By Stiles H.B. No. 530 75R2345 DLF-D A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to coverage for childhood immunizations under certain 1-3 health benefit 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 21.53F to read as follows: 1-7 Art. 21.53F. COVERAGE FOR CHILDHOOD IMMUNIZATIONS 1-8 Sec. 1. DEFINITION. In this article, "health benefit plan" 1-9 means a plan that provides benefits for medical or surgical 1-10 expenses incurred as a result of a health condition, accident, or 1-11 sickness and that is offered by any insurance company, group 1-12 hospital service corporation, or health maintenance organization 1-13 that delivers or issues for delivery an individual, group, blanket, 1-14 or franchise insurance policy or insurance agreement, a group 1-15 hospital service contract, or an evidence of coverage, or, to the 1-16 extent permitted by the Employee Retirement Income Security Act of 1-17 1974 (29 U.S.C. Section 1001 et seq.), by a multiple employer 1-18 welfare arrangement as defined by Section 3, Employee Retirement 1-19 Income Security Act of 1974 (29 U.S.C. Section 1002), or any other 1-20 analogous benefit arrangement. The term does not include: 1-21 (1) a plan that provides coverage: 1-22 (A) only for a specified disease; 1-23 (B) only for accidental death or dismemberment; 1-24 (C) for wages or payments in lieu of wages for a 2-1 period during which an employee is absent from work because of 2-2 sickness or injury; or 2-3 (D) as a supplement to liability insurance; 2-4 (2) a plan written under Chapter 26 of this code; 2-5 (3) a Medicare supplemental policy as defined by 2-6 Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss); 2-7 (4) workers' compensation insurance coverage; 2-8 (5) medical payment insurance issued as part of a 2-9 motor vehicle insurance policy; or 2-10 (6) a long-term care policy, including a nursing home 2-11 fixed indemnity policy, unless the commissioner determines that the 2-12 policy provides benefit coverage so comprehensive that the policy 2-13 meets the definition of a health benefit plan. 2-14 Sec. 2. REQUIRED BENEFIT FOR CHILDHOOD IMMUNIZATIONS. A 2-15 health benefit plan that provides benefits for a family member of 2-16 the insured shall provide coverage for each child of the insured, 2-17 from birth through the date the child is six years of age, for: 2-18 (1) immunization against: 2-19 (A) diphtheria; 2-20 (B) haemophilus influenzae type b; 2-21 (C) hepatitis B; 2-22 (D) measles; 2-23 (E) mumps; 2-24 (F) pertussis; 2-25 (G) polio; 2-26 (H) rubella; 2-27 (I) tetanus; and 3-1 (J) varicella; and 3-2 (2) any other immunization that the commissioner 3-3 determines to be required by law for the child. 3-4 Sec. 3. FIRST-DOLLAR COVERAGE REQUIRED. Benefits required 3-5 under Section 2 of this article may not be made subject to a 3-6 deductible, copayment, or coinsurance requirement. 3-7 SECTION 2. This Act takes effect September 1, 1997, and 3-8 applies only to a health benefit plan that is delivered, issued for 3-9 delivery, or renewed on or after January 1, 1998. A health 3-10 benefit plan that is delivered, issued for delivery, or renewed 3-11 before January 1, 1998, is governed by the law as it existed 3-12 immediately before the effective date of this Act, and that law is 3-13 continued in effect for this purpose. 3-14 SECTION 3. The importance of this legislation and the 3-15 crowded condition of the calendars in both houses create an 3-16 emergency and an imperative public necessity that the 3-17 constitutional rule requiring bills to be read on three several 3-18 days in each house be suspended, and this rule is hereby suspended.