1-1 AN ACT
1-2 relating to health benefits coverage of grandchildren.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Section 1(b), Article 3.51-6, Insurance Code, is
1-5 amended to read as follows:
1-6 (b) The spouse and dependents of employees or members,
1-7 including a dependent grandchild of an employee or member who is
1-8 less than 21 years old and living with and in the household of the
1-9 employee or member, referred to in Subdivisions (a)(1) through
1-10 (a)(6) of this section may be included within the coverage provided
1-11 in a group policy. For purposes of this subsection, a grandchild
1-12 of an employee or member is a dependent of the employee or member,
1-13 regardless of whether the employee or member treats the grandchild
1-14 as a dependent for federal income tax purposes.
1-15 SECTION 2. Section 3E(b), Article 3.51-6, Insurance Code, is
1-16 amended to read as follows:
1-17 (b) A health insurance policy that provides coverage for a
1-18 child of the policyholder must upon payment of a premium provide
1-19 coverage for any children of the policyholder's child if those
1-20 children are dependents of the policyholder. For purposes of this
1-21 subsection, a child of the policyholder's child is a dependent of
1-22 the policyholder regardless of whether the policyholder treats the
1-23 child as a dependent for federal income tax purposes.
1-24 SECTION 3. Section 2(A), Chapter 397, Acts of the 54th
2-1 Legislature, Regular Session, 1955 (Article 3.70-2, Vernon's Texas
2-2 Insurance Code), is amended to read as follows:
2-3 (A) No policy of accident and sickness insurance shall be
2-4 delivered or issued for delivery to any person in this state
2-5 unless:
2-6 (1) the entire money and other consideration therefor
2-7 are expressed therein or in the application, if it is made a part
2-8 of the policy; and
2-9 (2) the time at which the insurance takes effect and
2-10 terminates is expressed therein; and
2-11 (3) it purports to insure only one person, except that
2-12 a policy may insure, originally or by subsequent amendment, upon
2-13 the application of an adult member of a family who shall be deemed
2-14 the policy holder, any two or more eligible members of that family,
2-15 including:
2-16 (a) the spouse of the policy holder;
2-17 (b) a dependent child of the policy holder or
2-18 any child under a specified age that may not exceed 25 years of
2-19 age;
2-20 (c) [husband, wife, dependent children,
2-21 including] a dependent grandchild of the policy holder who is less
2-22 than 21 years old and living with and in the household of the
2-23 policy holder; provided that, for purposes of this paragraph, a
2-24 grandchild of a policy holder is a dependent of the policy holder
2-25 regardless of whether the policy holder treats the grandchild as a
2-26 dependent for federal income tax purposes;
2-27 (d) [or any children under a specified age which
3-1 shall not exceed twenty-five years,] a child the policy holder is
3-2 required to insure under a medical support order issued under
3-3 Chapter 154 [Section 14.061], Family Code, or enforceable by a
3-4 court in this state;[,] and
3-5 (e) any other person dependent upon the policy
3-6 holder; and
3-7 (4) the style, arrangement and over-all appearance of
3-8 the policy gives no undue prominence to any portion of the text,
3-9 and unless every printed portion of the text of the policy and of
3-10 any endorsements or attached papers (except copies of applications
3-11 and identification cards) are plainly printed in lightfaced type of
3-12 a style in general use, the size of which shall be uniform and not
3-13 less than ten-point with a lower-case unspaced alphabet length not
3-14 less than one hundred and twenty-point (the "text" shall include
3-15 all printed matter except the name and address of the insurer, name
3-16 or title of the policy, the brief description, if any, and captions
3-17 and subcaptions); and
3-18 (5) the exceptions and reductions of indemnity are set
3-19 forth in the policy and, except those which are set forth in
3-20 Section 3 of this Act, are printed, at the insurer's option, either
3-21 included with the benefit provision to which they apply, or under
3-22 an appropriate caption such as "Exceptions" or "Exceptions and
3-23 Reductions"; provided that if an exception or reduction
3-24 specifically applies only to a particular benefit of the policy, a
3-25 statement of such exception or reduction shall be included with the
3-26 benefit provision to which it applies; and
3-27 (6) each such form, including riders and endorsements,
4-1 shall be identified by a form number in the lower left-hand corner
4-2 of the first page thereof; and
4-3 (7) it contains no provision purporting to make any
4-4 portion of the charter, rules, constitution, or bylaws of the
4-5 insurer a part of the policy unless such portion is set forth in
4-6 full in the policy, except in the case of the incorporation of, or
4-7 reference to, a statement of rates or classification of risks, or
4-8 shortrate table filed with the Board; and
4-9 (8) it shall have printed thereon or attached thereto
4-10 a notice stating in substance that the person to whom the policy is
4-11 issued shall be permitted to return the policy within ten (10) days
4-12 of its delivery to such person and to have the premium paid
4-13 refunded if, after examination of the policy, such person is not
4-14 satisfied with it for any reason. If such person pursuant to such
4-15 notice, returns the policy to the insurer at its home or branch
4-16 office or to the agent through whom it was purchased, it shall be
4-17 void from the beginning and the parties shall be in the same
4-18 position as if no policy had been issued. This subdivision shall
4-19 not apply to single premium nonrenewable policies.
