By Maxey H.B. No. 813
75R4561 DLF-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to rates for insurance provided under the Small Employer
1-3 Health Insurance Availability Act.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Subchapter D, Chapter 26, Insurance Code, is
1-6 amended to read as follows:
1-7 SUBCHAPTER D. UNDERWRITING AND RATING
1-8 Art. 26.31. COMMUNITY RATING. (a) A small employer carrier
1-9 shall develop rates applicable to a small employer health benefit
1-10 plan based on an adjusted community rate and may vary the adjusted
1-11 community rate only for:
1-12 (1) geographic area;
1-13 (2) family composition; and
1-14 (3) age.
1-15 (b) The adjustment for age under Subsection (a)(3) of this
1-16 article may not be based on age brackets smaller than five-year
1-17 increments. The age brackets must begin with age 30 and end with
1-18 age 65.
1-19 (c) A small employer carrier may charge the lowest allowable
1-20 adult rate for child-only coverage.
1-21 (d) A small employer carrier may develop separate rates for
1-22 individuals older than 65 years of age for coverage for which
1-23 Medicare is the primary payer and coverage for which Medicare is
1-24 not the primary payer. These rates are subject to this article.
2-1 (e) The adjustments under Subsection (a)(3) of this article
2-2 to the rates for a health benefit plan may not result in a rate
2-3 per enrollee for the health benefit plan of more than:
2-4 (1) 400 percent of the lowest rate for all adult age
2-5 groups under the plan before January 1, 2000;
2-6 (2) 300 percent of the lowest rate for all adult age
2-7 groups under the plan on and after January 1, 2000, but before
2-8 January 1, 2003; and
2-9 (3) 200 percent of the lowest rate for all adult age
2-10 groups under the plan, on and after January 1, 2003.
2-11 [ESTABLISHMENT OF CLASSES OF BUSINESS. (a) A small employer
2-12 carrier may establish a separate class of business only to reflect
2-13 substantial differences in expected claim experience or
2-14 administrative costs related to the following reasons:]
2-15 [(1) the small employer carrier uses more than one
2-16 type of system for the marketing and sale of small employer health
2-17 benefit plans to small employers;]
2-18 [(2) the small employer carrier has acquired a class
2-19 of business from another health carrier; or]
2-20 [(3) the small employer carrier provides coverage to
2-21 one or more employer-based association groups.]
2-22 [(b) A small employer carrier may establish up to nine
2-23 separate classes of business under this article.]
2-24 [(c) The commissioner may establish regulations to provide
2-25 for a period of transition in order for a small employer carrier to
2-26 come into compliance with Subsection (b) of this article in the
2-27 instance of acquisition of an additional class of business from
3-1 another small employer carrier.]
3-2 [(d) The commissioner may approve the establishment of
3-3 additional classes of business on application to the commissioner
3-4 and a finding by the commissioner that the establishment of
3-5 additional classes would enhance the efficiency and fairness of the
3-6 insurance market for small employers.]
3-7 [(e) A small employer carrier may not establish a separate
3-8 class of business based on participation requirements.]
3-9 [(f) A small employer carrier may not establish a separate
3-10 class of business based on whether the coverage provided to a small
3-11 employer group is provided on a guaranteed issue basis or is
3-12 subject to underwriting or proof of insurability.]
3-13 Art. 26.32. APPLICATION OF RATING FACTORS. The small
3-14 employer carrier shall use rating factors that produce premiums for
3-15 identical groups that differ only by the amounts attributable to
3-16 plan design and that do not reflect differences in the nature of
3-17 the groups. [INDEX RATES. (a) The premium rates for a small
3-18 employer health benefit plan are subject to this article.]
3-19 [(b) The index rate for a rating period for any class of
3-20 business may not exceed the index rate for any other class of
3-21 business by more than 20 percent.]
3-22 [(c) For a class of business, the premium rates charged
3-23 during a rating period to small employers with similar case
3-24 characteristics for the same or similar coverage, or the rates that
3-25 could be charged to those employers under the rating system for
3-26 that class of business, may not vary from the index rate by more
3-27 than 25 percent.]
