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A BILL TO BE ENTITLED
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AN ACT
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relating to the eligibility of certain individuals to purchase |
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Medicare supplement benefit plans at the lowest standard premium |
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rate. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter A, Chapter 1652, Insurance Code, is |
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amended by adding Section 1652.006 to read as follows: |
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Sec. 1652.006. RATE REQUIREMENTS FOR POLICIES OFFERED AT |
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CERTAIN PERIODS. (a) In this section: |
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(1) "Entity" means an entity that delivers or issues |
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for delivery a Medicare supplement benefit plan in this state. |
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(2) "Substantially comparable plan" means a Medicare |
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supplement benefit plan that is of the same tier as another Medicare |
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supplement benefit plan as provided by Subsection (b). |
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(b) For purposes of this section: |
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(1) a Medicare supplement benefit plan is considered a |
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"tier one plan" if the plan is identified by the department as Plan |
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C, D, E, F except for high-deductible F, G except for |
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high-deductible G, I, J, M, or N; |
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(2) a Medicare supplement benefit plan is considered a |
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"tier two plan" if the plan is identified by the department as Plan |
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A or B; and |
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(3) a Medicare supplement benefit plan is considered a |
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"tier three plan" if the plan is identified by the department as |
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high-deductible Plan F or G or Plan K or L. |
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(c) Except as provided by Subsection (f), an entity shall |
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offer a plan at the lowest standard premium rate charged for that |
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plan if: |
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(1) on the date an applicant applies for the plan, the |
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applicant is covered by a substantially comparable plan; and |
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(2) the applicant applies for the plan during the |
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applicant's eligibility period described by Subsection (d). |
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(d) An applicant is eligible under Subsection (c) for a |
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period occurring once every five years, beginning the year in which |
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the applicant's 70th birthday occurs. The eligibility period: |
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(1) begins on the first day of the applicant's birth |
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month; and |
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(2) ends on the last day of the second month that |
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follows the applicant's birth month. |
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(e) An entity may not deny coverage or offer a plan to which |
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this section applies at a higher premium rate based on the |
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applicant's: |
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(1) height; |
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(2) weight; or |
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(3) medical history except for age and tobacco use. |
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(f) Notwithstanding Subsection (c), an entity may charge a |
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higher standard rate for tobacco users than non-tobacco users. |
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SECTION 2. The changes in law made by this Act apply only to |
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a Medicare supplement benefit plan delivered, issued for delivery, |
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or renewed on or after January 1, 2022. |
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SECTION 3. This Act takes effect September 1, 2021. |