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.
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