By Isett H.B. No. 3680
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 an interim study by the Texas Department of Insurance
1-3 regarding portability of certain health benefit plan coverage.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Subchapter C, Chapter 21, Insurance Code, is
1-6 amended by adding Article 21.24-4 to read as follows:
1-7 Art. 21.24-4. INTERIM STUDY BY DEPARTMENT OF PORTABILITY OF
1-8 CERTAIN HEALTH BENEFIT PLAN COVERAGE.
1-9 Sec. 1. DEFINITION. In this article, "health benefit plan"
1-10 means a plan subject to Section 2 of this article.
1-11 Sec. 2. SCOPE OF ARTICLE. (a) This article applies only to
1-12 a health benefit plan that provides benefits for medical or
1-13 surgical expenses incurred as a result of a health condition,
1-14 accident, or sickness, including an individual, group, blanket, or
1-15 franchise insurance policy or insurance agreement, a group hospital
1-16 service contract, or an individual or group evidence of coverage or
1-17 similar coverage document that is offered by:
1-18 (1) an insurance company;
1-19 (2) a group hospital service corporation operating
1-20 under Chapter 20 of this code;
1-21 (3) a fraternal benefit society operating under
2-1 Chapter 10 of this code;
2-2 (4) a stipulated premium insurance company operating
2-3 under Chapter 22 of this code;
2-4 (5) a reciprocal exchange operating under Chapter 19
2-5 of this code;
2-6 (6) a health maintenance organization operating under
2-7 the Texas Health Maintenance Organization Act (Chapter 20A,
2-8 Vernon's Texas Insurance Code);
2-9 (7) a multiple employer welfare arrangement that holds
2-10 a certificate of authority under Article 3.95-2 of this code; or
2-11 (8) an approved nonprofit health corporation that
2-12 holds a certificate of authority issued by the commissioner under
2-13 Article 21.52F of this code.
2-14 (b) This article does not apply to:
2-15 (1) a plan that provides coverage:
2-16 (A) only for a specified disease or other
2-17 limited benefit;
2-18 (B) only for accidental death or dismemberment;
2-19 (C) for wages or payments in lieu of wages for a
2-20 period during which an employee is absent from work because of
2-21 sickness or injury;
2-22 (D) as a supplement to liability insurance;
2-23 (E) for credit insurance;
2-24 (F) only for dental or vision care;
2-25 (G) only for hospital expenses; or
3-1 (H) only for indemnity for hospital confinement;
3-2 (2) a small employer health benefit plan written under
3-3 Chapter 26 of this code;
3-4 (3) a Medicare supplemental policy as defined by
3-5 Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);
3-6 (4) workers' compensation insurance coverage;
3-7 (5) medical payment insurance coverage issued as part
3-8 of a motor vehicle insurance policy; or
3-9 (6) a long-term care policy, including a nursing home
3-10 fixed indemnity policy, unless the commissioner determines that the
3-11 policy provides benefit coverage so comprehensive that the policy
3-12 is a health benefit plan as described by Subsection (a) of this
3-13 section.
3-14 Sec. 3. INTERIM STUDY. (a) The department shall conduct a
3-15 study of the implementation and operation of a program for
3-16 portability of health benefit plan coverage as provided by this
3-17 article.
3-18 (b) The department shall examine the feasibility of a
3-19 portability program under which an individual who is covered by a
3-20 health benefit plan provided to the individual as a benefit of
3-21 employment is able to obtain personal and portable coverage under
3-22 that plan on leaving that employment by paying any difference
3-23 between the cost to an employee for coverage under the plan offered
3-24 by the initial employer and the cost to an employee of a plan
3-25 offered by a subsequent employer.
4-1 (c) Under the program, the individual who elects to remain
4-2 covered under the plan offered by the initial employer would remain
4-3 eligible for any contribution made for health benefit plan coverage
4-4 by a subsequent employer. The individual would pay the difference
4-5 in the cost for an employee for coverage under the plan offered by
4-6 the initial employer and the cost for an employee of the plan
4-7 offered by the subsequent employer to the subsequent employer for
4-8 transmittal to the health benefit plan issuer of the initial plan.
4-9 The subsequent employer would pay the contribution that that
4-10 employer would otherwise make for the individual for health benefit
4-11 plan coverage to that health benefit plan issuer.
4-12 (d) In conducting the study, the department shall analyze
4-13 the effect of any applicable federal law or regulation, including
4-14 the Employee Retirement Income Security Act of 1974 (29 U.S.C. Sec.
4-15 1001 et seq., as amended.
4-16 Sec. 4. REPORT. The department shall submit a written
4-17 report regarding the results of the study, accompanied by any
4-18 recommendations for proposed legislation, to the lieutenant
4-19 governor, the speaker of the house of representatives, and the
4-20 members of the 77th Legislature not later than February 1, 2001.
4-21 Sec. 5. EXPIRATION. This article expires March 1, 2001.
4-22 SECTION 2. The importance of this legislation and the
4-23 crowded condition of the calendars in both houses create an
4-24 emergency and an imperative public necessity that the
4-25 constitutional rule requiring bills to be read on three several
5-1 days in each house be suspended, and this rule is hereby suspended,
5-2 and that this Act take effect and be in force from and after its
5-3 passage, and it is so enacted.