| |
| |
|
|
A BILL TO BE ENTITLED
|
|
|
AN ACT
|
|
|
relating to the provision of certain historical claims data and |
|
|
other information to school districts and other participating |
|
|
entities in the Texas school employees uniform group health |
|
|
coverage program. |
|
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
|
SECTION 1. Subchapter A, Chapter 1579, Insurance Code, is |
|
|
amended by adding Section 1579.010 to read as follows: |
|
|
Sec. 1579.010. PARTICIPATING ENTITY REQUEST FOR CERTAIN |
|
|
INFORMATION. (a) Subject to Subsection (b), the trustee shall |
|
|
provide to a participating entity any historical claims data, |
|
|
enrollment information, or other relevant information available to |
|
|
the trustee as requested by the entity in connection with a search |
|
|
for alternative health benefit plan coverage for the entity's |
|
|
employees and the employees' dependents. The information provided |
|
|
must include, for each tier of group coverage and for the five-year |
|
|
period preceding the date of the request: |
|
|
(1) the monthly claims experience history; |
|
|
(2) information concerning the type of illness or |
|
|
injury and the ongoing status of the illness or injury for: |
|
|
(A) each medical claim that exceeds $50,000; and |
|
|
(B) each related series of medical claims for the |
|
|
same covered individual and for the same diagnosis that exceeds |
|
|
$50,000; |
|
|
(3) any other information requested by the |
|
|
participating entity concerning covered individuals who are |
|
|
responsible for a claim or claims that total a large amount, as |
|
|
specified by the requesting participating entity; |
|
|
(4) information concerning prescription drug claims |
|
|
and costs; and |
|
|
(5) plan enrollment. |
|
|
(b) The information provided by the trustee under this |
|
|
section may not include any personally identifying information of a |
|
|
covered individual, including any information that would identify a |
|
|
named covered individual as having a particular medical condition. |
|
|
(c) The trustee shall provide the information requested |
|
|
under this section at no cost to the requesting participating |
|
|
entity. |
|
|
SECTION 2. This Act takes effect immediately if it receives |
|
|
a vote of two-thirds of all the members elected to each house, as |
|
|
provided by Section 39, Article III, Texas Constitution. If this |
|
|
Act does not receive the vote necessary for immediate effect, this |
|
|
Act takes effect September 1, 2021. |