SRC-MWN H.B. 2191 77(R)   BILL ANALYSIS


Senate Research Center   H.B. 2191
By: Averitt (Sponsor Unknown)
Business & Commerce
5/11/2001
Engrossed


DIGEST AND PURPOSE 

The Texas Health Insurance Risk Pool (pool) was created to provide access
to quality health care for Texans facing critical problems with the
availability and cost of health care coverage. The pool is how Texas meets
the requirements of the federal Health Insurance Portability and
Accountability Act. Some sections of the Insurance Code may need to be
amended to clarify how the pool applies to persons eligible for coverage
under HIPAA and to ensure fair and efficient administration of the pool.
H.B. 2191 modifies provisions regarding eligibility requirements and the
administration of the Texas Health Insurance Risk Pool.  

RULEMAKING AUTHORITY

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

SECTION BY SECTION ANALYSIS

H.B. 2191 amends the Insurance Code to add to the list of persons eligible
for health benefit plan coverage under the Texas Health Insurance Risk Pool
(pool) a Texas resident who provides to the pool evidence that the resident
had health insurance coverage under another state's qualified Health
Insurance Portability and Accountability Act health program that was
terminated not more than 63 days prior to application. The bill also
provides that if a resident has been a permanent resident of the United
States for at least three continuous years, the resident is eligible under
existing eligibility requirements.  

The bill provides that a person is not eligible for coverage from the pool
if the person has had prior coverage with the pool terminated during the 12
months immediately preceding the date of application for nonpayment of
premiums or has had prior coverage with the pool terminated for fraud. The
bill requires that coverage of a person who ceases to meet the eligibility
requirements be terminated on the earlier of the premium due date that
follows the date the pool determines the person does not meet the
eligibility requirements or the first day of the month that follows the
month in which the pool determines the person does not meet the eligibility
requirements. The pool has sole discretion to determine that a person does
not meet the eligibility requirements.  

The bill provides that a person who is eligible for health insurance
benefits sponsored by an employer is not eligible for pool coverage. An
insurer, agent, third party administrator, or other person licensed under
this code is prohibited from attempting placement in the pool of a person
who is eligible for employer sponsored health insurance for the purpose of
separating the person from the employersponsored health insurance benefits.

The bill provides that a violation of this provision is an unfair method of
competition and an unfair or deceptive act or practice (Sec. 10, Art.
3.77). The bill provides that an assessment imposed against an insurer is
due on a date specified by the board of directors of the pool that may not
be earlier than the 30th day after the date on which prior written notice
of the assessment due is transmitted to the insurer. Interest accrues on
the unpaid amount at a rate equal to the prime lending rate plus three
percent.  

 Effective date: September 1, 2001.