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.