By Shapiro                                              S.B. No. 53

      75R1466 PB-D                           

                                A BILL TO BE ENTITLED

 1-1                                   AN ACT

 1-2     relating to coverage under certain health benefit plans for

 1-3     newborns and adopted children.

 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

 1-5           SECTION 1.  Section 3D(b), Article 3.51-6, Insurance Code, is

 1-6     amended to read as follows:

 1-7           (b)  A health insurance policy that provides coverage for the

 1-8     immediate family or children of a person insured under the policy

 1-9     may not exclude from coverage or limit coverage to a child of the

1-10     insured solely because the child is adopted.   The insurer shall

1-11     provide full coverage under the policy to the child without

1-12     limiting coverage of a preexisting condition if an application  for

1-13     coverage for the child is made not later than the 31st day after

1-14     the date  on which the adoption is final.

1-15           SECTION 2.  The Texas Health Maintenance Organization Act

1-16     (Chapter 20A, Vernon's Texas Insurance Code) is amended by adding

1-17     Section 9A to read as follows:

1-18           Sec. 9A.  REQUIRED COVERAGE FOR NEWBORNS; ADOPTED CHILDREN.

1-19     (a)  Each health maintenance organization that provides coverage

1-20     for health care services for the dependents of an enrollee shall

1-21     include full coverage for the newborn child of an enrollee if the

1-22     child is enrolled in the health care plan not later than the 31st

1-23     day after the date of the child's birth.

1-24           (b)  A health maintenance organization that provides coverage

 2-1     for the immediate family or children of an enrollee may not exclude

 2-2     from coverage in a health care plan or limit coverage under a plan

 2-3     to a child of an enrollee solely because the child is adopted.  The

 2-4     health maintenance organization shall provide full coverage under

 2-5     the plan to the child without limiting coverage of a preexisting

 2-6     condition if the child is enrolled in the plan not later than the

 2-7     31st day after the date on which the adoption is final.

 2-8           SECTION 3.  Section 3D(b), Article 3.51-6, Insurance Code, as

 2-9     amended by Section 1 of this Act, applies only to an insurance

2-10     policy that is delivered, issued for delivery, or renewed on or

2-11     after January 1, 1998.  A policy that is delivered, issued for

2-12     delivery, or renewed before January 1, 1998, is governed by the law

2-13     as it existed immediately before the effective date of this Act,

2-14     and that law is continued in effect for that purpose.

2-15           SECTION 4.  Section 9A, The Texas Health Maintenance

2-16     Organization Act (Chapter 20A, Vernon's Texas Insurance Code), as

2-17     added by Section 2 of this Act, applies only to an evidence of

2-18     coverage that is delivered, issued for delivery, or renewed on or

2-19     after January 1, 1998.  An evidence of coverage that is delivered,

2-20     issued for delivery, or renewed before January 1, 1998, is governed

2-21     by the law as it existed immediately before the effective date of

2-22     this Act, and that law is continued in effect for that purpose.

2-23           SECTION 5.  This Act takes effect September 1, 1997.

2-24           SECTION 6.  The importance of this legislation and the

2-25     crowded condition of the calendars in both houses create an

2-26     emergency and an imperative public necessity that the

2-27     constitutional rule requiring bills to be read on three several

 3-1     days in each house be suspended, and this rule is hereby suspended.