By: Harris S.B. No. 1841
97S0891/1
A BILL TO BE ENTITLED
AN ACT
1-1 relating to increasing the number of Texas children covered by
1-2 health insurance; providing penalties.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Section 154.182, Family Code, is amended by
1-5 amending Subsection (b) and adding Subsection (c) to read as
1-6 follows:
1-7 (b) In determining the manner in which health insurance for
1-8 the child is to be ordered, the court shall render its order in
1-9 accordance with the following priorities, unless a party shows good
1-10 cause why a particular order would not be in the best interest of
1-11 the child:
1-12 (1) if health insurance is available for the child
1-13 through the obligor's employment or membership in a union, trade
1-14 association, or other organization, the court shall order the
1-15 obligor to include the child in the obligor's health insurance;
1-16 (2) if health insurance is not available for the child
1-17 through the obligor's employment but is available for the child
1-18 through the obligee's employment or membership in a union, trade
1-19 association, or other organization, the court may order the obligee
1-20 to provide health insurance for the child, and, in such event,
1-21 shall order the obligor to pay additional child support to be
1-22 withheld from earnings under Chapter 158 to the obligee for the
1-23 actual cost of the health insurance for the child; or
2-1 (3) if health insurance is not available for the child
2-2 under Subdivision (1) or (2), the court shall order the obligor to
2-3 provide health insurance for the child if [the court finds that
2-4 health insurance is available for the child from another source and
2-5 that] the obligor is financially able to provide it and the court
2-6 may order that:
2-7 (A) coverage be provided through the Texas
2-8 Healthy Kids Corporation established under Subchapter D; or
2-9 (B) the coverage be provided through the Texas
2-10 Health Benefits Purchasing Cooperative established under Chapter
2-11 26, Insurance Code; or
2-12 (C) the obligor pay a reasonable amount of cash
2-13 medical support in addition to child support ordered under this
2-14 code.
2-15 (c) In establishing the amount of additional medical child
2-16 support under Subsection (b)(3)(iii), the court shall presume that
2-17 $38 each month is a reasonable amount for a child but may order a
2-18 greater or lesser amount as appropriate under the circumstances.
2-19 The Health and Human Services Commission may promulgate guidelines
2-20 for the dollar amounts of medical child support that the court may
2-21 presumptively apply in circumstances in which the obligor is
2-22 responsible for medical child support for more than one child.
2-23 SECTION 2. Subchapter D, Chapter 154, Family Code, is
2-24 amended by adding Sections 154.193 through 154.204 to read as
2-25 follows:
3-1 Sec. 154.193. DEFINITIONS. In this subchapter:
3-2 (1) "Board" means the board of directors of the
3-3 corporation.
3-4 (2) "Child" means an individual younger than 18 years
3-5 of age who is not and has not been married or who has not had the
3-6 disabilities of minority removed for general purposes.
3-7 (3) "Corporation" means the Texas Healthy Kids
3-8 Corporation.
3-9 (4) "Eligible coverage provider" means an entity that
3-10 meets the requirement for providing health insurance coverage under
3-11 the program.
3-12 (5) "Program" means the health benefit program
3-13 provided by the corporation under this subchapter.
3-14 (6) "Title IV-D agency" means the state agency
3-15 designated under Chapter 231 to provide services under Part D of
3-16 Title IV of the federal Social Security Act (42 U.S.C. Section 651
3-17 et seq.).
3-18 (7) "Texas Health Benefits Purchasing Cooperative"
3-19 means the nonprofit organization, also known as Texas Insurance
3-20 Purchasing Alliance, established to make health care coverage
3-21 available to small employers and their eligible employees and
3-22 eligible employees' dependents.
3-23 Sec. 154.194. TEXAS HEALTHY KIDS FUND. (a) The Texas
3-24 healthy kids fund is a fund outside the state treasury held by the
3-25 Texas Treasury Safekeeping Trust Company. The fund is composed of
4-1 money appropriated to the fund and money appropriated to or
4-2 deposited in the premium stabilization revolving account
4-3 established under Section 154.201. The comptroller shall transfer
4-4 to the fund money appropriated to the fund from the state treasury.
4-5 (b) The comptroller may invest money in the fund in the same
4-6 manner as the comptroller may invest money in the state treasury.
4-7 (c) The comptroller shall draw warrants from the fund on
4-8 receipt of a voucher signed by an authorized representative of the
4-9 corporation. The board shall file with the comptroller a verified
4-10 copy of a board resolution that designates the authorized
4-11 representatives of the corporation who have authority to sign
4-12 vouchers for payment from the fund.
4-13 (d) During the time for which the corporation is not in
4-14 existence or does not administer a health insurance program for
4-15 children, the Texas Health Benefits Purchasing Cooperative will
4-16 provide its services to administer the health insurance program for
4-17 those children.
