMOs. It is not considered
a conflict if a topic that is not addressed in this subchapter appears
elsewhere in this chapter.
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