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A BILL TO BE ENTITLED
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AN ACT
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relating to a prohibition on the use of genetic information |
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gathered from direct-to-consumer genetic tests by a long-term care |
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benefit plan issuer or a life insurance company. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subtitle C, Title 5, Insurance Code, is amended |
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by adding Chapter 564 to read as follows: |
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CHAPTER 564. USE OF GENETIC INFORMATION GATHERED FROM |
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DIRECT-TO-CONSUMER GENETIC TEST |
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Sec. 564.001. APPLICABILITY OF CHAPTER. (a) This chapter |
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applies only to: |
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(1) an individual long-term care benefit plan that is |
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delivered or issued for delivery in this state; |
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(2) a group long-term care benefit plan that is: |
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(A) delivered or issued for delivery in this |
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state; and |
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(B) issued to an eligible group as described by |
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Subchapter B, Chapter 1251; |
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(3) an evidence of coverage delivered or issued for |
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delivery in this state for long-term care; and |
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(4) a life insurance policy issued or delivered in |
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this state. |
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(b) This chapter applies only to a policy, certificate, or |
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evidence of coverage that is issued by: |
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(1) a capital stock insurance company, including a |
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life, health and accident, or general casualty insurance company; |
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(2) a mutual life insurance company; |
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(3) a mutual assessment life insurance company, |
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including a statewide mutual assessment corporation, local mutual |
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aid association, and burial association; |
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(4) a mutual or mutual assessment association, |
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including an association subject to Section 887.101; |
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(5) a mutual insurance company other than a life |
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insurance company; |
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(6) a mutual or natural premium life or casualty |
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insurance company; |
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(7) a fraternal benefit society; |
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(8) a Lloyd's plan insurer; |
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(9) a reciprocal or interinsurance exchange; |
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(10) a nonprofit medical, hospital, or dental service |
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corporation, including a company subject to Chapter 842; |
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(11) a stipulated premium company; |
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(12) a health maintenance organization under Chapter |
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843; or |
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(13) another insurer required to be licensed by the |
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department. |
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Sec. 564.002. EXEMPTIONS. This chapter does not apply to: |
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(1) a group policy or certificate that is delivered or |
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issued for delivery in this state under a single employer or labor |
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union group policy that is delivered or issued for delivery outside |
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this state; or |
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(2) a benefit plan, including a health benefit plan, |
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that is not advertised, marketed, or offered as a long-term care |
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benefit plan or nursing home benefit plan. |
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Sec. 564.003. LONG-TERM CARE BENEFIT PLAN DEFINED. (a) In |
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this chapter, "long-term care benefit plan" means an insurance |
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policy or group certificate, or rider to the policy or certificate, |
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or evidence of coverage issued by a health maintenance organization |
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subject to Chapter 843, that is advertised or marketed as |
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providing, or offered or designed to provide, coverage for not less |
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than 12 consecutive months for each covered individual on an |
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expense-incurred, indemnity, prepaid, or other basis for one or |
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more necessary or medically necessary diagnostic, preventive, |
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therapeutic, rehabilitative, maintenance, or personal care |
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services provided in a setting other than an acute care unit of a |
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hospital. |
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(b) The term includes a plan or rider, other than a group or |
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individual annuity or life insurance policy, that provides for |
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payment of benefits based on cognitive impairment or the loss of |
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functional capacity. |
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(c) The term does not include an insurance policy, group |
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certificate, or evidence of coverage that is offered primarily to |
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provide: |
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(1) basic Medicare supplement coverage, basic |
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hospital expense coverage, basic medical-surgical expense |
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coverage, hospital confinement indemnity coverage, major medical |
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expense coverage, disability income protection coverage, |
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accident-only coverage, specified disease or specified accident |
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coverage, or limited benefit health coverage; or |
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(2) basic or single health care services. |
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Sec. 564.004. USE OF INFORMATION GATHERED FROM |
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DIRECT-TO-CONSUMER GENETIC TESTS PROHIBITED. (a) In this section, |
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"direct-to-consumer genetic test" means a genetic test that is |
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marketed directly to consumers using television, print |
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advertisements, or the Internet and that may be purchased directly |
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by a consumer. |
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(b) Without written consent from an individual applying for |
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coverage under a long-term care benefit plan or life insurance |
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policy, a long-term care benefit plan issuer or life insurance |
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company may not: |
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(1) require the individual to furnish genetic |
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information gathered from a direct-to-consumer genetic test; or |
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(2) use genetic information gathered from a |
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direct-to-consumer genetic test to reject, deny, limit, increase |
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the premiums for, or otherwise adversely affect eligibility for or |
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coverage under the plan or policy. |
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(c) Nothing in this section may be construed to prohibit or |
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limit the ability of an insurer to request and obtain medical |
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information from an individual applying for insurance. |
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SECTION 2. Chapter 564, Insurance Code, as added by this |
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Act, applies only to an insurance policy, contract, or evidence of |
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coverage that is delivered, issued for delivery, or renewed on or |
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after January 1, 2022. A policy, contract, or evidence of coverage |
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delivered, issued for delivery, or renewed before January 1, 2022, |
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is governed by the law as it existed immediately before the |
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effective date of this Act, and that law is continued in effect for |
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that purpose. |
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SECTION 3. This Act takes effect September 1, 2021. |