1-1     By:  Averitt (Senate Sponsor - Fraser)                H.B. No. 2191
 1-2           (In the Senate - Received from the House May 11, 2001;
 1-3     May 11, 2001, read first time and referred to Committee on Business
 1-4     and Commerce; May 11, 2001, reported favorably by the following
 1-5     vote:  Yeas 6, Nays 0; May 11, 2001, sent to printer.)
 1-6                            A BILL TO BE ENTITLED
 1-7                                   AN ACT
 1-8     relating to availability of health benefit plan coverage under the
 1-9     Texas Health Insurance Risk Pool.
1-10           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-11           SECTION 1. Section 2(17), Article 3.77, Insurance Code, is
1-12     amended to read as follows:
1-13                 (17)  "Resident" means:
1-14                       (A)  an individual who has been legally domiciled
1-15     in Texas for a minimum of 30 days for persons eligible for
1-16     enrollment in the pool under Section 10(b) [10(a)(1), (2), (3), or
1-17     (5)] of this article; or
1-18                       (B)  an individual who is legally domiciled in
1-19     Texas for persons eligible for enrollment in the pool under Section
1-20     10(a) [10(a)(4)] of this article.
1-21           SECTION 2. Section 10, Article 3.77, Insurance Code, is
1-22     amended to read as follows:
1-23           Sec. 10.  ELIGIBILITY FOR COVERAGE. (a)  An individual who is
1-24     a resident, as defined by Section 2(17)(B) of this article, and who
1-25     continues to be a resident, is eligible for coverage from the pool
1-26     if the individual:
1-27                 (1)  provides to the pool evidence that the individual
1-28     has maintained health insurance coverage for the previous 18
1-29     months, with no gap in coverage greater than 63 days, of which the
1-30     most recent coverage was through an employer-sponsored plan, church
1-31     plan, or government plan; or
1-32                 (2)  provides to the pool evidence that the individual
1-33     had health insurance coverage under another state's qualified
1-34     Health Insurance Portability and Accountability Act health program
1-35     that was terminated because the individual did not reside in that
1-36     state and submits an application for pool coverage not later than
1-37     the 63rd day after the date that coverage was terminated.
1-38           (b)  Any individual [person] who is and continues to be a
1-39     resident, as defined by Section 2(17)(A) of this article, [of
1-40     Texas] and who is a citizen of the United States or has been a
1-41     permanent resident of the United States for at least three
1-42     continuous years is [shall be] eligible for coverage from the pool
1-43     if the individual provides to the pool:
1-44                 (1)  a notice of rejection or refusal to issue
1-45     substantially similar individual insurance for health reasons by
1-46     one insurer, other than a rejection or refusal by an insurer
1-47     offering only stop-loss, excess loss, or reinsurance coverage;
1-48                 (2)  a certification from an agent or salaried
1-49     representative of an insurer, on a form developed by the board and
1-50     approved by the commissioner, that states that the agent or
1-51     salaried representative is unable to obtain substantially similar
1-52     individual insurance for the individual with any state-licensed
1-53     insurer that the agent or salaried representative represents
1-54     because the individual will be declined for coverage as a result of
1-55     a medical condition of the individual under the underwriting
1-56     guidelines of the insurer;
1-57                 (3)  an offer to issue substantially similar individual
1-58     insurance only with conditional riders;
1-59                 (4)  a refusal by an insurer to issue substantially
1-60     similar individual insurance except at a rate exceeding the pool
1-61     rate; or
1-62                 (5)  [evidence of the individual's maintenance of
1-63     health insurance coverage for the previous 18 months with no gap in
1-64     coverage greater than 63 days of which the most recent coverage was
 2-1     through an employer sponsored plan; or]
 2-2                 [(6)]  diagnosis of the individual with one of the
 2-3     medical or health conditions listed by the board under Section 6(c)
 2-4     of this article and for which a person shall be eligible for pool
 2-5     coverage.
 2-6           (c) [(b)]  Each dependent of a person who is eligible for
 2-7     coverage from the pool shall also be eligible for coverage from the
 2-8     pool.  In the instance of a child who is the primary insured,
 2-9     resident family members shall also be eligible for coverage.
2-10           (d) [(c)]  A person may maintain pool coverage for the period
2-11     of time the person is satisfying a preexisting waiting period under
2-12     another health insurance policy or insurance arrangement intended
2-13     to replace the pool policy.
