SRC-TBR C.S.H.B. 2146 77(R)BILL ANALYSIS


Senate Research CenterC.S.H.B. 2146
77R16063 DLF-DBy: Chisum (Bivins)
Business & Commerce
5/10/2001
Committee Report (Substituted)


DIGEST AND PURPOSE 

Current law does not require an issuer of group health benefit plans to
provide a small employer with the claims experience of the employees
covered by a group health benefit plan.  C.S.H.B. 2146 requires the issuer
of a group health benefit plan to provide a small employer with the claims
experience of the small employer's employees covered by the plan. 

RULEMAKING AUTHORITY

This bill does not expressly grant any additional rulemaking authority to a
state officer, institution, or agency. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Chapter 21E, Insurance Code, by adding Article 21.49-19,
as follows: 

Art. 21.49-19.  HEALTH BENEFIT CLAIM COST INFORMATION REQUIRED TO BE
PROVIDED TO EMPLOYER 

Sec. 1.  DEFINITION OF GROUP HEALTH BENEFIT PLAN. (a)  Defines "group
health benefit plan." 

(b)  Provides that the term "group health benefit plan" includes a small
employer health benefit plan written under Chapter 26 of this code. 

Sec. 2.  APPLICABILITY OF ARTICLE.  Provides that this article applies only
to a group health benefit plan issued to provide health benefits to the
employees of one or more employers that sponsor the plan. 

Sec. 3.  CLAIM COST INFORMATION.  (a)  Requires the issuer of the plan, on
the request of an employer sponsoring a group health benefit plan, to
provide to the employer the claims cost information for employees covered
by the plan during the preceding calendar year. Requires the information to
be reported separately for each month during which the plan was in effect. 

(b)  Authorizes claims cost information provided under this section to be
provided either in the aggregate or on a detailed basis, but prohibits it
from including any information through which a specific individual enrolled
in the group health benefit plan may be identified or diagnosis codes or
other information through which a diagnosis of a specific individual
enrolled in the group health benefit plan may be identified. 

(c)  Provides that information obtained by the employer under this section
is confidential and may be used by the employer only for purposes relating
to obtaining and maintaining group health benefit plan coverage for the
employer's employees. 

 SECTION 2.  Effective date: September 1, 2001.  Makes application of this
Act prospective.