The following words and terms, when used in this Division, shall have the following meanings, unless the context clearly indicates otherwise. (1) Claims corridor--Claims paid on behalf of a covered person in excess of $5,000 and less than $75,000 per calendar year. (2) Claims paid--Claims paid by a participating health benefit plan issuer pursuant to a qualifying health benefit plan issued under the Healthy Texas Program as determined by the date of payment rather than the date of service or date the claim was incurred. (3) Claims threshold--The aggregate amount that a participating health benefit plan issuer must pay out as claims paid before reaching the claims corridor and becoming eligible for reimbursement on behalf of an enrollee in a given calendar year. |