4-1 Art. 26.33. FREQUENCY OF ADJUSTMENT TO RATES. A small
4-2 employer carrier may not adjust the rates charged for a small
4-3 employer health benefit plan more frequently than annually, except
4-4 that the rates may be changed to reflect changes to:
4-5 (1) the enrollment of a small employer;
4-6 (2) the family composition of an eligible employee; or
4-7 (3) the health benefit plan, if the changes to the
4-8 plan are requested by an eligible employee. [PREMIUM RATES;
4-9 ADJUSTMENTS. (a) The percentage increase in the premium rate
4-10 charged to a small employer for a new rating period may not exceed
4-11 the sum of:]
4-12 [(1) the percentage change in the new business premium
4-13 rate measured from the first day of the prior rating period to the
4-14 first day of the new rating period;]
4-15 [(2) any adjustment, not to exceed 15 percent annually
4-16 and adjusted pro rata for rating periods of less than one year, due
4-17 to the claim experience, health status, or duration of coverage of
4-18 the employees or dependents of the small employer as determined
4-19 from the small employer carrier's rate manual for the class of
4-20 business; and]
4-21 [(3) any adjustment due to change in coverage or
4-22 change in the case characteristics of the small employer as
4-23 determined from the small employer carrier's rate manual for the
4-24 class of business.]
4-25 [(b) Adjustments in premium rates for claim experience,
4-26 health status, or duration of coverage may not be charged to
4-27 individual employees or dependents. Such an adjustment must be
5-1 applied uniformly to the rates charged for all employees and
5-2 dependents of employees of the small employer.]
5-3 [(c) A health carrier may use the industry classification to
5-4 which a small employer belongs as a case characteristic in
5-5 establishing premium rates, but the highest rate factor associated
5-6 with any industry classification may not exceed the lowest rate
5-7 factor associated with any industry classification by more than 15
5-8 percent.]
5-9 Art. 26.34. RATES NOT AFFECTED BY ASSESSMENT. The rates
5-10 charged by a small employer carrier must comply with this
5-11 subchapter without regard to whether the carrier is required to pay
5-12 an assessment under Subchapter F of this chapter [EFFECT OF PRIOR
5-13 COVERAGE. For a health benefit plan delivered or issued for
5-14 delivery before September 1, 1993, a premium rate for a rating
5-15 period may exceed the ranges set forth in Articles 26.32 and 26.33
5-16 of this code until September 1, 1995. The percentage increase in
5-17 the premium rate charged to a small employer under this article for
5-18 a new rating period may not exceed the sum of:]
5-19 [(1) the percentage change in the new business premium
5-20 rate measured from the first day of the prior rating period to the
5-21 first day of the new rating period; and]
5-22 [(2) any adjustment due to change in coverage or
5-23 change in the case characteristics of the small employer as
5-24 determined from the small employer carrier's rate manual for the
5-25 class of business].
5-26 Art. 26.35. RATE ADJUSTMENT IN CLOSED PLAN. In the case of
5-27 a health benefit plan into which a small employer carrier is no
6-1 longer enrolling new small employers, the small employer carrier
6-2 shall use the percentage change in the [base] premium rate to
6-3 adjust rates under Article 26.31 [Articles 26.33(a)(1) and
6-4 26.34(1)] of this code. The portion of change in rates computed
6-5 under that article [those subdivisions] may not exceed, on a
6-6 percentage basis, the change in the [new business premium] rate for
6-7 the most similar health benefit plan into which the small employer
6-8 carrier is actively enrolling new small employers.
6-9 Art. 26.36. [PREMIUM RATES; NONDISCRIMINATION. (a) A small
6-10 employer carrier shall apply rating factors, including case
6-11 characteristics, consistently with respect to all small employers
6-12 in a class of business. Rating factors shall produce premiums for
6-13 identical groups that differ only by the amounts attributable to
6-14 plan design and that do not reflect differences due to the nature
6-15 of the groups assumed to select particular health benefit plans.]
6-16 [(b) A small employer carrier shall treat each health
6-17 benefit plan issued or renewed in the same calendar month as having
6-18 the same rating period.]
6-19 [(c) A small employer carrier may not use case
6-20 characteristics without the prior approval of the commissioner
6-21 other than the geographic area in which the small employer's
6-22 employees reside, the age and gender of the individual employees
6-23 and their dependents, the appropriate industry classification, and
6-24 the number of employees and dependents.]
6-25 [(d) Premium rates for a small employer health benefit plan
6-26 must comply with the requirements of this chapter, notwithstanding
6-27 any assessments paid or payable by small employer carriers.]