4-18 Sec. 154.195. TEXAS HEALTHY KIDS CORPORATION. (a) The
4-19 Texas Healthy Kids Corporation shall be created not later than
4-20 February 1, 1998, and shall have the powers that are necessary and
4-21 convenient to carry out its duties. The corporation is a nonprofit
4-22 corporation and shall comply with the Texas Non-Profit Corporation
4-23 Act (Article 1396-1.01 et seq., Vernon's Texas Civil Statutes).
4-24 (b) The corporation is not subject to the franchise tax
4-25 imposed by Chapter 171, Tax Code.
5-1 (c) Subject to this chapter, the board shall take any
5-2 reasonable steps necessary to maintain an exemption from federal
5-3 income tax under Section 501(a) of the Internal Revenue Code of
5-4 1986 (26 U.S.C. Section 501(a) by being listed as an exempt
5-5 organization under Section 501(c)(3) or (4) of that code (26 U.S.C.
5-6 Section 501(c)(3) or (4)).
5-7 Sec. 154.196. HEALTH BENEFIT PROGRAM. (a) The corporation
5-8 shall:
5-9 (1) establish a program to provide, through eligible
5-10 coverage providers, health benefits for eligible children in this
5-11 state who:
5-12 (A) are not covered by insurance or another type
5-13 of health benefit plan;
5-14 (B) are not covered by insurance or another type
5-15 of health benefit plan for a specified medical condition; or
5-16 (C) are not covered by insurance or another type
5-17 of health benefit plan that, in the opinion of the board, provides
5-18 adequate coverage;
5-19 (2) develop the design and benefits structure of the
5-20 health benefit program offered by the corporation through eligible
5-21 coverage providers;
5-22 (3) provide that the noncustodial parent's income
5-23 level must be at or below 250 percent of the federal poverty level
5-24 to participate in the program;
5-25 (4) develop and implement a public awareness program
6-1 to educate the public about the program;
6-2 (5) establish participation objectives for the
6-3 program;
6-4 (6) negotiate premiums for coverage under the program
6-5 and applicable copayments, coinsurance, or deductibles to be paid
6-6 on behalf of a covered child; and
6-7 (7) contract for the provision of health benefit
6-8 coverage under the program.
6-9 (b) The parent, managing conservator, or guardian of a
6-10 child, or another person sponsoring coverage for the child, is
6-11 responsible for premiums for coverage under the program and for
6-12 applicable copayments, coinsurance, or deductibles, as determined
6-13 by the corporation. The corporation may develop a premium
6-14 structure that varies according to ability to pay and may require,
6-15 in accordance with the premium structure, that the parent,
6-16 conservator, guardian, or sponsor pay the full cost of the child's
6-17 coverage.
6-18 Sec. 154.197. APPLICATION. (a) A party ordered under
6-19 Section 154.182 to apply for coverage for a child under the program
6-20 shall provide to the corporation:
6-21 (1) a copy of an order rendered under Section 154.182;
6-22 and
6-23 (2) the name and address of the obligor's employer.
6-24 Sec. 154.198. DUTIES OF CORPORATION OR DESIGNEE OF
6-25 CORPORATION. (a) The corporation or the designee of the
7-1 corporation shall review an application and, if the corporation or
7-2 designee finds that the child is eligible for coverage under the
7-3 program, shall:
7-4 (1) issue coverage to the child in accordance with the
7-5 program; and
7-6 (2) notify the obligor's employer in accordance with
7-7 Subsection (b).
7-8 (b) The notice provided under Subsection (a)(2) must:
7-9 (1) explain the employer's obligations under Section
7-10 154.199;
7-11 (2) state:
7-12 (A) the amount to be paid for coverage of the
7-13 child, including the amount of the premium and the premium
7-14 stabilization revolving account fee imposed under Section 154.202;
7-15 (B) whether the amount is to be paid to the
7-16 corporation or the corporation's designee; and
7-17 (C) the address to which the payment is to be
7-18 sent; and
7-19 (3) include a copy of the medical child support order
7-20 rendered under this chapter.
7-21 (c) The corporation or the corporation's designee shall
7-22 notify the employer of an obligor of any increase in the amount to
7-23 be paid for coverage of the child under the program.
7-24 Sec. 154.199. DUTY OF EMPLOYER. (a) An employer who
7-25 receives notice under Section 154.198 shall withhold an appropriate
8-1 amount from the obligor's earnings for the required payment and
8-2 remit the amount as instructed on the notice.
8-3 (b) An employer who fails to withhold or remit payments as
8-4 required by this section or who discriminates in hiring or
8-5 employment on the basis of a medical support order is subject to
8-6 the penalties and fines imposed under Subchapter C, Chapter 158.
8-7 Sec. 154.200. TERMINATION FOR FAILURE TO PAY PREMIUMS.
