SRC-MSY, VRA S.B. 41 78(R)   BILL ANALYSIS


Senate Research Center   S.B. 41
78R1421 DLF-DBy: Zaffirini
State Affairs
2/27/2003
As Filed


DIGEST AND PURPOSE 

Under current Texas law, health plans are only required to cover those
vaccines that are mandated by law.  As a result, there are a number of
important vaccines that may not be covered by a child's health plan,
including Hepatitis A, pneumoccoccal, and influenza.  As proposed, S.B. 41
amends the Insurance Code to require certain health plans to provide
coverage for immunizations that are recommended by the Advisory Committee
on Immunization Practices of the Centers for Disease Control and
Prevention with the aim of encouraging a higher immunization rate among
Texas children. 

RULEMAKING AUTHORITY

Rulemaking authority is expressly granted to the Commissioner of Insurance
in SECTION 1 (Section 4, Article 21.52I, Insurance Code) of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Chapter 21E, Insurance Code, by adding Article 21.52I
as follows: 

Art.  21.52I.  HEALTH BENEFIT PLAN COVERAGE FOR IMMUNIZATIONS

Sec. 1.  APPLICABILITY OF ARTICLE.  Provides that this article applies
only to a health benefit plan that provides benefits for medical or
surgical expenses incurred as a result of a health condition, accident, or
sickness, including an individual, group, blanket, or franchise insurance
policy or insurance agreement, a group hospital service contract, or an
individual or group evidence of coverage or similar coverage document that
is offered by certain entities.   

(b)  Provides that this article applies to a small employer health benefit
plan written under Chapter 26 of this code. 

  (c)  Provides that this article does not apply to certain plans or
policies. 

Sec.  2.  REQUIRED COVERAGE FOR IMMUNIZATIONS.  (a)  Requires a health
benefit plan to provide coverage for immunizations as recommended by the
Advisory Committee on Immunization Practices of the Centers for Disease
Control and Prevention. 

(b)  Authorizes the coverage required by this section to be subject to
annual deductibles, copayments, and coinsurance consistent with annual
deductibles, copayment, and coinsurance required for other benefits under
the health benefit plan. 

Sec.  3.  COVERAGE FOR CERTAIN  CHILDHOOD IMMUNIZATIONS.  Prohibits this
article from applying to an immunization for which coverage is required
under Section 3, Article 21.53F, Insurance Code, as added by Chapter 683,
Acts of the 75th Legislature, Regular Session, 1997 or Section 9F, Texas
Health Maintenance Organization Act (Article 20A.09F, Vernon's Texas
Insurance Code). 

 Sec.  4.  RULES.  Authorizes the Commissioner of Insurance  to adopt
rules as necessary to implement this article. 

SECTION 2.  Effective date:  September 1, 2003.
                      Makes application of this Act prospective to January
1, 2004.