By Wohlgemuth H.B. No. 3267
75R9433 DLF-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to health benefit plans for children.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. The Insurance Code is amended by adding Chapter
1-5 27 to read as follows:
1-6 CHAPTER 27. HEALTH BENEFIT PLANS FOR CHILDREN
1-7 Art. 27.01. DEFINITION. In this chapter, "health benefit
1-8 plan" means a health benefit plan described by Article 27.02 of
1-9 this code.
1-10 Art. 27.02. SCOPE OF CHAPTER. This chapter applies to a
1-11 health benefit plan that:
1-12 (1) provides benefits for medical or surgical expenses
1-13 incurred as a result of a health condition, accident, or sickness,
1-14 including:
1-15 (A) an individual, group, blanket, or franchise
1-16 insurance policy or insurance agreement, a group hospital service
1-17 contract, or an individual or group evidence of coverage that is
1-18 offered by:
1-19 (i) an insurance company;
1-20 (ii) a group hospital service corporation
1-21 operating under Chapter 20 of this code;
1-22 (iii) a fraternal benefit society
1-23 operating under Chapter 10 of this code;
1-24 (iv) a stipulated premium insurance
2-1 company operating under Chapter 22 of this code; or
2-2 (v) a health maintenance organization
2-3 operating under the Texas Health Maintenance Organization Act
2-4 (Chapter 20A, Vernon's Texas Insurance Code); or
2-5 (B) to the extent permitted by the Employee
2-6 Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et
2-7 seq.), a health benefit plan that is offered by:
2-8 (i) a multiple employer welfare
2-9 arrangement as defined by Section 3, Employee Retirement Income
2-10 Security Act of 1974 (29 U.S.C. Section 1002) or another analogous
2-11 benefit arrangement; or
2-12 (ii) any other entity not licensed under
2-13 this code or another insurance law of this state that contracts
2-14 directly for health care services on a risk sharing basis,
2-15 including an entity that contracts for health care services on a
2-16 capitation basis; or
2-17 (2) is offered by an approved nonprofit health
2-18 corporation that is certified under Section 5.01(a), Medical
2-19 Practice Act (Article 4495b, Vernon's Texas Civil Statutes), and
2-20 that holds a certificate of authority issued by the commissioner
2-21 under Article 21.52F of this code.
2-22 Art. 27.03. CHILDREN'S HEALTH BENEFIT PLAN. The issuer of a
2-23 health benefit plan may offer a children's health benefit plan in
2-24 accordance with this chapter. The health benefit plan may provide
2-25 coverage only to children younger than 18 years of age.
2-26 Art. 27.04. MANDATED BENEFIT PROVISIONS INAPPLICABLE. A
2-27 children's health benefit plan is not subject to a law that
3-1 requires coverage or the offer of coverage of a health care service
3-2 or benefit.
3-3 Art. 27.05. EXEMPTION FROM PREMIUM TAX. The issuer of a
3-4 children's health benefit plan is not subject to the premium tax
3-5 imposed by Article 4.11 of this code or the tax on revenues imposed
3-6 under Section 33, Texas Health Maintenance Organization Act
3-7 (Section 20A.33, Vernon's Texas Insurance Code), with respect to
3-8 money received for coverage provided under that plan.
3-9 Art. 27.06. RULES. The commissioner may adopt rules to
3-10 implement this chapter.
3-11 SECTION 2. This Act takes effect September 1, 1997. The
3-12 issuer of a health benefit plan may not offer a children's health
3-13 benefit plan under Chapter 27, Insurance Code, as added by this
3-14 Act, before January 1, 1998.
3-15 SECTION 3. The importance of this legislation and the
3-16 crowded condition of the calendars in both houses create an
3-17 emergency and an imperative public necessity that the
3-18 constitutional rule requiring bills to be read on three several
3-19 days in each house be suspended, and this rule is hereby suspended.