1-1 AN ACT 1-2 relating to unfair discrimination by the issuer of a health benefit 1-3 plan; providing penalties. 1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-5 SECTION 1. Subchapter E, Chapter 21, Insurance Code, is 1-6 amended by adding Article 21.52L to read as follows: 1-7 Art. 21.52L. DENIAL OF HEALTH BENEFIT PLAN ENROLLMENT BASED 1-8 ON EXISTING COVERAGE PROHIBITED 1-9 Sec. 1. APPLICABILITY OF ARTICLE. (a) This article 1-10 applies only to a health benefit plan that provides benefits for 1-11 medical or surgical expenses incurred as a result of a health 1-12 condition, accident, or sickness, including an individual, group, 1-13 blanket, or franchise insurance policy or insurance agreement, a 1-14 group hospital service contract, or an individual or group evidence 1-15 of coverage or similar coverage document that is offered by: 1-16 (1) an insurance company; 1-17 (2) a group hospital service corporation operating 1-18 under Chapter 20 of this code; 1-19 (3) a fraternal benefit society operating under 1-20 Chapter 10 of this code; 1-21 (4) a stipulated premium insurance company operating 1-22 under Chapter 22 of this code; 1-23 (5) a reciprocal exchange operating under Chapter 19 1-24 of this code; 2-1 (6) a health maintenance organization operating under 2-2 the Texas Health Maintenance Organization Act (Chapter 20A, 2-3 Vernon's Texas Insurance Code); 2-4 (7) a multiple employer welfare arrangement that holds 2-5 a certificate of authority under Article 3.95-2 of this code; or 2-6 (8) an approved nonprofit health corporation that 2-7 holds a certificate of authority under Article 21.52F of this code. 2-8 (b) This article applies to a small employer health benefit 2-9 plan written under Chapter 26 of this code. 2-10 (c) This article does not apply to: 2-11 (1) a plan that provides coverage: 2-12 (A) only for benefits for a specified disease or 2-13 for another limited benefit; 2-14 (B) only for accidental death or dismemberment; 2-15 (C) for wages or payments in lieu of wages for a 2-16 period during which an employee is absent from work because of 2-17 sickness or injury; 2-18 (D) as a supplement to a liability insurance 2-19 policy; 2-20 (E) for credit insurance; 2-21 (F) only for dental or vision care; 2-22 (G) only for hospital expenses; 2-23 (H) only for indemnity for hospital confinement; 2-24 or 2-25 (I) pursuant to Title XXI of the Social Security 2-26 Act (42 U.S.C. Section 1397aa et seq.); 2-27 (2) a Medicare supplemental policy as defined by 3-1 Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss), 3-2 as amended; 3-3 (3) a workers' compensation insurance policy; 3-4 (4) medical payment insurance coverage provided under 3-5 a motor vehicle insurance policy; or 3-6 (5) a long-term care insurance policy, including a 3-7 nursing home fixed indemnity policy, unless the commissioner 3-8 determines that the policy provides benefit coverage so 3-9 comprehensive that the policy is a health benefit plan as described 3-10 by Subsection (a) of this section. 3-11 Sec. 2. PROHIBITION. The issuer of a health benefit plan may 3-12 not refuse to enroll a person in the plan solely because the person 3-13 is enrolled in another health benefit plan at the time the person 3-14 applies for the coverage. 3-15 Sec. 3. VIOLATION. An issuer of a health benefit plan who 3-16 violates the article engages in unfair discrimination under Article 3-17 21.21-8 of this code. 3-18 SECTION 2. This Act takes effect September 1, 2001. _______________________________ _______________________________ President of the Senate Speaker of the House I certify that H.B. No. 2127 was passed by the House on April 27, 2001, by a non-record vote; and that the House concurred in Senate amendments to H.B. No. 2127 on May 25, 2001, by a non-record vote. _______________________________ Chief Clerk of the House I certify that H.B. No. 2127 was passed by the Senate, with amendments, on May 22, 2001, by a viva-voce vote. _______________________________ Secretary of the Senate APPROVED: __________________________ Date __________________________ Governor