1-1 By: Uher (Senate Sponsor - Jackson) H.B. No. 1066
1-2 (In the Senate - Received from the House April 25, 2001;
1-3 April 26, 2001, read first time and referred to Committee on
1-4 Business and Commerce; May 3, 2001, reported adversely, with
1-5 favorable Committee Substitute by the following vote: Yeas 7, Nays
1-6 0; May 3, 2001, sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR H.B. No. 1066 By: Jackson
1-8 A BILL TO BE ENTITLED
1-9 AN ACT
1-10 relating to health benefits coverage of grandchildren.
1-11 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-12 SECTION 1. Section 1(b), Article 3.51-6, Insurance Code, is
1-13 amended to read as follows:
1-14 (b) The spouse and dependents of employees or members,
1-15 including a dependent grandchild of an employee or member who is
1-16 less than 21 years old and living with and in the household of the
1-17 employee or member, referred to in Subdivisions (a)(1) through
1-18 (a)(6) of this section may be included within the coverage provided
1-19 in a group policy. For purposes of this subsection, a grandchild
1-20 of an employee or member is a dependent of the employee or member,
1-21 regardless of whether the employee or member treats the grandchild
1-22 as a dependent for federal income tax purposes.
1-23 SECTION 2. Section 3E(b), Article 3.51-6, Insurance Code, is
1-24 amended to read as follows:
1-25 (b) A health insurance policy that provides coverage for a
1-26 child of the policyholder must upon payment of a premium provide
1-27 coverage for any children of the policyholder's child if those
1-28 children are dependents of the policyholder. For purposes of this
1-29 subsection, a child of the policyholder's child is a dependent of
1-30 the policyholder regardless of whether the policyholder treats the
1-31 child as a dependent for federal income tax purposes.
1-32 SECTION 3. Section 2(A), Chapter 397, Acts of the 54th
1-33 Legislature, Regular Session, 1955 (Article 3.70-2, Vernon's Texas
1-34 Insurance Code), is amended to read as follows:
1-35 (A) No policy of accident and sickness insurance shall be
1-36 delivered or issued for delivery to any person in this state
1-37 unless:
1-38 (1) the entire money and other consideration therefor
1-39 are expressed therein or in the application, if it is made a part
1-40 of the policy; and
1-41 (2) the time at which the insurance takes effect and
1-42 terminates is expressed therein; and
1-43 (3) it purports to insure only one person, except that
1-44 a policy may insure, originally or by subsequent amendment, upon
1-45 the application of an adult member of a family who shall be deemed
1-46 the policy holder, any two or more eligible members of that family,
1-47 including:
1-48 (a) the spouse of the policy holder;
1-49 (b) a dependent child of the policy holder or
1-50 any child under a specified age that may not exceed 25 years of
1-51 age;
1-52 (c) [husband, wife, dependent children,
1-53 including] a dependent grandchild of the policy holder who is less
1-54 than 21 years old and living with and in the household of the
1-55 policy holder; provided that, for purposes of this paragraph, a
1-56 grandchild of a policy holder is a dependent of the policy holder
1-57 regardless of whether the policy holder treats the grandchild as a
1-58 dependent for federal income tax purposes;
1-59 (d) [or any children under a specified age which
1-60 shall not exceed twenty-five years,] a child the policy holder is
1-61 required to insure under a medical support order issued under
1-62 Chapter 154 [Section 14.061], Family Code, or enforceable by a
1-63 court in this state;[,] and
1-64 (e) any other person dependent upon the policy
2-1 holder; and
2-2 (4) the style, arrangement and over-all appearance of
2-3 the policy gives no undue prominence to any portion of the text,
2-4 and unless every printed portion of the text of the policy and of
2-5 any endorsements or attached papers (except copies of applications
2-6 and identification cards) are plainly printed in lightfaced type of
2-7 a style in general use, the size of which shall be uniform and not
2-8 less than ten-point with a lower-case unspaced alphabet length not
2-9 less than one hundred and twenty-point (the "text" shall include
2-10 all printed matter except the name and address of the insurer, name
2-11 or title of the policy, the brief description, if any, and captions
2-12 and subcaptions); and
2-13 (5) the exceptions and reductions of indemnity are set
2-14 forth in the policy and, except those which are set forth in
2-15 Section 3 of this Act, are printed, at the insurer's option, either