7-1 [(e) The board may adopt rules to implement this article and
7-2 to ensure that rating practices used by small employer carriers are
7-3 consistent with the purposes of this chapter, including rules that
7-4 ensure that differences in rates charged for each small employer
7-5 health benefit plan are reasonable and reflect objective
7-6 differences in plan design.]
7-7 [(f) A small employer carrier may not transfer a small
7-8 employer involuntarily into or out of a class of business. A small
7-9 employer carrier may not offer to transfer a small employer into or
7-10 out of a class of business unless the offer is made to transfer all
7-11 small employers in that class of business without regard to case
7-12 characteristics, claim experience, health status, or duration of
7-13 coverage since the issuance of the health benefit plan.]
7-14 [Art. 26.37.] RESTRICTED PROVIDER NETWORKS. A [For purposes
7-15 of this subchapter, a] small employer health benefit plan may use a
7-16 restricted provider network to provide the benefits under the plan.
7-17 For purposes of this subchapter, a [A] plan that uses a restricted
7-18 provider network does not provide similar coverage to a small
7-19 employer health benefit plan that does not use a restricted
7-20 provider network, if the use of the network results in [reduced
7-21 premiums to the small employer or] substantial differences in claim
7-22 costs.
7-23 Art. 26.37 [26.38]. HEALTH MAINTENANCE ORGANIZATION;
7-24 APPROVED HEALTH BENEFIT PLAN. (a) The premium rates for a
7-25 state-approved health benefit plan offered by a health maintenance
7-26 organization under Article 26.48 of this code must be established
7-27 in accordance with formulas or schedules of charges filed with the
8-1 department.
8-2 (b) A health maintenance organization that participates in a
8-3 purchasing cooperative that provides employees of small employers a
8-4 choice of benefit plans[, that has established a separate class of
8-5 business as provided by Article 26.31 of this code,] and that has
8-6 established a separate line of business as provided under Article
8-7 26.48(a) of this code and Title XIII, Public Health Service Act (42
8-8 U.S.C. Section 300e et seq.) may use rating methods in accordance
8-9 with this subchapter that are used by other small employer carriers
8-10 participating in the same cooperative, including rating by age and
8-11 gender.
8-12 Art. 26.38 [26.39]. ENFORCEMENT. If the commissioner finds
8-13 that a small employer carrier subject to this chapter exceeds the
8-14 applicable rate established under this subchapter, the commissioner
8-15 may order restitution and assess penalties as provided by Section
8-16 7, Article 1.10, of this code.
8-17 Art. 26.39 [26.40]. DISCLOSURE. In connection with the
8-18 offering for sale of any small employer health benefit plan, each
8-19 small employer carrier and each agent shall make a reasonable
8-20 disclosure, as part of its solicitation and sales materials, of:
8-21 (1) [the extent to which premium rates for a specific
8-22 small employer are established or adjusted based on the actual or
8-23 expected variation in claim costs or the actual or expected
8-24 variation in health status of the employees of the small employer
8-25 and their dependents;]
8-26 [(2)] provisions of the health benefit plan concerning
8-27 the small employer carrier's right to change premium rates and the
9-1 factors other than claim experience that affect changes in premium
9-2 rates;
9-3 (2) [(3)] provisions of the health benefit plan
9-4 relating to renewability of policies and contracts; and
9-5 (3) [(4)] any preexisting condition provision.
9-6 Art. 26.40 [26.41]. REPORTING REQUIREMENTS. (a) Compliance
9-7 with the underwriting and rating requirements of this chapter shall
9-8 be demonstrated through actuarial certification. Small employer
9-9 carriers offering a small employer health benefit plan shall file
9-10 annually with the commissioner an actuarial certification stating
9-11 that the underwriting and rating methods of the small employer
9-12 carrier:
9-13 (1) comply with accepted actuarial practices;
9-14 (2) are uniformly applied to each small employer
9-15 health benefit plan covering a small employer; and
9-16 (3) comply with the provisions of this chapter.
9-17 (b) Each small employer carrier shall maintain at its
9-18 principal place of business a complete and detailed description of
9-19 its rating practices and renewal underwriting practices, including
9-20 information and documentation that demonstrate that its rating
9-21 methods and practices are based on commonly accepted actuarial
9-22 assumptions and are in accordance with sound actuarial principles.
