SRC-PNG C.S.S.B. 1237 76(R)BILL ANALYSIS


Senate Research CenterC.S.S.B. 1237
76R10507 DLF-FBy: Nelson
Economic Development
3/31/1999
Committee Report (Substituted)


DIGEST 

Currently, under Texas law, insurers are not required to include
standardized information on enrollees' pharmacy identification cards.  This
bill would require health benefit plans to provide uniform pharmacy
identification cards for each enrollee, to include certain standardized
information. 

PURPOSE

As proposed, C.S.S.B. 1237 requires health benefit plans to provide to each
enrollee uniform pharmacy identification cards, which shall include certain
standardized information. 

RULEMAKING AUTHORITY

Rulemaking authority is granted to the insurance commissioner in SECTION 2
(Section 19A(b), Article 21.07-6, Insurance Code) of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Section 1(1), Article 21.07-6, Insurance Code, to
redefine "administrator." 

SECTION 2. Amends Article 21.07-6, Insurance Code, by adding Section 19A,
as follows: 

Sec.  19A.  IDENTIFICATION CARDS FOR CERTAIN PLANS.  Requires an
administrator for a plan that provides pharmacy benefits to issue an
identification card to each individual covered by the plan who is at least
17 years of age.  Requires the insurance commissioner (commissioner), by
rule, to adopt standard information to be included on the identification
card.  Requires the standard form to include certain information.  Requires
an administrator for a plan that provides pharmacy benefits to issue to an
individual an identification card by a certain date. 

SECTION 3. Amends Chapter 21E, Insurance Code, by adding Article 21.53L, as
follows: 

Art.  21.53L.  PHARMACY BENEFIT CARDS

Sec.  1.  DEFINITION.  Defines "health benefit plan."

Sec.  2.  SCOPE OF ARTICLE.  Provides that this article applies only to a
health benefit plan that provides benefits for medical or surgical expenses
incurred as a result of a health condition, accident, or sickness.
Provides that this article does not apply to certain plans and policies. 

Sec.  3.  IDENTIFICATION CARD; PHARMACY BENEFITS.  Sets forth required
information to be included on the identification cards issued by a health
benefit plan that provides pharmacy benefits.  Provides that this section
does not require a health benefit plan that administers its own pharmacy
benefits to issue an identification card separate from any identification
card issued to an enrollee to evidence coverage under the health benefit
plan, if the identification card contains the information required by
Subsection (a) of this section. Makes conforming changes. 

 SECTION 4. Effective date: September 1, 1999.

SECTION 5. Makes application of this Act prospective to January 1, 2000.
Provides that an administrator is not required to issue a new
identification card to an individual, as required by Section 19A, Article
21.07-6, Insurance Code, if the identification card held by the individual
on the effective date of this Act contains the required information,
described by Sections 19A(b)(2)-(5), Article 21.07-6, Insurance Code.
Requires a new card complying with Section 19A, Article 21.07-6, Insurance
Code, to be issued at the time the individual's coverage is modified.
Provides that a health benefit plan is not required to issue a new
identification card to an enrollee, as required by Section 3, Article
21.53L, Insurance Code, if the identification card held by the enrollee on
the effective date of this Act contains the information required by
Sections 3(a)(2)-(5), Article 21.53L, Insurance Code. Requires a new card
complying with Article 21.53L, Insurance Code, to be issued at the time the
enrollee's coverage is modified. 

SECTION 6. Emergency clause.

SUMMARY OF COMMITTEE CHANGES

SECTION 2. 

Amends Section 19A, Article 21.07-6, Insurance Code, to require an
administrator for a plan that provides pharmacy benefits to issue an
identification card to each individual covered by the plan who is at least
17 years of age.  Requires the commissioner, by rule, to adopt standard
information to be included on the identification card, rather than a
standard form for the identification card.  Requires the standard form to
include certain information, including the name or logo of the entity that
is administering the pharmacy benefits, the International Identification
Number that is assigned by the American National Standards Institute for
the entity that is administering the pharmacy benefits, and the effective
date, rather than the expiration date, of the coverage evidenced by the
card.  Requires an administrator for a plan that provides pharmacy benefits
to issue to an individual an identification card by a certain date. 

SECTION 3.

Amends Chapter 21E, Insurance Code, by adding Article 21.53L, to require
pharmacy benefit cards under health benefit plans to include certain
required information.  Deletes existing SECTION 3 applying Article 21.07-6,
Insurance Code, to an entity that acts as an administrator with respect to
pharmacy benefits. 

SECTION 5.

Provides that an administrator or a health benefit plan is not required to
issue a new identification card to an individual, or enrollee, as required,
by this Act, if the identification card held by the individual, or
enrollee, on the effective date of this Act contains the required
information.  Requires a new card complying with this Act to be issued at
the time the individual's or enrollee's coverage is modified.  Deletes text
providing that an administrator is not required to provide an
identification card to an individual, as required, before January 1, 2000.