2-16 included with the benefit provision to which they apply, or under
2-17 an appropriate caption such as "Exceptions" or "Exceptions and
2-18 Reductions"; provided that if an exception or reduction
2-19 specifically applies only to a particular benefit of the policy, a
2-20 statement of such exception or reduction shall be included with the
2-21 benefit provision to which it applies; and
2-22 (6) each such form, including riders and endorsements,
2-23 shall be identified by a form number in the lower left-hand corner
2-24 of the first page thereof; and
2-25 (7) it contains no provision purporting to make any
2-26 portion of the charter, rules, constitution, or bylaws of the
2-27 insurer a part of the policy unless such portion is set forth in
2-28 full in the policy, except in the case of the incorporation of, or
2-29 reference to, a statement of rates or classification of risks, or
2-30 shortrate table filed with the Board; and
2-31 (8) it shall have printed thereon or attached thereto
2-32 a notice stating in substance that the person to whom the policy is
2-33 issued shall be permitted to return the policy within ten (10) days
2-34 of its delivery to such person and to have the premium paid
2-35 refunded if, after examination of the policy, such person is not
2-36 satisfied with it for any reason. If such person pursuant to such
2-37 notice, returns the policy to the insurer at its home or branch
2-38 office or to the agent through whom it was purchased, it shall be
2-39 void from the beginning and the parties shall be in the same
2-40 position as if no policy had been issued. This subdivision shall
2-41 not apply to single premium nonrenewable policies.
2-42 SECTION 4. Section 2(L), Chapter 397, Acts of the 54th
2-43 Legislature, Regular Session, 1955 (Article 3.70-2, Vernon's Texas
2-44 Insurance Code), is amended to read as follows:
2-45 (L) An individual or group policy of accident and sickness
2-46 insurance that is delivered, issued for delivery, or renewed in
2-47 this state, including a policy issued by a company subject to
2-48 Chapter 20, Insurance Code, evidence of coverage issued by a health
2-49 maintenance organization subject to the Texas Health Maintenance
2-50 Organization Act (Chapter 20A, Vernon's Texas Insurance Code), and
2-51 a self-funded or self-insured welfare or benefit plan or program to
2-52 the extent that regulation of the plan or program is not preempted
2-53 by federal law that provides coverage for a child of the
2-54 policyholder, must provide coverage upon payment of a premium for:
2-55 (1) any children of the policyholder's child if those
2-56 children are dependents of the policyholder; provided that, for
2-57 purposes of this subdivision, a grandchild of a policyholder is a
2-58 dependent of the policyholder regardless of whether the
2-59 policyholder treats the grandchild as a dependent for federal
2-60 income tax purposes; or
2-61 (2) [for] a child for whom the group member or insured
2-62 must provide medical support under an order issued under Chapter
2-63 154 [Section 14.061], Family Code, or enforceable by a court in
2-64 this state.
2-65 SECTION 5. Section 9(k), Texas Health Maintenance
2-66 Organization Act (Article 20A.09, Vernon's Texas Insurance Code)
2-67 (former Subsection (j)), as amended by Chapters 905 and 1026, Acts
2-68 of the 75th Legislature, Regular Session, 1997, is redesignated as
2-69 Section 9H, Texas Health Maintenance Organization Act (Article
3-1 20A.9H, Vernon's Texas Insurance Code), and amended to read as
3-2 follows:
3-3 Sec. 9H. DEPENDENT GRANDCHILDREN. (a) [(k) (r)] A health
3-4 maintenance organization may provide benefits under a health care
3-5 plan to a dependent grandchild of an enrollee when the dependent
3-6 grandchild is less than 21 years old and living with and in the
3-7 household of the enrollee.
3-8 (b) For purposes of this section, a grandchild of an
3-9 enrollee is a dependent, regardless of whether the enrollee treats
3-10 the grandchild as a dependent for federal income tax purposes.
3-11 SECTION 6. This Act applies only to an insurance policy,
3-12 contract, or evidence of coverage delivered, issued for delivery,
3-13 or renewed on or after January 1, 2002. A policy, contract, or
3-14 evidence of coverage delivered, issued for delivery, or renewed
3-15 before January 1, 2002, is governed by the law as it existed
3-16 immediately before the effective date of this Act, and that law is
3-17 continued in effect for that purpose.
3-18 SECTION 7. This Act takes effect September 1, 2001.
3-19 * * * * *