9-23 (c) A small employer carrier shall make the information and
9-24 documentation described in Subsection (b) of this article available
9-25 to the commissioner on request. Except in cases of violations of
9-26 this chapter, the information shall be considered proprietary and
9-27 trade secret information and shall not be subject to disclosure by
10-1 the commissioner to persons outside the department except as agreed
10-2 to by the small employer carrier or as ordered by a court of
10-3 competent jurisdiction.
10-4 Art. 26.41. RULES TO IMPLEMENT SUBCHAPTER. Rules adopted
10-5 under Article 26.04 of this code may include rules to implement
10-6 this subchapter and to ensure that rating practices used by small
10-7 employers are consistent with the purposes of this chapter. Rules
10-8 adopted under this article may include rules that:
10-9 (1) ensure that differences in rates charged for
10-10 health benefit plans by small employer carriers are reasonable and
10-11 reflect objective differences in plan design and coverage and do
10-12 not reflect differences resulting from the nature of groups assumed
10-13 to select particular health benefit plans; and
10-14 (2) prescribe the manner in which geographic areas are
10-15 established for purposes of Article 26.31 of this code.
10-16 SECTION 2. Article 26.02, Insurance Code, is amended to read
10-17 as follows:
10-18 Art. 26.02. DEFINITIONS. In this chapter:
10-19 (1) "Affiliated employer" means a person connected by
10-20 commonality of ownership with a small employer. The term includes
10-21 a person that owns a small employer, shares directors with a small
10-22 employer, or is eligible to file a consolidated tax return with a
10-23 small employer.
10-24 (2) "Agent" means a person who may act as an agent for
10-25 the sale of a health benefit plan under a license issued under
10-26 Section 15 or 15A, Texas Health Maintenance Organization Act
10-27 (Article 20A.15 or 20A.15A, Vernon's Texas Insurance Code), or
11-1 under Subchapter A, Chapter 21, of this code.
11-2 (3) ["Base premium rate" means, for each class of
11-3 business and for a specific rating period, the lowest premium rate
11-4 that is charged or that could be charged under a rating system for
11-5 that class of business by the small employer carrier to small
11-6 employers with similar case characteristics for small employer
11-7 health benefit plans with the same or similar coverage.]
11-8 [(4)] "Board of directors" means the board of
11-9 directors of the Texas Health Reinsurance System.
11-10 (4) [(5) "Case characteristics" means, with respect to
11-11 a small employer, the geographic area in which that employer's
11-12 employees reside, the age and gender of the individual employees
11-13 and their dependents, the appropriate industry classification as
11-14 determined by the small employer carrier, the number of employees
11-15 and dependents, and other objective criteria as established by the
11-16 small employer carrier that are considered by the small employer
11-17 carrier in setting premium rates for that small employer. The term
11-18 does not include claim experience, health status, duration of
11-19 coverage since the date of issuance of a health benefit plan, or
11-20 whether a covered person is or may become pregnant.]
11-21 [(6) "Class of business" means all small employers or
11-22 a separate grouping of small employers established under this
11-23 chapter.]
11-24 [(7)] "Dependent" means:
11-25 (A) a spouse;
11-26 (B) a newborn child;
11-27 (C) a child under the age of 19 years;
12-1 (D) a child who is a full-time student under the
12-2 age of 23 years and who is financially dependent on the parent;
12-3 (E) a child of any age who is medically
12-4 certified as disabled and dependent on the parent; and
12-5 (F) any person who must be covered under:
12-6 (i) Section 3D or 3E, Article 3.51-6, of
12-7 this code; or
12-8 (ii) Section 2(L), Chapter 397, Acts of
12-9 the 54th Legislature, Regular Session, 1955 (Article 3.70-2,
12-10 Vernon's Texas Insurance Code).
12-11 (5) [(8)] "Eligible employee" means an employee who
12-12 works on a full-time basis and who usually works at least 30 hours
12-13 a week. The term includes a sole proprietor, a partner, and an
12-14 independent contractor, if the sole proprietor, partner, or
12-15 independent contractor is included as an employee under a health
12-16 benefit plan of a small employer. The term does not include:
12-17 (A) an employee who works on a part-time,
12-18 temporary, seasonal, or substitute basis; or
12-19 (B) an employee who is covered under:
12-20 (i) another health benefit plan;
12-21 (ii) a self-funded or self-insured
12-22 employee welfare benefit plan that provides health benefits and
12-23 that is established in accordance with the Employee Retirement
12-24 Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.);
12-25 (iii) the Medicaid program if the employee
12-26 elects not to be covered;
12-27 (iv) another federal program, including
13-1 the CHAMPUS program or Medicare program, if the employee elects not
13-2 to be covered; or
13-3 (v) a benefit plan established in another
13-4 country if the employee elects not to be covered.
