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By:  Rose                                                         H.B. No. 3405



A BILL TO BE ENTITLED

AN ACT

relating to health benefit plan coverage for a hospital stay 
following mastectomy and certain related procedures.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Section 1357.052, Insurance Code, as effective 
April 1, 2005, is amended to read as follows:
	Sec. 1357.052.  APPLICABILITY OF SUBCHAPTER.  (a)  This 
subchapter applies only to a health benefit plan that:
		(1)  provides benefits for medical or surgical expenses 
incurred as a result of a health condition, accident, or sickness, 
including:
			(A)  an individual, group, blanket, or franchise 
insurance policy or insurance agreement, a group hospital service 
contract, or an individual or group evidence of coverage that is 
offered by:
				(i)  an insurance company;                                                  
				(ii)  a group hospital service corporation 
operating under Chapter 842;   
				(iii)  a fraternal benefit society operating 
under Chapter 885;           
				(iv)  a stipulated premium company operating 
under Chapter 884; or        
				(v)  a health maintenance organization 
operating under Chapter 843; and   
			(B)  to the extent permitted by the Employee 
Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et 
seq.), a health benefit plan that is offered by:
				(i)  a multiple employer welfare arrangement 
as defined by Section 3 of that Act; or
				(ii)  another analogous benefit 
arrangement;                              
		(2)  is offered by an approved nonprofit health 
corporation that holds a certificate of authority under Chapter 
844; or
		(3)  provides coverage only for a specific disease or 
condition or for hospitalization.
	(b)  Notwithstanding any other law, a standard health 
benefit plan provided under Chapter 1507 or Article 3.80 or 20A.09N 
must provide the coverage required by this subchapter.
	SECTION 2.  The change in law made by this Act applies only 
to a health benefit plan that is delivered, issued for delivery, or 
renewed on or after January 1, 2006.  A health benefit plan that is 
delivered, issued for delivery, or renewed before January 1, 2006, 
is covered by the law in effect at the time the health benefit plan 
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.