79R9442 KCR-D


By:  Menendez                                                     H.B. No. 765

Substitute the following for H.B. No. 765:                                    

By:  Oliveira                                                 C.S.H.B. No. 765



A BILL TO BE ENTITLED

AN ACT

relating to certificate of insurance and notice of coverage 
requirements for certain group health insurance policies.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Section 1251.201, Insurance Code, as effective 
April 1, 2005, is amended to read as follows:
	Sec. 1251.201.  CERTIFICATE OF INSURANCE; NOTICE OF SEPARATE 
AVAILABLE COVERAGE.  (a)  An insurer issuing a group policy under 
this chapter shall provide to the policyholder for delivery to each 
employee or member of the insured group:
		(1)  a certificate of insurance that:                                  
			(A) [(1)]  summarizes the essential features of 
the insurance coverage of the employee or member, including the 
annual deductibles, annual and lifetime policy limits, and maximum 
out-of-pocket expenses under the policy; and
			(B) [(2)]  states the person to whom benefits are 
payable; and
		(2)  a notice that informs the employee or member of the 
availability of and premiums for a rider or separate insurance 
policy that would provide coverage in addition to the coverage 
provided under the policy.
	(b)  If dependents are included in the coverage, an insurer 
is not required to provide more than one certificate or notice for 
each family unit.
	SECTION 2.  The change in law made by this Act applies only 
to an insurance policy that is delivered, issued for delivery, or 
renewed on or after January 1, 2006.  An insurance policy that is 
delivered, issued for delivery, or renewed before January 1, 2006, 
is covered by the law in effect at the time the policy was 
delivered, issued for delivery, or renewed, and that law is 
continued in effect for that purpose.
	SECTION 3.  This Act takes effect September 1, 2005.