13-5 (6) [(9)] "Health benefit plan" means a group,
13-6 blanket, or franchise insurance policy, a certificate issued under
13-7 a group policy, a group hospital service contract, or a group
13-8 subscriber contract or evidence of coverage issued by a health
13-9 maintenance organization that provides benefits for health care
13-10 services. The term does not include:
13-11 (A) accident-only insurance coverage;
13-12 (B) credit insurance coverage;
13-13 (C) disability insurance coverage;
13-14 (D) specified disease coverage or other limited
13-15 benefit policies;
13-16 (E) coverage of Medicare services under a
13-17 federal contract;
13-18 (F) Medicare supplement and Medicare Select
13-19 policies regulated in accordance with federal law;
13-20 (G) long-term care insurance coverage;
13-21 (H) coverage limited to dental care;
13-22 (I) coverage limited to care of vision;
13-23 (J) coverage provided by a single service health
13-24 maintenance organization;
13-25 (K) insurance coverage issued as a supplement to
13-26 liability insurance;
13-27 (L) insurance coverage arising out of a workers'
14-1 compensation system or similar statutory system;
14-2 (M) automobile medical payment insurance
14-3 coverage;
14-4 (N) jointly managed trusts authorized under 29
14-5 U.S.C. Section 141 et seq. that contain a plan of benefits for
14-6 employees that is negotiated in a collective bargaining agreement
14-7 governing wages, hours, and working conditions of the employees
14-8 that is authorized under 29 U.S.C. Section 157;
14-9 (O) hospital confinement indemnity coverage; or
14-10 (P) reinsurance contracts issued on a stop-loss,
14-11 quota-share, or similar basis.
14-12 (7) [(10)] "Health carrier" means any entity
14-13 authorized under this code or another insurance law of this state
14-14 that provides health insurance or health benefits in this state,
14-15 including an insurance company, a group hospital service
14-16 corporation under Chapter 20 of this code, a health maintenance
14-17 organization under the Texas Health Maintenance Organization Act
14-18 (Chapter 20A, Vernon's Texas Insurance Code), and a stipulated
14-19 premium company under Chapter 22 of this code.
14-20 (8) [(11) "Index rate" means, for each class of
14-21 business as to a rating period for small employers with similar
14-22 case characteristics, the arithmetic average of the applicable base
14-23 premium rate and corresponding highest premium rate.]
14-24 [(12)] "Late enrollee" means an eligible employee or
14-25 dependent who requests enrollment in a small employer's health
14-26 benefit plan after the expiration of the initial enrollment period
14-27 established under the terms of the first plan for which that
15-1 employee or dependent was eligible through the small employer or
15-2 after the expiration of an open enrollment period under Article
15-3 26.21(h) of this code. An eligible employee or dependent is not a
15-4 late enrollee if:
15-5 (A) the individual:
15-6 (i) was covered under another employer
15-7 health benefit plan at the time the individual was eligible to
15-8 enroll;
15-9 (ii) declines in writing, at the time of
15-10 the initial eligibility, stating that coverage under another
15-11 employer health benefit plan was the reason for declining
15-12 enrollment;
15-13 (iii) has lost coverage under another
15-14 employer health benefit plan as a result of the termination of
15-15 employment, the termination of the other plan's coverage, the death
15-16 of a spouse, or divorce; and
15-17 (iv) requests enrollment not later than
15-18 the 31st day after the date on which coverage under another
15-19 employer health benefit plan terminates;
15-20 (B) the individual is employed by an employer
15-21 who offers multiple health benefit plans and the individual elects
15-22 a different health benefit plan during an open enrollment period;
15-23 or
15-24 (C) a court has ordered coverage to be provided
15-25 for a spouse or minor child under a covered employee's plan and
15-26 request for enrollment is made not later than the 31st day after
15-27 issuance of the date on which the court order is issued.
