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.