By Davila H.B. No. 1713 75R2946 DLF-F A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to discrimination against victims of family violence in 1-3 the issuance of insurance. 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 21.21-5 to read as follows: 1-7 Art. 21.21-5. DISCRIMINATION AGAINST VICTIMS OF FAMILY 1-8 VIOLENCE 1-9 Sec. 1. DEFINITIONS. In this article: 1-10 (1) "Family violence" has the meaning assigned by 1-11 Section 71.01, Family Code. 1-12 (2) "Health benefit plan" means a health benefit plan 1-13 to which this article applies under Section 2(a)(2) of this 1-14 article. 1-15 (3) "Health benefit plan provider" means an entity 1-16 that writes, issues, or otherwise provides a health benefit plan. 1-17 (4) "Insurance policy" means a policy to which this 1-18 article applies under Section 2(a)(1) of this article. 1-19 (5) "Insurer" means the issuer of an insurance policy. 1-20 Sec. 2. SCOPE OF ARTICLE. This article applies to: 1-21 (1) any group or individual policy of insurance, other 1-22 than a health benefit plan, written by: 1-23 (A) a domestic or foreign, stock or mutual, 1-24 life, health, or accident insurance company; 2-1 (B) a domestic or foreign, stock or mutual, fire 2-2 and casualty insurance company; 2-3 (C) a Mexican casualty company; 2-4 (D) a domestic or foreign Lloyd's plan insurer; 2-5 (E) a domestic or foreign reciprocal or 2-6 insurance exchange; 2-7 (F) a domestic or foreign fraternal benefit 2-8 society; 2-9 (G) a stipulated premium insurance company; 2-10 (H) a nonprofit legal service corporation; 2-11 (I) a statewide mutual assessment company; 2-12 (J) a local mutual aid association; 2-13 (K) a local mutual burial association; 2-14 (L) an association exempt under Article 14.17 of 2-15 this code; 2-16 (M) a nonprofit hospital, medical, or dental 2-17 service corporation, including a company subject to Chapter 20 of 2-18 this code; 2-19 (N) a county mutual insurance company; 2-20 (O) a farm mutual insurance company; 2-21 (P) a risk retention group; 2-22 (Q) a purchasing group; 2-23 (R) a surplus lines carrier; and 2-24 (S) a guaranty association created and operating 2-25 under Article 21.28-C or 21.28-D of this code; and 2-26 (2) a health benefit plan that provides benefits for 2-27 medical or surgical expenses incurred as a result of a health 3-1 condition, accident, or sickness, including: 3-2 (A) an individual, group, blanket, or franchise 3-3 insurance policy or insurance agreement, a group hospital service 3-4 contract, or an individual or group evidence of coverage that is 3-5 offered by: 3-6 (i) an insurance company; 3-7 (ii) a group hospital service corporation 3-8 operating under Chapter 20 of this code; 3-9 (iii) a fraternal benefit society 3-10 operating under Chapter 10 of this code; 3-11 (iv) a stipulated premium insurance 3-12 company operating under Chapter 22 of this code; or 3-13 (v) a health maintenance organization 3-14 operating under the Texas Health Maintenance Organization Act 3-15 (Chapter 20A, Vernon's Texas Insurance Code); and 3-16 (B) to the extent permitted by the Employee 3-17 Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et 3-18 seq.), a health benefit plan that is offered by: 3-19 (i) a multiple employer welfare 3-20 arrangement as defined by Section 3, Employee Retirement Income 3-21 Security Act of 1974 (29 U.S.C. Section 1002); or 3-22 (ii) another analogous benefit 3-23 arrangement. 3-24 Sec. 3. PROHIBITIONS. (a) An insurer or health benefit 3-25 plan provider may not directly or indirectly discriminate in the 3-26 writing of an insurance policy or health benefit plan because any 3-27 of the following persons are the subject of family violence: 4-1 (1) the applicant for coverage, insured, or enrollee; 4-2 (2) an employee of the applicant, insured, or 4-3 enrollee; or 4-4 (3) another person with whom the applicant, insured, 4-5 or enrollee is known to have a personal or business relationship or 4-6 association. 4-7 (b) Subsection (a) of this section applies without regard to 4-8 whether the person has an injury, illness, or disorder that 4-9 resulted from family violence or whether the person sought or 4-10 should have sought medical or psychological treatment or protection 4-11 or shelter from family violence. 4-12 (c) For purposes of Subsection (a) of this section, an 4-13 insurer or health benefit plan provider discriminates in the 4-14 writing of an insurance policy or health benefit plan if the 4-15 insurer or health benefit plan provider: 4-16 (1) denies, refuses to issue or renew, or cancels or 4-17 otherwise terminates an insurance policy or health benefit plan 4-18 because a person described by Subsection (a) of this section is the 4-19 subject of family violence; 4-20 (2) restricts, excludes, or limits coverage for a loss 4-21 resulting from family violence or denies a claim solely because the 4-22 claim is a result of family violence, except as provided by Article 4-23 21.23 of this code; or 4-24 (3) charges a different premium because a person 4-25 described by Subsection (a) of this section is the subject of 4-26 family violence. 4-27 Sec. 4. CONTINUATION COVERAGE. (a) A health benefit plan 5-1 provider shall offer continuation coverage under a health benefit 5-2 plan to a person who is the subject of family violence if: 5-3 (1) the health benefit plan was originally issued in 5-4 the name of the perpetrator of family violence and the person who 5-5 is the subject of family violence has divorced or separated from or 5-6 is no longer in the custody of the perpetrator; or 5-7 (2) the perpetrator's health benefit plan has 5-8 terminated voluntarily or involuntarily. 