By Hernandez, Pitts H.B. No. 2379 74R6445 GCH-F A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to comparable health insurance coverage for employees of 1-3 public school districts. 1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-5 SECTION 1. Section 13.913(a), Education Code, is amended to 1-6 read as follows: 1-7 (a) Each district shall make available to its employees 1-8 group health coverage provided by a risk pool established by one or 1-9 more school districts under Chapter 172, Local Government Code, or 1-10 under a policy of insurance or group contract issued by an insurer, 1-11 a company subject to Chapter 20, Insurance Code, or a health 1-12 maintenance organization under the Texas Health Maintenance 1-13 Organization Act (Chapter 20A, Vernon's Texas Insurance Code). The 1-14 coverage must meet the substantive coverage requirements of Article 1-15 3.51-6, Insurance Code, and any other law applicable to group 1-16 health insurance policies or contracts issued in this state. The 1-17 coverage must include major medical treatment but may exclude 1-18 experimental procedures. In this subsection, "major medical 1-19 treatment" means a medical, surgical, or diagnostic procedure or 1-20 intervention that has a significant recovery period, presents a 1-21 significant risk, employs a general anesthetic, or, in the opinion 1-22 of the primary physician, involves a significant invasion of bodily 1-23 integrity that requires the extraction of bodily fluids or an 1-24 incision or that produces substantial pain, discomfort, or 2-1 debilitation. The coverage may include managed care or preventive 2-2 care and must be comparable to the basic health coverage provided 2-3 under the Texas Employees Uniform Group Insurance Benefits Act 2-4 (Article 3.50-2, Vernon's Texas Insurance Code). For purposes of 2-5 this subsection, coverage is comparable only if it is substantially 2-6 similar to the basic health coverage provided under the Texas 2-7 Employees Uniform Group Insurance Benefits Act. The cost of the 2-8 coverage may be shared by the employees and the district. Each 2-9 district shall certify the district's compliance with this 2-10 subsection to the executive director of the Teacher Retirement 2-11 System of Texas by February 1 of each year in the manner required 2-12 by the board of trustees of the Teacher Retirement System of Texas. 2-13 The certification must include a copy of the district's current 2-14 contract for group health coverage. The executive director of the 2-15 Teacher Retirement System of Texas shall determine whether a 2-16 district's coverage is comparable to the basic health coverage 2-17 provided under the Texas Employees Uniform Group Insurance Benefits 2-18 Act. The executive director shall make the determination from 2-19 factors that must include an examination of the entity underwriting 2-20 the district's plan, an accounting of all uninsured costs to or 2-21 copayments by the employee, district costs by employee and 2-22 category, the schedule of benefits including percentage of costs 2-23 paid by the insurer, and the length of service offered by the 2-24 insurance provider in the district. The Teacher Retirement System 2-25 of Texas shall report to the applicable school district and the 2-26 Legislative Budget Board those districts in which the executive 2-27 directors determine that the basic health coverage is not 3-1 comparable. 3-2 SECTION 2. This Act applies beginning with the 1995-1996 3-3 school year. 3-4 SECTION 3. The importance of this legislation and the 3-5 crowded condition of the calendars in both houses create an 3-6 emergency and an imperative public necessity that the 3-7 constitutional rule requiring bills to be read on three several 3-8 days in each house be suspended, and this rule is hereby suspended, 3-9 and that this Act take effect and be in force from and after its 3-10 passage, and it is so enacted.