76R14931 DLF-F                          
         By Nelson, et al.                                     S.B. No. 1237
         Substitute the following for S.B. No. 1237:
         By Olivo                                          C.S.S.B. No. 1237
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to the administration of pharmacy benefits under certain
 1-3     health benefit plans.
 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-5           SECTION 1.  Subdivision (1), Section 1, Article 21.07-6,
 1-6     Insurance Code, is amended to read as follows:
 1-7                 (1)  "Administrator" means a person who collects
 1-8     premiums or contributions from or who adjusts or settles claims in
 1-9     connection with life, health, and accident benefits, including
1-10     pharmacy benefits, or annuities for residents of this state but
1-11     does not include:
1-12                       (A)  an employer on behalf of its employees or
1-13     the employees of one or more subsidiaries or affiliated
1-14     corporations of the employer;
1-15                       (B)  a union on behalf of its members;
1-16                       (C)  an insurance company or a group hospital
1-17     service corporation subject to Chapter 20 of this code with respect
1-18     to a policy lawfully issued and delivered by it in and under the
1-19     law of a state in which the insurer was authorized to do an
1-20     insurance business;
1-21                       (D)  a health maintenance organization that is
1-22     authorized to operate in this state under the Texas Health
1-23     Maintenance Organization Act (Chapter 20A, Vernon's Texas Insurance
1-24     Code), with respect to any activity that is specifically regulated
 2-1     under that Act;
 2-2                       (E)  an agent licensed under Article 21.07 or
 2-3     Chapter 213, Acts of the 54th Legislature, Regular Session, 1955
 2-4     (Article 21.07-1, Vernon's Texas Insurance Code), who is acting
 2-5     under appointment on behalf of an insurance company authorized to
 2-6     do business in this state and within the customary scope and duties
 2-7     of the insurance agent's authority as an agent and who receives
 2-8     commissions as an agent;
 2-9                       (F)  a creditor who is acting on behalf of its
2-10     debtors with respect to insurance that covers a debt between the
2-11     creditor and its debtor so long as only the functions of a group
2-12     policyholder or creditor are performed;
2-13                       (G)  a trust established in conformity with 29
2-14     U.S.C. Section 186 and the trustees and employees who are acting
2-15     under the trust;
2-16                       (H)  a trust that is exempt from taxation under
2-17     Section 501(a) of the Internal Revenue Code of 1986 and the
2-18     trustees and employees acting under the trust, or a custodian and
2-19     the custodian's agents and employees who are acting pursuant to a
2-20     custodian account that complies with Section 401(f), Internal
2-21     Revenue Code of 1986;
2-22                       (I)  a bank, credit union, savings and loan
2-23     association, or other financial institution that is subject to
2-24     supervision or examination under federal or state law by federal or
2-25     state regulatory authorities so long as that institution is
2-26     performing only those functions for which it holds a license under
2-27     federal or state law;
 3-1                       (J)  a company that advances and collects a
 3-2     premium or charge from its credit card holders on their
 3-3     authorization, if the company does not adjust or settle claims and
 3-4     acts only in the company's debtor-creditor relationship with its
 3-5     credit card holders;
 3-6                       (K)  a person who adjusts or settles claims in
 3-7     the normal course of his practice or employment as a licensed
 3-8     attorney and who does not collect any premium or charge in
 3-9     connection with life, health, or accident benefits, including
3-10     pharmacy benefits, or annuities;
3-11                       (L)  an adjuster licensed by the commissioner, if
3-12     the adjuster is engaged in the performance of his powers and duties
3-13     as an adjuster within the scope of his license;
3-14                       (M)  a person who provides technical, advisory,
3-15     utilization review, precertification, or consulting services to an
3-16     insurer, plan, or plan sponsor and who does not make any management
3-17     or discretionary decisions on behalf of an insurer, plan, or plan
3-18     sponsor;
3-19                       (N)  an attorney in fact for a Lloyd's operating
3-20     under Chapter 18 of this code or a reciprocal or interinsurance
3-21     exchange operating under Chapter 19 of this code if acting in the
3-22     capacity of attorney in fact under the applicable chapter;
3-23                       (O)  a municipality that is self-insured or a
3-24     joint fund, risk management pool, or a self-insurance pool composed
3-25     of political subdivisions of this state that participate in a fund
3-26     or pool through interlocal agreements and any nonprofit
3-27     administrative agency or governing body or any nonprofit entity
 4-1     that acts solely on behalf of a fund, pool, agency, or body or any
 4-2     other funds, pools, agencies, or bodies that are established
 4-3     pursuant to or for the purpose of implementing an interlocal
 4-4     governmental agreement;
 4-5                       (P)  a self-insured political subdivision;