5-9 (b) The provider may require the victim of family violence 5-10 to pay the health benefit plan premium. 5-11 (c) The commissioner shall adopt rules to implement this 5-12 section. 5-13 Sec. 5. USE OF INFORMATION. (a) Except as ordered by the 5-14 commissioner or a court, an insurer or health benefit plan provider 5-15 may not use, disclose, or transfer information relating to the fact 5-16 that a person described by Section 3(a) of this article is the 5-17 subject of family violence or has a medical condition that results, 5-18 at least in part, from family violence. 5-19 (b) This section does not prohibit the disclosure of 5-20 information related to the direct provision of health care or 5-21 disclosure by a medical professional as necessary to comply with 5-22 Chapter 73, Family Code. 5-23 (c) This section does not prohibit a person who is the 5-24 subject of family violence from obtaining the person's own medical 5-25 records from an insurer or health benefit plan provider. 5-26 (d) A person who is the subject of family violence may 5-27 disclose that fact to an insurer or health benefit plan provider to 6-1 demonstrate that a medical condition results, at least in part, 6-2 from family violence or to facilitate treatment of the condition. 6-3 Sec. 6. STATEMENT OF REASONS FOR ADVERSE ACTION. (a) An 6-4 insurer or health benefit plan provider that takes an action with 6-5 respect to an insurance policy or health benefit plan that is 6-6 adverse to the interests of an applicant for coverage or a covered 6-7 person who is the subject of family violence shall provide the 6-8 applicant or covered person a written statement of each reason for 6-9 the action. 6-10 (b) A statement that an action with respect to an insurance 6-11 policy or health benefit plan was taken because of an insurer's or 6-12 health benefit plan's general underwriting standards or guidelines 6-13 does not satisfy the requirements of this section. 6-14 (c) For purposes of this section, an action that is adverse 6-15 to the interests of an applicant or covered person includes 6-16 denying, refusing to issue or renew, or canceling or otherwise 6-17 terminating an insurance policy or health benefit plan. 6-18 Sec. 7. LIFE INSURANCE. This article does not prohibit an 6-19 insurer from declining to issue a life insurance policy if the 6-20 applicant for coverage or prospective owner of the policy: 6-21 (1) is or would be designated as a beneficiary of the 6-22 policy; and 6-23 (2) lacks an insurable interest in the insured or is 6-24 known, on the basis of law enforcement or court records, to have 6-25 committed an act of family violence. 6-26 Sec. 8. SUBROGATION. Notwithstanding any other law, an 6-27 insurer or health benefit plan provider is not subrogated to a 7-1 claim of a person who is the subject of family violence against the 7-2 perpetrator of family violence unless: 7-3 (1) the insurer or health benefit plan provider 7-4 obtains the informed consent of the person who is the subject of 7-5 family violence; or 7-6 (2) the person who is the subject of family violence 7-7 has recovered damages for the claim. 7-8 Sec. 9. SANCTIONS. An insurer or health benefit plan 7-9 provider who violates this article commits unfair discrimination 7-10 under Article 21.21-6 of this code, as added by Chapter 415, Acts 7-11 of the 74th Legislature, Regular Session, 1995, and an unfair and 7-12 deceptive practice under Article 21.21 of this code and is subject 7-13 to the penalties imposed under those articles. 7-14 SECTION 2. Section 14(b), Texas Health Maintenance 7-15 Organization Act (Article 20A.14, Vernon's Texas Insurance Code), 7-16 is amended to read as follows: 7-17 (b) Articles 21.21, 21.21A, 21.21-2, 21.21-3, and 21.21-5, 7-18 Insurance Code, Article 21.21-6, Insurance Code, as added by 7-19 Chapter 415, Acts of the 74th Legislature, Regular Session, 1995, 7-20 and Chapter 122, Acts of the 57th Legislature, Regular Session, 7-21 1961 (Article 21.21-1, Vernon's Texas Insurance Code), apply to 7-22 health maintenance organizations that offer both basic and single 7-23 health care coverages and to basic and single health care plans and 7-24 the evidence of coverage under those plans, except to the extent 7-25 that the commissioner determines that the nature of health 7-26 maintenance organizations and health care plans and evidence of 7-27 coverage renders any provision of those articles clearly 8-1 inappropriate. 8-2 SECTION 3. This Act takes effect September 1, 1997, and 8-3 applies only to an insurance policy or health benefit plan that is 8-4 delivered, issued for delivery, or renewed on or after January 1, 8-5 1998. An insurance policy or health benefit plan that is 8-6 delivered, issued for delivery, or renewed before January 1, 1998, 8-7 is governed by the law as it existed immediately before the 8-8 effective date of this Act, and that law is continued in effect for 8-9 that purpose. 8-10 SECTION 4. The importance of this legislation and the 8-11 crowded condition of the calendars in both houses create an 8-12 emergency and an imperative public necessity that the 8-13 constitutional rule requiring bills to be read on three several 8-14 days in each house be suspended, and this rule is hereby suspended.