By Madden H.B. No. 712
75R2774 DLF-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to discrimination against employees in certain businesses
1-3 in the issuance of a group health benefit plan.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Subchapter B, Chapter 21, Insurance Code, is
1-6 amended by adding Article 21.21-9 to read as follows:
1-7 Art. 21.21-9. DISCRIMINATION AGAINST CERTAIN BUSINESSES IN
1-8 ISSUANCE OF GROUP HEALTH BENEFIT PLAN
1-9 Sec. 1. DEFINITION. In this article, "group health benefit
1-10 plan" means a plan described by Section 2 of this article.
1-11 Sec. 2. SCOPE OF ARTICLE. (a) This article applies only to
1-12 a group health benefit plan that provides benefits for medical or
1-13 surgical expenses incurred as a result of a health condition,
1-14 accident, or sickness, including a group, blanket, or franchise
1-15 insurance policy or insurance agreement, a group hospital service
1-16 contract, or a group evidence of coverage that is offered by:
1-17 (1) an insurance company;
1-18 (2) a group hospital service corporation operating
1-19 under Chapter 20 of this code;
1-20 (3) a stipulated premium insurance company operating
1-21 under Chapter 22 of this code; or
1-22 (4) a health maintenance organization operating under
1-23 the Texas Health Maintenance Organization Act (Chapter 20A,
1-24 Vernon's Texas Insurance Code).
2-1 (b) This article does not apply to:
2-2 (1) a plan that provides coverage:
2-3 (A) only for a specified disease;
2-4 (B) only for accidental death or dismemberment;
2-5 (C) for wages or payments in lieu of wages for a
2-6 period during which an employee is absent from work because of
2-7 sickness or injury; or
2-8 (D) as a supplement to liability insurance;
2-9 (2) a plan written under Chapter 26 of this code;
2-10 (3) a Medicare supplemental policy as defined by
2-11 Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);
2-12 (4) workers' compensation insurance coverage;
2-13 (5) medical payment insurance issued as part of a
2-14 motor vehicle insurance policy; or
2-15 (6) a long-term care policy, including a nursing home
2-16 fixed indemnity policy, unless the commissioner determines that the
2-17 policy provides benefit coverage so comprehensive that the policy
2-18 is a group health benefit plan as described by Subsection (a) of
2-19 this section.
2-20 Sec. 3. DISCRIMINATION WITHIN BUSINESS OR INDUSTRY
2-21 PROHIBITED. (a) If a health benefit plan provider provides
2-22 coverage under a group health benefit plan to the employees of an
2-23 employer engaged in a particular business or industry, the provider
2-24 may not refuse to issue or renew a group health benefit plan
2-25 covering the employees of another employer engaged in the same
2-26 business or industry solely because of:
2-27 (1) the particular business or industry; or
3-1 (2) the number of employees.
3-2 (b) Notwithstanding Subsection (a)(1) of this section, a
3-3 health benefit plan provider may refuse to issue or renew a group
3-4 health benefit plan covering the employees of an employer engaged
3-5 in a particular business or industry after the provider notifies
3-6 the commissioner in writing that the provider intends to cease
3-7 issuing and renewing all group health benefit plans for employees
3-8 in that business or industry.
3-9 Sec. 4. UNFAIR ACT. A person who violates this article
3-10 commits an unfair act in the business of insurance for purposes of
3-11 Article 21.21 of this code and is subject to the sanctions imposed
3-12 under that article. A person who has sustained actual damages as a
3-13 result of the violation is entitled to relief under Section 16,
3-14 Article 21.21, of this code.
3-15 SECTION 2. This Act takes effect September 1, 1997, and
3-16 applies only to conduct occurring on or after that date. Conduct
3-17 occurring before the effective date of this Act is governed by the
3-18 law as it existed immediately before that effective date, and that
3-19 law is continued in effect for that purpose.
3-20 SECTION 3. The importance of this legislation and the
3-21 crowded condition of the calendars in both houses create an
3-22 emergency and an imperative public necessity that the
3-23 constitutional rule requiring bills to be read on three several
3-24 days in each house be suspended, and this rule is hereby suspended.