1-1     By:  Armbrister                                        S.B. No. 682

 1-2           (In the Senate - Filed February 20, 1997; February 24, 1997,

 1-3     read first time and referred to Committee on Economic Development;

 1-4     April 11, 1997, reported adversely, with favorable Committee

 1-5     Substitute by the following vote:  Yeas 11, Nays 0; April 11, 1997,

 1-6     sent to printer.)

 1-7     COMMITTEE SUBSTITUTE FOR S.B. No. 682                    By:  Lucio

 1-8                            A BILL TO BE ENTITLED

 1-9                                   AN ACT

1-10     relating to advertisements for certain health benefit plans.

1-11           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

1-12           SECTION 1.  Subchapter B, Chapter 21, Insurance Code, is

1-13     amended by adding Article 21.20-2 to read as follows:

1-14           Art. 21.20-2.  ADVERTISEMENTS FOR CERTAIN HEALTH BENEFIT

1-15     PLANS

1-16           Sec. 1.  SCOPE OF ARTICLE.  (a)  This article applies only to

1-17     a health benefit plan that provides benefits for medical or

1-18     surgical expenses incurred as a result of a health condition,

1-19     accident, or sickness, including an individual, group, blanket, or

1-20     franchise insurance policy or agreement, a group hospital service

1-21     contract, or an individual or group evidence of coverage issued by:

1-22                 (1)  an insurance company;

1-23                 (2)  a group hospital service corporation operating

1-24     under Chapter 20 of this code;

1-25                 (3)  a health maintenance organization operating under

1-26     the Texas Health Maintenance Organization Act (Chapter 20A,

1-27     Vernon's Texas Insurance Code); or

1-28                 (4)  an approved nonprofit health corporation that is

1-29     certified under Section 5.01(a), Medical Practice Act (Article

1-30     4495b, Vernon's Texas Civil Statutes), and that holds a certificate

1-31     of authority issued by the commissioner under Article 21.52F of

1-32     this code.

1-33           (b)  This article does not apply to:

1-34                 (1)  a health benefit plan that provides coverage:

1-35                       (A)  only for a specified disease;

1-36                       (B)  only for accidental death or dismemberment;

1-37     or

1-38                       (C)  for wages or payments in lieu of wages for a

1-39     period during which an employee is absent from work because of

1-40     sickness or injury; or

1-41                 (2)  a long-term care policy, including a nursing home

1-42     fixed indemnity policy, unless the commissioner determines that the

1-43     policy provides benefit coverage so comprehensive that the policy

1-44     is a health benefit plan as described by Subsection (a) of this

1-45     section.

1-46           Sec. 2.  DISCLAIMERS.  (a)  Subject to Article 21.21 of this

1-47     code, an advertisement for a health benefit plan may include rate

1-48     information without including information about all benefit

1-49     exclusions and limitations if the advertisement includes prominent

1-50     disclaimers that clearly indicate that:

1-51                 (1)  the rates are illustrative;

1-52                 (2)  a person should not send money to the issuer of

1-53     the health benefit plan in response to the advertisement;

1-54                 (3)  a person cannot obtain coverage under the health

1-55     benefit plan until the person completes an application for

1-56     coverage; and

1-57                 (4)  benefit exclusions and limitations may apply to

1-58     the health benefit plan.

1-59           (b)  Any rate mentioned in the advertisement shall indicate

1-60     the age, gender, and geographic location on which the rate is

1-61     based.

1-62           SECTION 2.  The importance of this legislation and the

1-63     crowded condition of the calendars in both houses create an

1-64     emergency and an imperative public necessity that the

 2-1     constitutional rule requiring bills to be read on three several

 2-2     days in each house be suspended, and this rule is hereby suspended,

 2-3     and that this Act take effect and be in force from and after its

 2-4     passage, and it is so enacted.

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