SRC-CTC S.B. 992 77(R)   BILL ANALYSIS


Senate Research Center   S.B. 992
2001S0590/1By: Sibley
Business & Commerce
3/12/2001
As Filed


DIGEST AND PURPOSE 

The Texas Health Insurance Risk Pool (pool) was created to comply with the
Health Insurance Portability and Accountability Act (HIPAA) to provide
access to quality health care for Texans with pre-existing conditions who
otherwise could not obtain health coverage.  The board of directors of the
pool recommends several statutory changes relating to eligibility
requirements, in part to address concerns expressed by the federal Health
Care Financing Administration and in part to clarify eligibility
requirements in the statute, and to provide for a specific interest rate on
unpaid assessments from health carriers.  As proposed, S.B. 992 makes the
statutory changes suggested by the board of directors of the Texas Health
Insurance Risk Pool. 

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 Subdivision (17), Section 2, Article 3.77, Insurance
Code, to redefine "resident." 

SECTION 2.  Amends Section 10, Article 3.77, Insurance Code, to require an
individual person who is a resident of Texas as defined in Section 2(17)(B)
of this article and who continues to be a resident of Texas to be eligible
for coverage from the pool if the individual provides certain evidence to
the Texas Health Insurance Risk Pool (pool). 

(b)  Adds an individual person who is a resident of Texas as defined in
Section 2(17)(B) of this article and a permanent resident of the United
States for at least three continuous years to the list of people who are
required to be eligible for certain coverage under certain conditions.
Deletes wording relating to evidence of an individual's maintenance of
health insurance coverage. 

(e) Provides that a person is not eligible for coverage from the pool if
the person has had prior coverage with the pool terminated for nonpayment
of premiums, within the 12 months immediately preceding the date of
application.  Makes conforming changes. 

(g) Provides, rather than authorizes, the coverage of a person who ceases
to meet the eligibility requirements of this section to be terminated as of
the earlier of the next premium due date or the first day of the month
following the date the pool determines the person does not meet the
eligibility requirement, in the pool's sole discretion, rather than at the
end of the policy period. 

(h) Provides that a person who is eligible for health insurance benefits
provided in connection with a policy, plan, or program paid for or
sponsored by an employer, even though such employer coverage is declined,
is not eligible for pool coverage.  Provides that no insurer, agent, third
party administrator, or other person licensed under this code may arrange
or assist  or attempt to arrange or assist in the application or placement
of such person in the pool for the purpose of separating the person from
health insurance benefits offered or provided in connection with employment
that would be available to the person as an employee or as a dependent of
an employee.  Provides that a violation of this subsection is an unfair
method of competition and an unfair or deceptive act or practice under
Article 21.21 of this code. 

SECTION 3.  Amends Section 13(d), Article 3.77, Insurance Code, to prohibit
the board of directors of the pool from specifying that an assessment is
due on a date earlier than the 30th day after the date on which prior
written notice of the assessment due is transmitted to the insurer.  Sets
forth the rate at which interest accrues on a certain unpaid amount. 

SECTION 4.  Effective date: September 1, 2001.