By Wise H.B. No. 1590
75R6479 CAS-F
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to group health insurance coverage for school district
1-3 employees.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Section 22.004(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
1-15 Article 3.51-6, Insurance Code, and any other law applicable to
1-16 group health insurance policies or contracts issued in this state.
1-17 The 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 substantially similar [comparable] to the basic
2-3 health coverage provided under the Texas Employees Uniform Group
2-4 Insurance Benefits Act (Article 3.50-2, Vernon's Texas Insurance
2-5 Code). The cost of the coverage may be shared by the employees and
2-6 the district. Each district shall certify the district's
2-7 compliance with this subsection to the executive director of the
2-8 Teacher Retirement System of Texas not later than February 1 of
2-9 each year in the manner required by the board of trustees of the
2-10 Teacher Retirement System of Texas. The certification must
2-11 include a copy of the district's current contract for group health
2-12 coverage. The executive director of the Teacher Retirement System
2-13 of Texas shall review the group health coverage offered by each
2-14 district and shall determine whether that coverage is substantially
2-15 similar to the basic health coverage provided under the Texas
2-16 Employees Uniform Group Insurance Benefits Act (Article 3.50-2,
2-17 Vernon's Texas Insurance Code). If the executive director
2-18 determines that the group health coverage offered by a district is
2-19 not substantially similar, the executive director shall report that
2-20 information to the district and to the commissioner.
2-21 SECTION 2. This Act takes effect September 1, 1997.
2-22 SECTION 3. The importance of this legislation and the
2-23 crowded condition of the calendars in both houses create an
2-24 emergency and an imperative public necessity that the
2-25 constitutional rule requiring bills to be read on three several
2-26 days in each house be suspended, and this rule is hereby suspended.