SRC-JFA S.B. 172 75(R)    BILL ANALYSIS


Senate Research CenterS.B. 172
By: Zaffirini
Health & Human Services
1-21-97
As Filed


DIGEST 

Currently, Texas law requires immunizations of children by the time they
enter school, which is generally when they are six years old.  The
Insurance Code does not require health benefit plans to pay for
immunizations of children of those insured.  This bill would require
certain health benefit plans to pay for certain immunizations of  children
between the years of 0 to 6 of those insured by the plans. 

PURPOSE

As proposed, S.B. 172 requires certain health care plans to provide
childhood immunizations for certain diseases without requiring the insured
to pay a deductible, copayment, or coinsurance requirement.   

RULEMAKING AUTHORITY

This bill does not grant any additional rulemaking authority to a state
officer, institution, or agency. 

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Chapter 21E, Insurance Code, by adding Article 21.53F,
as follows: 

Art. 21.53F.  COVERAGE FOR CHILDHOOD IMMUNIZATIONS

Sec.  1.  DEFINITION.  Defines "health benefit plan." 

Sec.  2.  SCOPE OF ARTICLE.  Sets forth the health benefit plans that are
within the scope of this article and those that are not within the scope
of this article.  Provides that a long-term care policy is not within the
scope of this article unless the commissioner of the Texas Department of
Insurance (commissioner) determines that such a policy is comprehensive
enough to be within the scope of this article.   

Sec.  3.  REQUIRED BENEFIT FOR CHILDHOOD IMMUNIZATIONS.  Requires a health
benefit plan that provides benefits for a family member of the insured to
provide immunization for each newly born child of the insured, between the
ages of 0 to 6 years, for diphtheria, haemophilus influenzae type b;
hepatitis B; measles; mumps; pertussis; polio; rubella; tetanus;
varicella; and any other immunization that the commissioner determines to
be required by law for the child.  

Sec.  4.  FIRST DOLLAR COVERAGE REQUIRED.  Prohibits the benefits required
under Section 3 from being made subject to a deductible, copayment, or
coinsurance requirement.  

SECTION 2. Effective date: September 1, 1997. 
  Makes application of this Act prospective to January 1, 1998.

SECTION 3. Emergency clause.