 4-6                       (Q)  a plan under which insurance benefits are
 4-7     provided exclusively by a carrier licensed to do business in this
 4-8     state and the administrator of the plan is either:
 4-9                             (i)  a full-time employee of the plan's
4-10     organizing or sponsoring association, trust, or other entity; or
4-11                             (ii)  the trustee or trustees of the
4-12     organizing or sponsoring trust; or
4-13                       (R)  a parent of a wholly owned direct or
4-14     indirect subsidiary insurer licensed to do business in this state
4-15     or a wholly owned direct or indirect subsidiary insurer that is a
4-16     part of the parent's holding company system that, only on behalf of
4-17     itself or its affiliated insurers:
4-18                             (i)  collects premiums or contributions, if
4-19     the parent or subsidiary insurer prepares only billing statements,
4-20     places those statements in the United States mail, and causes all
4-21     collected premiums to be deposited directly in a depository account
4-22     of the particular affiliated insurer, and the services rendered by
4-23     the parent or subsidiary are performed under an agreement regulated
4-24     and approved under Article 21.49-1 of this code or a similar
4-25     statute of the domiciliary state if the parent or subsidiary is a
4-26     foreign insurer doing business in this state; or
4-27                             (ii)  furnishes proof-of-loss forms,
 5-1     reviews claims, determines the amount of the liability for those
 5-2     claims, and negotiates settlements, but pays claims only from the
 5-3     funds of the particular subsidiary by checks or drafts of that
 5-4     subsidiary and the services rendered by the parent or subsidiary
 5-5     are performed under an agreement regulated and approved under
 5-6     Article 21.49-1 of this code or a similar statute of the
 5-7     domiciliary state if the parent or subsidiary is a foreign insurer
 5-8     doing business in this state.
 5-9           SECTION 2.  Article 21.07-6, Insurance Code, is amended by
5-10     adding Section 19A to read as follows:
5-11           Sec. 19A.  IDENTIFICATION CARDS FOR CERTAIN PLANS.  (a)
5-12     Except as provided by rules adopted by the commissioner, an
5-13     administrator for a plan that provides pharmacy benefits shall
5-14     issue an identification card to each individual covered by the
5-15     plan.
5-16           (b)  The commissioner by rule shall adopt standard
5-17     information to be included on the identification card.  At minimum,
5-18     the standard form identification card must include:
5-19                 (1)  the name or logo of the entity that is
5-20     administering the pharmacy benefits;
5-21                 (2)  the International Identification Number that is
5-22     assigned by the American National Standards Institute for the
5-23     entity that is administering the pharmacy benefits;
5-24                 (3)  the group number applicable for the individual;
5-25                 (4)  the effective date of the coverage evidenced by
5-26     the card;
5-27                 (5)  a telephone number to be used to contact an
 6-1     appropriate person to obtain information relating to the pharmacy
 6-2     benefits provided under the coverage; and
 6-3                 (6)  copayment information for generic and brand-name
 6-4     prescription drugs.
 6-5           (c)  An administrator for a plan that provides pharmacy
 6-6     benefits shall issue to an individual an identification card not
 6-7     later than the 30th day after the date the administrator receives
 6-8     notice that the individual is eligible for the benefits.
 6-9           SECTION 3.  Subchapter E, Chapter 21, Insurance Code, is
6-10     amended by adding Article 21.53L to read as follows:
6-11           Art. 21.53L.  PHARMACY BENEFIT CARDS
6-12           Sec. 1.  DEFINITION.  In this article, "health benefit plan"
6-13     means a health benefit plan described by Section 2 of this article.
6-14           Sec. 2.  SCOPE OF ARTICLE.  (a)  This article applies only to
6-15     a health benefit plan that provides benefits for medical or
6-16     surgical expenses incurred as a result of a health condition,
6-17     accident, or sickness, including an individual, group, blanket, or
6-18     franchise insurance policy or insurance agreement, a group hospital
6-19     service contract, or an individual or group evidence of coverage or
6-20     similar coverage document that is offered by:
6-21                 (1)  an insurance company;
6-22                 (2)  a group hospital service corporation operating
6-23     under Chapter 20 of this code;
6-24                 (3)  a fraternal benefit society operating under
6-25     Chapter 10 of this code;
6-26                 (4)  a stipulated premium insurance company operating
6-27     under Chapter 22 of this code;
 7-1                 (5)  a reciprocal exchange operating under Chapter 19
 7-2     of this code;
 7-3                 (6)  a health maintenance organization operating under
 7-4     the Texas Health Maintenance Organization Act (Chapter 20A,
 7-5     Vernon's Texas Insurance Code);
 7-6                 (7)  a multiple employer welfare arrangement that holds
 7-7     a certificate of authority under Article 3.95-2 of this code; or
 7-8                 (8)  an approved nonprofit health corporation that
 7-9     holds a certificate of authority issued by the commissioner under
7-10     Article 21.52F of this code.
