78R5953 DLF-D

By:  Taylor                                                       H.B. No. 1336



A BILL TO BE ENTITLED

AN ACT

relating to certain small employer and large employer health 
benefit plans. 
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Section 4, Article 3.51-14, Insurance Code, is 
amended to read as follows:
	Sec. 4.  SMALL EMPLOYER COVERAGE.  This article does not 
apply to a small employer [An issuer of a group] health benefit plan 
written under Chapter 26 of this code [to a small employer must 
offer the coverage described in Section 3 of this article but is not 
required to provide the coverage if the small employer rejects the 
coverage].
	SECTION 2.  Section 1(3), Article 3.51-14, Insurance Code, 
is repealed.      
	SECTION 3.  Section 2(b), Article 21.52L, Insurance Code, as 
added by Chapter 1106, Acts of the 77th Legislature, Regular 
Session, 2001, is amended to read as follows:
	(b)  "Health benefit plan" does not include [includes] a 
small employer health benefit plan offered in accordance with 
Chapter 26 of this code.
	SECTION 4.  Section 2, Article 21.53N, Insurance Code, is 
amended to read as follows:
	Sec. 2.  APPLICABILITY OF ARTICLE.  (a) 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:
		(1)  an insurance company;                                                    
		(2)  a group hospital service corporation operating 
under Chapter 842 [20] of this code;
		(3)  a fraternal benefit society operating under 
Chapter 885 [10] of this code;
		(4)  a stipulated premium insurance company operating 
under Chapter 884 [22] of this code;
		(5)  an [a reciprocal] exchange operating under Chapter 
942 [19] of this code;
		(6)  a health maintenance organization operating under 
Chapter 843 of this code [the Texas Health Maintenance Organization 
Act (Chapter 20A, Vernon's Texas Insurance Code)];
		(7)  a multiple employer welfare arrangement that holds 
a certificate of authority under Chapter 846 [Article 3.95-2] of 
this code; or
		(8)  an approved nonprofit health corporation that 
holds a certificate of authority under Chapter 844 [Article 21.52F] 
of this code.
	(b)  This article does not apply to [; or              
		[(9)]  a small employer health benefit plan written 
under Chapter 26 of this code.
	SECTION 5.  Section 1(b), Article 21.53Q, Insurance Code, is 
amended to read as follows:
	(b)  This article does not apply [applies] to a small 
employer health benefit plan written under Chapter 26 of this code.
	SECTION 6.  Subchapter H, Chapter 26, Insurance Code, is 
amended by adding Article 26.835 to read as follows:
	Art. 26.835.  EXEMPT HEALTH BENEFIT PLANS.  (a)  
Notwithstanding any other law, a large employer carrier may offer 
to a large employer an exempt health benefit plan under this 
article.
	(b)  An exempt health benefit plan offered under this article 
is not subject to a law that requires coverage or the offer of 
coverage of a health care service or benefit.
	(c)  A large employer carrier that offers an exempt health 
benefit plan under this article shall notify the large employer, in 
the form and manner required by the commissioner, that the plan is 
an exempt health benefit plan. The notice must specify each health 
care service or benefit that is not covered under the exempt health 
benefit plan and that would otherwise be required to be covered or 
offered to be covered.
	SECTION 7.  This Act applies only to a small employer health 
benefit plan that is delivered, issued for delivery, or renewed on 
or after January 1, 2004.  A small employer health benefit plan that 
is delivered, issued for delivery, or renewed before January 1, 
2004, is governed by the law as it existed immediately before the 
effective date of this Act, and that law is continued in effect for 
that purpose.
	SECTION 8.  This Act takes effect September 1, 2003.