By Smithee H.B. No. 2361
74R2451 DLF-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to health insurance for employees of certain small
1-3 employers.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Article 26.02(23), Insurance Code, is amended to
1-6 read as follows:
1-7 (23) "Small employer health benefit plan" means the
1-8 preventive and primary care benefit plan, the in-hospital benefit
1-9 plan, or the standard health benefit plan described by Subchapter E
1-10 of this chapter. The term does not include a nonstandard <or any
1-11 other> health benefit plan offered to the employees of a small
1-12 employer in accordance with Subchapter H of this chapter <Article
1-13 26.42(d) of this code>.
1-14 SECTION 2. Article 26.06(a), Insurance Code, is amended to
1-15 read as follows:
1-16 (a) Except as provided by Subchapter H of this chapter, an
1-17 <An> individual or group health benefit plan is subject to this
1-18 chapter if it provides health care benefits covering three or more
1-19 eligible employees of a small employer and if it meets any one of
1-20 the following conditions:
1-21 (1) a portion of the premium or benefits is paid by or
1-22 on behalf of a small employer;
1-23 (2) a covered individual is reimbursed, whether
1-24 through wage adjustments or otherwise, by or on behalf of a small
2-1 employer for a portion of the premium; or
2-2 (3) the health benefit plan is treated by the employer
2-3 or by a covered individual as part of a plan or program for the
2-4 purposes of Section 106 or 162, Internal Revenue Code of 1986 (26
2-5 U.S.C. Section 106 or 162).
2-6 SECTION 3. Article 26.42(d), Insurance Code, is amended to
2-7 read as follows:
2-8 (d) Subject to Subchapter H <the provisions> of this
2-9 chapter, a small employer carrier may also offer to small employers
2-10 any other health benefit plan <authorized under this code. Article
2-11 26.06(c) does not apply to a health benefit plan offered to a small
2-12 employer under this subsection>.
2-13 SECTION 4. Chapter 26, Insurance Code, is amended by adding
2-14 Subchapter H to read as follows:
2-15 SUBCHAPTER H. NONSTANDARD HEALTH BENEFIT PLANS
2-16 Art. 26.91. SMALL EMPLOYER MAY OFFER NONSTANDARD PLAN. A
2-17 small employer may offer a nonstandard health benefit plan to the
2-18 employees of the employer under this subchapter.
2-19 Art. 26.92. APPLICABILITY OF OTHER LAWS. (a) A nonstandard
2-20 health benefit plan offered under this subchapter is not subject to
2-21 Subchapters B-G of this chapter.
2-22 (b) A nonstandard health benefit plan offered under this
2-23 subchapter is not subject to a law that requires:
2-24 (1) coverage or the offer of coverage of a health care
2-25 service or benefit;
2-26 (2) coverage of a particular percentage or number of
2-27 employees; or
3-1 (3) payment by the small employer of any portion of
3-2 the premium for the coverage.
3-3 Art. 26.93. NOTICE TO EMPLOYEES. Before providing coverage
3-4 to employees under a nonstandard health benefit plan, a small
3-5 employer must notify the employees:
3-6 (1) that coverage will be provided under a nonstandard
3-7 health benefit plan;
3-8 (2) what portion of the premium the employer will pay,
3-9 if any; and
3-10 (3) that the health benefit plan is not subject to a
3-11 law described by Article 26.92(b) of this code.
3-12 Art. 26.94. PORTABILITY. (a) A nonstandard health benefit
3-13 plan issued under this subchapter must include an option for each
3-14 person covered by the plan to be covered under an individual
3-15 contract providing identical coverage if, for any reason:
3-16 (1) the benefit plan is not renewed;
3-17 (2) the employment of the employee terminates;
3-18 (3) coverage of the employee under the nonstandard
3-19 health benefit plan otherwise terminates.
3-20 (b) The individual to be covered under the individual
3-21 contract is responsible for payment of premiums under the
3-22 individual contract.
3-23 (c) The commissioner may adopt rules to implement this
3-24 article.
3-25 SECTION 5. This Act takes effect September 1, 1995, and
3-26 applies only to an insurance policy that is delivered, issued for
3-27 delivery, or renewed on or after January 1, 1996. A policy that is
4-1 delivered, issued for delivery, or renewed before January 1, 1996,
4-2 is governed by the law as it existed immediately before the
4-3 effective date of this Act, and that law is continued in effect for
4-4 that purpose.
4-5 SECTION 6. The importance of this legislation and the
4-6 crowded condition of the calendars in both houses create an
4-7 emergency and an imperative public necessity that the
4-8 constitutional rule requiring bills to be read on three several
4-9 days in each house be suspended, and this rule is hereby suspended.