2-14           (e) [(d)]  A person is not eligible for coverage from the
2-15     pool if the person:
2-16                 (1)  has in effect on the date pool coverage takes
2-17     effect health insurance coverage from an insurer or insurance
2-18     arrangement;
2-19                 (2)  is eligible for other health care benefits at the
2-20     time application is made to the pool, including COBRA continuation,
2-21     except:
2-22                       (A)  coverage, including COBRA continuation,
2-23     other continuation or conversion coverage, maintained for the
2-24     period of time the person is satisfying any pre-existing condition
2-25     waiting period under a pool policy; or
2-26                       (B)  employer group coverage conditioned by the
2-27     type of limitations described by Subsections (b)(1) or (2) [(a)(1)
2-28     and (2)] of this section; or
2-29                       (C)  individual coverage conditioned by the
2-30     limitations described by Subsections (b)(3) or (4) [(a)(1)-(3)] of
2-31     this section;
2-32                 (3)  has terminated coverage in the pool within 12
2-33     months of the date that application is made to the pool, unless the
2-34     person demonstrates a good faith reason for the termination;
2-35                 (4)  is confined in a county jail or imprisoned in a
2-36     state prison;
2-37                 (5)  has premiums that are paid for or reimbursed under
2-38     any government sponsored program or by any government agency or
2-39     health care provider, except as an otherwise qualifying full-time
2-40     employee, or dependent thereof, of a government agency or health
2-41     care provider; [or]
2-42                 (6)  has [not] had prior coverage with the pool
2-43     terminated during the 12 months immediately preceding the date of
2-44     application for nonpayment of premiums; or
2-45                 (7)  has had prior coverage with the pool terminated
2-46     for fraud.
2-47           (f) [(e)]  Pool coverage shall cease:
2-48                 (1)  on the date a person is no longer a resident of
2-49     this state, except for a child who is a student under the age of 23
2-50     years and who is financially dependent upon the parent, a child for
2-51     whom a person may be obligated to pay child support, or a child of
2-52     any age who is disabled and dependent upon the parent;
2-53                 (2)  on the date a person requests coverage to end;
2-54                 (3)  upon the death of the covered person;
2-55                 (4)  on the date state law requires cancellation of the
2-56     policy;
2-57                 (5)  at the option of the pool, 30 days after the pool
2-58     sends to the person any inquiry concerning the person's
2-59     eligibility, including an inquiry concerning the person's
2-60     residence, to which the person does not reply;
2-61                 (6)  on the 31st day after the day on which a premium
2-62     payment for pool coverage becomes due if the payment is not made
2-63     before that date; or
2-64                 (7)  at such time as the person ceases to meet the
2-65     eligibility requirements of this section.
2-66           (g)  Coverage of a [(f)  A] person who ceases to meet the
2-67     eligibility requirements of this section shall be [may have his
2-68     coverage] terminated on the earlier of the premium due date that
2-69     follows the date the pool determines the person does not meet the
 3-1     eligibility requirements or the first day of the month that follows
 3-2     the month in which the pool determines the person does not meet the
 3-3     eligibility requirements [at the end of the policy period].  The
 3-4     pool has the sole discretion to determine that a person does not
 3-5     meet the eligibility requirements.
 3-6           (h)  A person who is eligible for health insurance benefits
 3-7     provided in connection with a policy, plan, or program paid for or
 3-8     sponsored by an employer, even though the employer coverage is
 3-9     declined, is not eligible for pool coverage.  An insurer, agent,
3-10     third party administrator, or other person licensed under this code
3-11     may not arrange or assist in or attempt to arrange or assist in the
3-12     application for pool coverage by, or placement in the pool of a
3-13     person who is ineligible under this subsection for the purpose of
3-14     separating the person from health insurance benefits offered or
3-15     provided in connection with employment that would be available to
3-16     the person as an employee or dependent of an employee.  A violation
3-17     of this section is an unfair method of competition and an unfair or
3-18     deceptive act or practice under Article 21.21 of this code.
3-19           SECTION 3. Section 13(d), Article 3.77, Insurance Code, is
3-20     amended to read as follows:
3-21           (d)  The assessment imposed against each insurer shall be in
3-22     an amount that is equal to the ratio of the gross premiums
3-23     collected by the insurer for health insurance in this state during
3-24     the preceding calendar year, except for Medicare supplement
3-25     premiums subject to Article 3.74 and small group health insurance
3-26     premiums subject to Articles 26.01 through 26.76, to the gross
3-27     premiums collected by all insurers for health insurance, except for
3-28     Medicare supplement premiums subject to Article 3.74 and small
3-29     group health insurance premiums subject to Articles 26.01 through
3-30     26.76, in this state during the preceding calendar year.  An
3-31     assessment is due on a date specified by the board that may not be
3-32     earlier than the 30th day after the date on which prior written
3-33     notice of the assessment due is transmitted to the insurer.
3-34     Interest accrues on the unpaid amount at a rate equal to the prime
3-35     lending rate, as stated in the most recent issue of the Wall Street
3-36     Journal, plus three percent, determined as of the date such
3-37     assessment is delinquent.
3-38           SECTION 4. This Act takes effect September 1, 2001.
3-39                                  * * * * *