16-1 (9) [(13) "New business premium rate" means, for each
16-2 class of business as to a rating period, the lowest premium rate
16-3 that is charged or offered or that could be charged or offered by
16-4 the small employer carrier to small employers with similar case
16-5 characteristics for newly issued small employer health benefit
16-6 plans that provide the same or similar coverage.]
16-7 [(14)] "Person" means an individual, corporation,
16-8 partnership, association, or other private legal entity.
16-9 (10) [(15)] "Plan of operation" means the plan of
16-10 operation of the system established under Article 26.55 of this
16-11 code.
16-12 (11) "Point-of-service contract" means a benefit plan
16-13 offered through a health maintenance organization that:
16-14 (A) includes corresponding indemnity benefits in
16-15 addition to benefits relating to out-of-area or emergency services
16-16 provided through insurers or group hospital service corporations;
16-17 and
16-18 (B) permits the insured to obtain coverage under
16-19 either the health maintenance organization conventional plan or the
16-20 indemnity plan as determined in accordance with the terms of the
16-21 contract.
16-22 (12) [(16)] "Preexisting condition provision" means a
16-23 provision that denies, excludes, or limits coverage as to a disease
16-24 or condition for a specified period after the effective date of
16-25 coverage.
16-26 (13) [(17)] "Premium" means all amounts paid by a
16-27 small employer and eligible employees as a condition of receiving
17-1 coverage from a small employer carrier, including any fees or other
17-2 contributions associated with a health benefit plan.
17-3 (14) [(18) "Rating period" means a calendar period for
17-4 which premium rates established by a small employer carrier are
17-5 assumed to be in effect.]
17-6 [(19)] "Reinsured carrier" means a small employer
17-7 carrier participating in the system.
17-8 (15) [(20)] "Risk-assuming carrier" means a small
17-9 employer carrier that elects not to participate in the system.
17-10 (16) [(21)] "Small employer" means a person that is
17-11 actively engaged in business and that, on at least 50 percent of
17-12 its working days during the preceding calendar year, employed at
17-13 least three but not more than 50 eligible employees, including the
17-14 employees of an affiliated employer, the majority of whom were
17-15 employed in this state.
17-16 (17) [(22)] "Small employer carrier" means a health
17-17 carrier, to the extent that that carrier is offering, delivering,
17-18 issuing for delivery, or renewing health benefit plans subject to
17-19 this chapter under Article 26.06(a) of this code.
17-20 (18) [(23)] "Small employer health benefit plan" means
17-21 a plan developed by the commissioner under Subchapter E of this
17-22 chapter or any other health benefit plan offered to a small
17-23 employer in accordance with Article 26.42(c) or 26.48 of this code.
17-24 (19) [(24)] "System" means the Texas Health
17-25 Reinsurance System established under Subchapter F of this chapter.
17-26 [(25) "Point-of-service contract" means a benefit plan
17-27 offered through a health maintenance organization that:]
18-1 [(A) includes corresponding indemnity benefits
18-2 in addition to benefits relating to out-of-area or emergency
18-3 services provided through insurers or group hospital service
18-4 corporations; and]
18-5 [(B) permits the insured to obtain coverage
18-6 under either the health maintenance organization conventional plan
18-7 or the indemnity plan as determined in accordance with the terms of
18-8 the contract.]
18-9 SECTION 3. Article 26.71(b), Insurance Code, is amended to
18-10 read as follows:
18-11 (b) The department may require periodic reports by small
18-12 employer carriers and agents regarding small employer health
18-13 benefit plans issued by those carriers and agents. The reporting
18-14 requirements shall include information regarding [case
18-15 characteristics and] the numbers of small employer health benefit
18-16 plans [in various categories] that are marketed or issued to small
18-17 employers.
18-18 SECTION 4. This Act takes effect September 1, 1997, and
18-19 applies only to a small employer health benefit plan that is
18-20 delivered, issued for delivery, or renewed on or after January 1,
18-21 1998. A plan that is delivered, issued for delivery, or renewed
18-22 before January 1, 1998, is governed by the law as it existed
18-23 immediately before the effective date of this Act, and that law is
18-24 continued in effect for this purpose.
18-25 SECTION 5. The importance of this legislation and the
18-26 crowded condition of the calendars in both houses create an
18-27 emergency and an imperative public necessity that the
19-1 constitutional rule requiring bills to be read on three several
19-2 days in each house be suspended, and this rule is hereby suspended.