8-8 Except as provided by this subchapter, the corporation shall
8-9 terminate the coverage of a child for failure to pay a premium as
8-10 required under Section 154.196(b).
8-11 Sec. 154.201. PREMIUM STABILIZATION REVOLVING ACCOUNT.
8-12 (a) The premium stabilization revolving account is an account
8-13 designed to provide health insurance premium payments for a child
8-14 whose noncustodial parent is unable to make child support payments
8-15 for a short period of time.
8-16 (b) The premium stabilization revolving account is composed
8-17 of money contributed to the account under this subchapter, money
8-18 appropriated to the account by the legislature, and any gift of
8-19 money accepted by the board for the purposes of the account.
8-20 Sec. 154.202. FEE; DEPOSIT TO ACCOUNT. (a) The corporation
8-21 shall charge for each child covered under the program a reasonable
8-22 premium stabilization revolving account fee not to exceed $5 each
8-23 month.
8-24 (b) The corporation shall remit money collected under this
8-25 section to the comptroller, in accordance with rules adopted by the
9-1 comptroller, for deposit to the credit of the premium stabilization
9-2 revolving account.
9-3 Sec. 154.203. USE OF MONEY IN ACCOUNT. (a) Money in the
9-4 premium stabilization revolving account may be used by the
9-5 corporation only to pay a premium for coverage provided through the
9-6 program for a child for whom a premium is not paid in accordance
9-7 with Section 154.196(b).
9-8 (b) A premium may not be paid for a child who is covered by
9-9 a health benefits plan other than the plan offered by the
9-10 corporation.
9-11 (c) The corporation shall determine the period for which
9-12 premiums may be paid from the fund and the circumstances under
9-13 which a premium may be paid.
9-14 (d) The parent, managing conservator, or guardian of a child
9-15 for whom a premium is paid from the premium stabilization revolving
9-16 account, or another person sponsoring coverage for the child,
9-17 remains responsible for reimbursing the account for the premium
9-18 paid. The coverage for the child is subject to termination, in
9-19 accordance with criteria adopted by the board, if the parent,
9-20 managing conservator, guardian, or sponsor fails to reimburse the
9-21 account as required by this subsection. The corporation shall
9-22 remit money collected under this subsection to the comptroller for
9-23 deposit to the credit of the account.
9-24 Sec. 154.204. COOPERATION OF AND ASSISTANCE TO STATE
9-25 AGENCIES. A health and human services agency, as that term is
10-1 defined by Section 531.001, Government Code, the Texas Department
10-2 of Insurance, the Title IV-D agency, and the comptroller shall
10-3 cooperate with the corporation as it performs its duties.
10-4 (b) The corporation shall work with the Title IV-D agency,
10-5 the Texas Department of Human Services, and the Texas Department of
10-6 Health to facilitate the electronic exchange of information among
10-7 the corporation and the agencies that relates to individuals who:
10-8 (1) are covered under the program; and
10-9 (2) are the subject of a medical child support order
10-10 or are or may be eligible for benefits under a federally or
10-11 state-funded program administered by the Texas Department of Human
10-12 Services or the Texas Department of Health.
10-13 SECTION 3. Not later than January 15, 1999, the Texas
10-14 Healthy Kids Corporation shall submit a written report to the
10-15 governor, the lieutenant governor, the speaker of the house of
10-16 representatives, and the commissioner of insurance. The report
10-17 must state the status of the health benefit program provided by the
10-18 corporation under Subchapter D, Chapter 154, Family Code, as
10-19 amended by this Act, and must include a statement of the
10-20 corporation's financial condition for the first year.
10-21 SECTION 4. A court may not order that coverage be provided a
10-22 child through the Texas Healthy Kids Corporation under Section
10-23 154.182, Family Code, as amended by this Act, before the date the
10-24 corporation first offers coverage under a health benefit plan.
10-25 SECTION 5. (a) As soon as practicable after the effective
11-1 date of this Act, the Title IV-D agency shall seek the modification
11-2 of child support orders that are enforced by the Title IV-D agency
11-3 and to which Section 154.182(b)(3), Family Code, as amended by this
11-4 Act, applies to obtain additional medical child support under that
11-5 subdivision.
11-6 (b) Not later than January 15, 1999, the director of the
11-7 Title IV-D agency shall submit a written report to the governor,
11-8 the lieutenant governor, and the speaker of the house of
11-9 representatives on the implementation of this section.
11-10 SECTION 6. The importance of this legislation and the
11-11 crowded condition of the calendars in both houses create an
11-12 emergency and an imperative public necessity that the
11-13 constitutional rule requiring bills to be read on three several
11-14 days in each house be suspended, and this rule is hereby suspended,
11-15 and that this Act take effect and be in force from and after its
11-16 passage, and it is so enacted.