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. 2-5 * * * * *