By: Menendez (Senate Sponsor - Van de Putte) H.B. No. 765
(In the Senate - Received from the House April 14, 2005;
April 18, 2005, read first time and referred to Committee on State
Affairs; May 21, 2005, reported favorably, as amended, by the
following vote: Yeas 7, Nays 0; May 21, 2005, sent to printer.)
COMMITTEE AMENDMENT NO. 1 By: Harris
Amend H.B. 765 as follows:
In Section 2 of the bill, delete subsection c in its entirety.
A BILL TO BE ENTITLED
AN ACT
relating to notice of coverage under certain group health insurance
policies and standard health benefit plans.
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. Subchapter E, Chapter 1251, Insurance Code, is
amended by adding Section 1251.202 to read as follows:
Sec. 1251.202. NOTICE REGARDING CERTAIN EMPLOYER HEALTH
BENEFIT PLANS. (a) In this section, "standard health benefit
plan" means a plan offered under Article 3.80, Article 20A.09N, or
Chapter 1507.
(b) If an employer offers to employees a standard health
benefit plan, the employer shall:
(1) provide a copy of the disclosure statement
provided to the employer by the plan issuer under Section 6, Article
3.80, Article 20A.09N(g), Section 1507.006, or Section 1507.056 to:
(A) each employee:
(i) before the employee initially enrolls
in the plan, unless the employee received notice under Paragraph
(B) on or after the 90th day before the date the employee initially
enrolls; and
(ii) not later than the 30th day before the
date the employee renews enrollment in the plan; and
(B) each prospective employee before the
prospective employee is hired by the employer; and
(2) obtain a copy of the notice signed by the employee
or prospective employee at the time the notice is provided.
(c) The employer must:
(1) retain the signed disclosure statement in the
employer's records; and
(2) on request of the commissioner, provide the signed
disclosure statement to the department.
SECTION 3. 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 4. This Act takes effect September 1, 2005.
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