By Rangel H.B. No. 1179
Line and page numbers may not match official copy.
Bill not drafted by TLC or Senate E&E.
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to group health coverage for school district employees.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Section 22.004(a), Education Code, is amended to
1-5 read as follows:
1-6 (a) Each district shall provide to its employees group
1-7 health coverage provided by a risk pool established by one or more
1-8 school districts under Chapter 172, Local Government Code, or under
1-9 a policy of insurance or group contract issued by an insurer, a
1-10 company subject to Chapter 20, Insurance Code, or a health
1-11 maintenance organization under the Texas Health Maintenance
1-12 Organization Act (Chapter 20A, Vernon's Texas Insurance Code). The
1-13 coverage must meet the substantive coverage requirements of Article
1-14 3.51-6, Insurance Code, and any other law applicable to group
1-15 health insurance policies or contracts issued in this state. The
1-16 coverage must include major medical treatment but may exclude
1-17 experimental procedures. In this subsection, "major medical
1-18 treatment" means a medical, surgical, or diagnostic procedure for
1-19 illness or injury. The coverage may include managed care or
1-20 preventive care and must be comparable to the basic health coverage
1-21 provided under the Texas Employees Uniform Group Insurance Benefits
2-1 Act (Article 3.50-2, Vernon's Texas Insurance Code). The board of
2-2 trustees of the Teacher Retirement System of Texas shall adopt
2-3 rules to determine whether a school district's group health
2-4 coverage maintains a standard of comparability of at least 95
2-5 percent based on each individual health plan option offered in the
2-6 district and a composite average of all individual health plan
2-7 options offered in the district when compared [is comparable] to
2-8 the basic health coverage specified by this subsection. The rules
2-9 must provide for consideration of the following factors concerning
2-10 the district's coverage in determining whether the district's
2-11 coverage is comparable to the basic health coverage specified by
2-12 this subsection:
2-13 (1) the deductible amount for service provided inside
2-14 and outside of the network;
2-15 (2) the coinsurance percentages for service provided
2-16 inside and outside of the network;
2-17 (3) the maximum amount of coinsurance payments a
2-18 covered person is required to pay;
2-19 (4) the amount of the copayment for an office visit;
2-20 (5) the schedule of benefits and the scope of
2-21 coverage;
2-22 (6) the lifetime maximum benefit amount;
2-23 (7) the employee cost of coverage; and
2-24 (8) [(7)] verification that the coverage is issued by
2-25 a provider licensed to do business in this state by the Texas
3-1 Department of Insurance or is provided by a risk pool authorized
3-2 under Chapter 172, Local Government Code, or that a district is
3-3 capable of covering the assumed liabilities in the case of
3-4 coverage provided through district self-insurance.
3-5 SECTION 2. Section 39.075(a), Education Code, is amended to
3-6 read as follows:
3-7 (a) The commissioner shall authorize special accreditation
3-8 investigations to be conducted under the following circumstances:
3-9 (1) when excessive numbers of absences of students
3-10 eligible to be tested on state assessment instruments are
3-11 determined;
3-12 (2) when excessive numbers of allowable exemptions
3-13 from the required state assessment are determined;
3-14 (3) in response to complaints submitted to the agency
3-15 with respect to alleged violations of civil rights or other
3-16 requirements imposed on the state by federal law or court order;
3-17 (4) in response to established compliance reviews of
3-18 the district's financial accounting practices and state and federal
3-19 program requirements;
3-20 (5) when extraordinary numbers of student placements
3-21 in alternative education programs, other than placements under
3-22 Sections 37.006 and 37.007, are determined; [or]
3-23 (6) in response to an allegation involving a conflict
3-24 between members of the board of trustees or between the board and
3-25 the district administration if it appears that the conflict
4-1 involves a violation of a role or duty of the board members or the
4-2 administration clearly defined by this code; or
4-3 (7) when a district is found to be out of compliance
4-4 with Section 22.004.
4-5 SECTION 3. Sections 22.004 and 39.075, Education Code, as
4-6 amended by this Act, apply beginning with the 1999-2000 school
4-7 year.
4-8 SECTION 4. The importance of this legislation and the
4-9 crowded condition of the calendars in both houses create an
4-10 emergency and an imperative public necessity that the
4-11 constitutional rule requiring bills to be read on three several
4-12 days in each house be suspended, and this rule is hereby suspended.