By Coleman H.B. No. 1097
76R2668 DB-D
A BILL TO BE ENTITLED
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 board [evidence is provided of]:
1-11 (1) a notice of rejection or refusal to issue
1-12 substantially similar insurance for health reasons by two insurers,
1-13 other than a[. A] rejection or refusal by an insurer offering only
1-14 stop-loss, excess loss, or reinsurance coverage;
1-15 (2) copies of the requirements of two insurance plans
1-16 that are substantially similar to the plan offered by the pool,
1-17 other than plans offering only stop-loss, excess loss, or
1-18 reinsurance coverage, and a certified copy of the individual's
1-19 medical record showing a pre-existing condition that together
1-20 demonstrate the strong probability that the individual would have
1-21 been refused coverage under those insurance plans [with respect to
1-22 the applicant shall not be sufficient evidence under this
1-23 subsection];
1-24 (3) [(2)] an offer to issue insurance only with
2-1 conditional riders;
2-2 (4) [(3)] a refusal by an insurer to issue insurance
2-3 except at a rate exceeding the pool rate;
2-4 (5) evidence of [(4)] the individual's maintenance of
2-5 health insurance coverage for the previous 18 months with no gap in
2-6 coverage greater than 63 days of which the most recent coverage was
2-7 through an employer sponsored plan; or
2-8 (6) [(5)] diagnosis of the individual with one of the
2-9 medical or health conditions listed by the board under Section 6(c)
2-10 of this article and for which a person shall be eligible for pool
2-11 coverage without applying for health insurance coverage.
2-12 SECTION 2. This Act takes effect September 1, 1999, and
2-13 applies only to an application for coverage under the Texas Health
2-14 Insurance Risk Pool under Article 3.77, Insurance Code, as amended
2-15 by this Act, that is filed with that pool on or after the effective
2-16 date of this Act.
2-17 SECTION 3. The importance of this legislation and the
2-18 crowded condition of the calendars in both houses create an
2-19 emergency and an imperative public necessity that the
2-20 constitutional rule requiring bills to be read on three several
2-21 days in each house be suspended, and this rule is hereby suspended.