By Capelo                                             H.B. No. 2868
         76R7169 AJA-F                           
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to provision of certain information by a large employer
 1-3     health insurance carrier to an insured large employer.
 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-5           SECTION 1.  Subchapter H, Chapter 26, Insurance Code, is
 1-6     amended by adding Article 26.96 to read as follows:
 1-7           Art. 26.96.  REPORTING OF CLAIMS INFORMATION.  (a)  This
 1-8     article applies only to an insured large employer health benefit
 1-9     plan.
1-10           (b)  A large employer carrier, on written request from an
1-11     insured large employer covered by that carrier, shall report to the
1-12     employer information from the 12 months preceding the date of the
1-13     report regarding:
1-14                 (1)  the total amount of charges submitted to the
1-15     carrier for persons covered under the large employer health benefit
1-16     plan;
1-17                 (2)  the total amount of payments made by the carrier
1-18     to health care providers for persons covered under the plan;
1-19                 (3)  to the extent available, information on claims
1-20     paid by type of health care provider, including the total hospital
1-21     charges, physician charges, pharmaceutical charges, and other
1-22     charges; and
1-23                 (4)  the total amount of claims paid by the carrier for
1-24     each person covered under the plan.
 2-1           (c)  A large employer carrier shall provide information
 2-2     requested by a large employer under this article  annually not
 2-3     later than the 30th day before the anniversary or renewal date of
 2-4     the employer's health benefit plan.
 2-5           (d)  Notwithstanding Subsection (c) of this article, a large
 2-6     employer is not required to provide information under Subsection
 2-7     (a) of this article earlier than the 30th day after the date of the
 2-8     initial written request.
 2-9           (e)  A large employer carrier may not report any information
2-10     required under this article the release of which is prohibited by
2-11     federal law or regulation.
2-12           SECTION 2.  This Act takes effect September 1, 1999, and
2-13     applies only to an insured large employer health benefit plan that
2-14     is delivered,  issued for delivery, or renewed on or after January
2-15     1, 2000.  A plan delivered, issued for delivery, or renewed before
2-16     January 1, 2000, is governed by the law as it existed immediately
2-17     before the effective date of this Act, and that law is continued in
2-18     effect for that purpose.
2-19           SECTION 3.  The importance of this legislation and the
2-20     crowded condition of the calendars in both houses create an
2-21     emergency and an imperative public necessity that the
2-22     constitutional rule requiring bills to be read on three several
2-23     days in each house be suspended, and this rule is hereby suspended.