4-20 SECTION 4. Section 2(L), Chapter 397, Acts of the 54th
4-21 Legislature, Regular Session, 1955 (Article 3.70-2, Vernon's Texas
4-22 Insurance Code), is amended to read as follows:
4-23 (L) An individual or group policy of accident and sickness
4-24 insurance that is delivered, issued for delivery, or renewed in
4-25 this state, including a policy issued by a company subject to
4-26 Chapter 20, Insurance Code, evidence of coverage issued by a health
4-27 maintenance organization subject to the Texas Health Maintenance
5-1 Organization Act (Chapter 20A, Vernon's Texas Insurance Code), and
5-2 a self-funded or self-insured welfare or benefit plan or program to
5-3 the extent that regulation of the plan or program is not preempted
5-4 by federal law that provides coverage for a child of the
5-5 policyholder, must provide coverage upon payment of a premium for:
5-6 (1) any children of the policyholder's child if those
5-7 children are dependents of the policyholder; provided that, for
5-8 purposes of this subdivision, a grandchild of a policyholder is a
5-9 dependent of the policyholder regardless of whether the
5-10 policyholder treats the grandchild as a dependent for federal
5-11 income tax purposes; or
5-12 (2) [for] a child for whom the group member or insured
5-13 must provide medical support under an order issued under Chapter
5-14 154 [Section 14.061], Family Code, or enforceable by a court in
5-15 this state.
5-16 SECTION 5. Section 9(k), Texas Health Maintenance
5-17 Organization Act (Article 20A.09, Vernon's Texas Insurance Code)
5-18 (former Subsection (j)), as amended by Chapters 905 and 1026, Acts
5-19 of the 75th Legislature, Regular Session, 1997, is redesignated as
5-20 Section 9H, Texas Health Maintenance Organization Act (Article
5-21 20A.9H, Vernon's Texas Insurance Code), and amended to read as
5-22 follows:
5-23 Sec. 9H. DEPENDENT GRANDCHILDREN. (a) [(k) (r)] A health
5-24 maintenance organization may provide benefits under a health care
5-25 plan to a dependent grandchild of an enrollee when the dependent
5-26 grandchild is less than 21 years old and living with and in the
5-27 household of the enrollee.
6-1 (b) For purposes of this section, a grandchild of an
6-2 enrollee is a dependent, regardless of whether the enrollee treats
6-3 the grandchild as a dependent for federal income tax purposes.
6-4 SECTION 6. This Act applies only to an insurance policy,
6-5 contract, or evidence of coverage delivered, issued for delivery,
6-6 or renewed on or after January 1, 2002. A policy, contract, or
6-7 evidence of coverage delivered, issued for delivery, or renewed
6-8 before January 1, 2002, is governed by the law as it existed
6-9 immediately before the effective date of this Act, and that law is
6-10 continued in effect for that purpose.
6-11 SECTION 7. This Act takes effect September 1, 2001.
_______________________________ _______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 1066 was passed by the House on April
24, 2001, by a non-record vote; and that the House concurred in
Senate amendments to H.B. No. 1066 on May 15, 2001, by a non-record
vote.
_______________________________
Chief Clerk of the House
I certify that H.B. No. 1066 was passed by the Senate, with
amendments, on May 10, 2001, by the following vote: Yeas 29, Nays
0, 1 present, not voting.
_______________________________
Secretary of the Senate
APPROVED: __________________________
Date
__________________________
Governor