By: Hochberg H.B. No. 2011 73R3125 DLF-D A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to the application of preexisting condition provisions in 1-3 certain group health plans. 1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-5 SECTION 1. Subchapter E, Chapter 21, Insurance Code, is 1-6 amended by adding Article 21.52C to read as follows: 1-7 Art. 21.52C. PREEXISTING CONDITION PROVISIONS 1-8 Sec. 1. DEFINITIONS. In this article: 1-9 (1) "Group health insurer" means a person that 1-10 delivers, issues for delivery, or renews a group health plan in 1-11 this state. 1-12 (2) "Group health plan" means a group health insurance 1-13 policy, group hospital service contract, or group contract issued 1-14 by a health maintenance organization that provides benefits for 1-15 medical or surgical expenses incurred as a result of an accident or 1-16 sickness. 1-17 (3) "Preexisting condition provision" means a 1-18 provision in a group health plan that excludes coverage for 1-19 expenses incurred during a specified period following the effective 1-20 date of an individual's coverage for a condition that was manifest 1-21 during a specified period before that effective date. 1-22 (4) "Waiting period" means the specified period 1-23 following the effective date of an individual's coverage during 1-24 which a preexisting condition provision applies. 2-1 Sec. 2. EFFECTIVE PERIOD OF PREEXISTING CONDITION PROVISION 2-2 REDUCED. A group health insurer shall reduce the length of the 2-3 waiting period for an individual by the number of days the 2-4 individual was covered by a previous group health plan if, not 2-5 later than the 60th day after the date the individual's coverage 2-6 under the previous group health plan terminated, the individual: 2-7 (1) becomes eligible and applies for coverage under 2-8 the group health insurer's plan; or 2-9 (2) is covered under the group health insurer's plan. 2-10 SECTION 2. This Act takes effect September 1, 1993, and 2-11 applies only to a group health plan that is delivered, issued for 2-12 delivery, or renewed on or after January 1, 1994. A group health 2-13 plan that is delivered, issued for delivery, or renewed before 2-14 January 1, 1994, is governed by the law as it existed immediately 2-15 before the effective date of this Act, and that law is continued in 2-16 effect for that purpose. 2-17 SECTION 3. The importance of this legislation and the 2-18 crowded condition of the calendars in both houses create an 2-19 emergency and an imperative public necessity that the 2-20 constitutional rule requiring bills to be read on three several 2-21 days in each house be suspended, and this rule is hereby suspended.