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79R2373 AJA-D

By:  Farabee                                                      H.B. No. 688



A BILL TO BE ENTITLED

AN ACT

relating to reinstatement of individual accident and health 
insurance policies under certain circumstances.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Subchapter B, Chapter 1202, Insurance Code, as 
effective April 1, 2005, is amended by adding Section 1202.053 to 
read as follows:
	Sec. 1202.053.  REINSTATEMENT OF INDIVIDUAL ACCIDENT AND 
HEALTH INSURANCE POLICY FOLLOWING GROUP COVERAGE.  (a)  In this 
section, "group health benefit plan" means a plan offered on a group 
basis, including franchise or blanket insurance, that provides 
creditable coverage for the purposes of Section 1205.004.
	(b)  An insurer that delivers or issues for delivery an 
individual accident and health insurance policy in this state to an 
individual who maintains coverage under the policy for at least six 
months must reinstate the individual's coverage under the policy 
following a period under which the individual is covered under a 
group health benefit plan if:
		(1)  there is no gap between the end of the initial 
coverage under the individual accident and health insurance policy 
and the beginning of the individual's coverage under the group 
health benefit plan; and
		(2)  on or before the 30th day after the date the 
individual's eligibility for coverage under the group health 
benefit plan, other than eligibility for continuation or conversion 
of coverage under the Consolidated Omnibus Budget Reconciliation 
Act of 1985 (Pub. L. No. 99-272), terminates, the individual:
			(A)  requests reinstatement; and                                      
			(B)  provides proof of the period of coverage 
under the group health benefit plan that complies with requirements 
established by the commissioner by rule.
	(c)  Coverage under and premiums charged for an individual 
accident and health insurance policy reinstated under this section 
shall be determined as if the individual had continued to be covered 
under the policy during the period after the termination of the 
initial coverage under the policy and before the reinstatement of 
the coverage.
	SECTION 2.  The change in law made by this Act applies only 
to an individual accident and health insurance policy delivered, 
issued for delivery, or renewed on or after January 1, 2006.  A 
policy delivered, issued for delivery, or renewed before that date 
is governed by the law in effect immediately before that date, and 
that law is continued in effect for that purpose.
	SECTION 3.  This Act takes effect September 1, 2005.