HBA-ATS H.B. 2340 76(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 2340
By: Wise
Insurance
3/28/1999
Introduced



BACKGROUND AND PURPOSE 

A preferred provider organization (PPO) insurance plan is a type of plan in
which a network of physicians, providers, and hospitals agree to discount
rates for an insurance company.  Members have the choice of receiving
network or non-network coverage, although non-network coverage is subject
to higher deductibles and copayments.  Currently, the only employers in
Texas that can provide coverage for dental benefits through a PPO are those
employers that have self-funded ERISA health benefit plans (a plan funded
strictly from employer contributions and employee premiums).  

H.B. 2340 redefines the definition of a "health insurance policy" offered
by an insurance company which issues a preferred provider benefit plan to
include dental expenses among the expenses for which the policy must
provide coverage.  This bill also includes the provision that a preferred
provider benefit plan that provides different benefits from the basic level
of coverage for the use of preferred providers is not subject to the
provisions of Article 21.53, Insurance Code. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that this bill does
not expressly delegate any additional rulemaking authority to a state
officer, department, agency, or institution. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 1(2), Article 3.70-3C, Insurance Code, as added
by Chapter 1024, Acts of the 75th Legislature, Regular Session, 1997, to
redefine "health insurance policy" by including dental expenses among the
expenses for which the policy must provide coverage. 

SECTION 2.  Amends Section 2, Article 3.70-3C, Insurance Code, as added by
Chapter 1024, Acts of the 75th Legislature, Regular Session, 1997, to make
a conforming change. 

SECTION 3.  Amends Section 3(a), Article 3.70-3C, Insurance Code, as added
by Chapter 1024, Acts of the 75th Legislature, Regular Session, 1997, to
include the provision that a health insurance policy that provides
different benefits from the basic level of coverage for the use of
preferred providers is not subject to the provisions of Article 21.53
(Dental Care Benefits;  Insurance Policies and Employee Benefit Plans),
Insurance Code, if it meets the requirements of this section. 

SECTION 4.  Effective date: September 1, 1999.
          Makes application of this Act prospective for an insurance policy
that is delivered,            issued for delivery, or renewed on or after
January 1, 2000. 

SECTION 5.  Emergency clause.