1-1 AN ACT
1-2 relating to application requirements for participation in the Texas
1-3 Health Insurance Risk Pool.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Section 10(a), Article 3.77, Insurance Code, is
1-6 amended to read as follows:
1-7 (a) Any individual person who is and continues to be a
1-8 resident of Texas and a citizen of the United States shall be
1-9 eligible for coverage from the pool if the individual provides to
1-10 the pool [evidence is provided of]:
1-11 (1) a notice of rejection or refusal to issue
1-12 substantially similar individual insurance for health reasons by
1-13 one insurer, other than a [two insurers. A] rejection or refusal
1-14 by an insurer offering only stop-loss, excess loss, or reinsurance
1-15 coverage;
1-16 (2) a certification from an agent or salaried
1-17 representative of an insurer, on a form developed by the board and
1-18 approved by the commissioner, that states that the agent or
1-19 salaried representative is unable to obtain substantially similar
1-20 individual insurance for the individual with any state-licensed
1-21 insurer that the agent or salaried representative represents
1-22 because the individual will be declined for coverage as a result of
1-23 a medical condition of the individual under the underwriting
1-24 guidelines of the insurer [with respect to the applicant shall not
2-1 be sufficient evidence under this subsection];
2-2 (3) [(2)] an offer to issue substantially similar
2-3 individual insurance only with conditional riders;
2-4 (4) [(3)] a refusal by an insurer to issue
2-5 substantially similar individual insurance except at a rate
2-6 exceeding the pool rate;
2-7 (5) evidence of [(4)] the individual's maintenance of
2-8 health insurance coverage for the previous 18 months with no gap in
2-9 coverage greater than 63 days of which the most recent coverage was
2-10 through an employer sponsored plan; or
2-11 (6) [(5)] diagnosis of the individual with one of the
2-12 medical or health conditions listed by the board under Section 6(c)
2-13 of this article and for which a person shall be eligible for pool
2-14 coverage [without applying for health insurance coverage].
2-15 SECTION 2. This Act takes effect September 1, 1999, and
2-16 applies only to an application for coverage under the Texas Health
2-17 Insurance Risk Pool under Article 3.77, Insurance Code, as amended
2-18 by this Act, that is filed with that pool on or after the effective
2-19 date of this Act.
2-20 SECTION 3. The importance of this legislation and the
2-21 crowded condition of the calendars in both houses create an
2-22 emergency and an imperative public necessity that the
2-23 constitutional rule requiring bills to be read on three several
2-24 days in each house be suspended, and this rule is hereby suspended.
_______________________________ _______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 1097 was passed by the House on May
4, 1999, by a non-record vote.
_______________________________
Chief Clerk of the House
I certify that H.B. No. 1097 was passed by the Senate on May
26, 1999, by the following vote: Yeas 30, Nays 0.
_______________________________
Secretary of the Senate
APPROVED: _____________________
Date
_____________________
Governor