7-11           (b)  This article does not apply to:
7-12                 (1)  a plan that provides coverage:
7-13                       (A)  only for a specified disease or other
7-14     limited benefit;
7-15                       (B)  only for accidental death or dismemberment;
7-16                       (C)  for wages or payments in lieu of wages for a
7-17     period during which an employee is absent from work because of
7-18     sickness or injury;
7-19                       (D)  as a supplement to liability insurance;
7-20                       (E)  for credit insurance;
7-21                       (F)  only for dental or vision care;
7-22                       (G)  only for hospital expenses; or
7-23                       (H)  only for indemnity for hospital confinement;
7-24                 (2)  a small employer health benefit plan written under
7-25     Chapter 26 of this code;
7-26                 (3)  a Medicare supplemental policy as defined by
7-27     Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);
 8-1                 (4)  workers' compensation insurance coverage;
 8-2                 (5)  medical payment insurance coverage issued as part
 8-3     of a motor vehicle insurance policy; or
 8-4                 (6)  a long-term care policy, including a nursing home
 8-5     fixed indemnity policy, unless the commissioner determines that the
 8-6     policy provides benefit coverage so comprehensive that the policy
 8-7     is a health benefit plan as described by Subsection (a) of this
 8-8     section.
 8-9           Sec. 3.  IDENTIFICATION CARD; PHARMACY BENEFITS.  (a)  A
8-10     health benefit plan that provides pharmacy benefits for enrollees
8-11     in the plan shall include on the identification card of each
8-12     enrollee:
8-13                 (1)  the name or logo of the entity that is
8-14     administering the pharmacy benefits, if different from the health
8-15     benefit plan;
8-16                 (2)  the group number applicable to the individual;
8-17                 (3)  the effective date of the coverage evidenced by
8-18     the card;
8-19                 (4)  a telephone number to be used to contact an
8-20     appropriate person to obtain information relating to the pharmacy
8-21     benefits provided under the coverage; and
8-22                 (5)  copayment information for generic and brand-name
8-23     prescription drugs.
8-24           (b)  This section does not require a health benefit plan that
8-25     administers its own pharmacy benefits to issue an identification
8-26     card separate from any identification card issued to an enrollee to
8-27     evidence coverage under the health benefit plan, if the
 9-1     identification card contains the elements required by Subsection
 9-2     (a) of this section.
 9-3           Sec. 4.  RULES.  The commissioner shall adopt rules as
 9-4     necessary to implement this article.
 9-5           SECTION 4.  This Act takes effect September 1, 1999.
 9-6           SECTION 5.  (a)  This Act applies only to a person acting as
 9-7     an administrator, as that term is defined by Subdivision (1),
 9-8     Section 1, Article 21.07-6, Insurance Code, as amended by this Act,
 9-9     with respect to pharmacy benefits on or after January 1, 2000.  A
9-10     person acting as an administrator with respect to pharmacy
9-11     benefits before January 1, 2000, is governed by the law as it
9-12     existed immediately before the effective date of this Act, and that
9-13     law is continued in effect for that purpose.
9-14           (b)  An administrator, as that term is defined by Subdivision
9-15     (1), Section 1, Article 21.07-6, Insurance Code, as amended by this
9-16     Act, is not required to issue a new identification card to an
9-17     individual, as required by Section 19A, Article 21.07-6, Insurance
9-18     Code, as added by this Act, if the identification card held by the
9-19     individual on the effective date of this Act contains the elements
9-20     described by Subdivisions (2) through (5), Subsection (b), Section
9-21     19A, Article 21.07-6, Insurance Code, as added by this Act.  A new
9-22     card complying with Section 19A, Article 21.07-6, Insurance Code,
9-23     as added by this Act, must be issued at the time the individual's
9-24     coverage is modified.
9-25           (c)  A health benefit plan, as that term is defined by
9-26     Section 1, Article 21.53L, Insurance Code, as added by this Act, is
9-27     not required to issue a new identification card to an enrollee, as
 10-1    required by Section 3, Article 21.53L, Insurance Code, as added by
 10-2    this Act, if the identification card held by the enrollee on the
 10-3    effective date of this Act contains the elements described by
 10-4    Subdivisions (2), (3), and (4), Subsection (a), Section 3, Article
 10-5    21.53L, Insurance Code, as added by this Act.  A new card complying
 10-6    with Article 21.53L, Insurance Code, as added by this Act, must be
 10-7    issued at the time the enrollee's coverage is modified.
 10-8          SECTION 6.  The importance of this legislation and the
 10-9    crowded condition of the calendars in both houses create an
10-10    emergency and an imperative public necessity that the
10-11    constitutional rule requiring bills to be read on three several
10-12    days in each house be suspended, and this rule is hereby suspended.