1-1 By: Coleman (Senate Sponsor - Madla) H.B. No. 1097
1-2 (In the Senate - Received from the House May 5, 1999;
1-3 May 6, 1999, read first time and referred to Committee on Economic
1-4 Development; May 14, 1999, reported favorably by the following
1-5 vote: Yeas 5, Nays 0; May 14, 1999, sent to printer.)
1-6 A BILL TO BE ENTITLED
1-7 AN ACT
1-8 relating to application requirements for participation in the Texas
1-9 Health Insurance Risk Pool.
1-10 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-11 SECTION 1. Section 10(a), Article 3.77, Insurance Code, is
1-12 amended to read as follows:
1-13 (a) Any individual person who is and continues to be a
1-14 resident of Texas and a citizen of the United States shall be
1-15 eligible for coverage from the pool if the individual provides to
1-16 the pool [evidence is provided of]:
1-17 (1) a notice of rejection or refusal to issue
1-18 substantially similar individual insurance for health reasons by
1-19 one insurer, other than a [two insurers. A] rejection or refusal
1-20 by an insurer offering only stop-loss, excess loss, or reinsurance
1-21 coverage;
1-22 (2) a certification from an agent or salaried
1-23 representative of an insurer, on a form developed by the board and
1-24 approved by the commissioner, that states that the agent or
1-25 salaried representative is unable to obtain substantially similar
1-26 individual insurance for the individual with any state-licensed
1-27 insurer that the agent or salaried representative represents
1-28 because the individual will be declined for coverage as a result of
1-29 a medical condition of the individual under the underwriting
1-30 guidelines of the insurer [with respect to the applicant shall not
1-31 be sufficient evidence under this subsection];
1-32 (3) [(2)] an offer to issue substantially similar
1-33 individual insurance only with conditional riders;
1-34 (4) [(3)] a refusal by an insurer to issue
1-35 substantially similar individual insurance except at a rate
1-36 exceeding the pool rate;
1-37 (5) evidence of [(4)] the individual's maintenance of
1-38 health insurance coverage for the previous 18 months with no gap in
1-39 coverage greater than 63 days of which the most recent coverage was
1-40 through an employer sponsored plan; or
1-41 (6) [(5)] diagnosis of the individual with one of the
1-42 medical or health conditions listed by the board under Section 6(c)
1-43 of this article and for which a person shall be eligible for pool
1-44 coverage [without applying for health insurance coverage].
1-45 SECTION 2. This Act takes effect September 1, 1999, and
1-46 applies only to an application for coverage under the Texas Health
1-47 Insurance Risk Pool under Article 3.77, Insurance Code, as amended
1-48 by this Act, that is filed with that pool on or after the effective
1-49 date of this Act.
1-50 SECTION 3. The importance of this legislation and the
1-51 crowded condition of the calendars in both houses create an
1-52 emergency and an imperative public necessity that the
1-53 constitutional rule requiring bills to be read on three several
1-54 days in each house be suspended, and this rule is hereby suspended.
1-55 * * * * *