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79R4263 PB-D
By: Shapleigh S.B. No. 301
A BILL TO BE ENTITLED
AN ACT
relating to the collection and reporting of certain information
regarding uninsured individuals in this state.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Chapter 531, Government Code, is amended by
adding Subchapter M to read as follows:
SUBCHAPTER M. DATA COLLECTING AND REPORTING
REGARDING CERTAIN UNINSURED INDIVIDUALS
Sec. 531.451. DEFINITIONS. In this subchapter:
(1) "Eligible employee" means an employee who works on
a full-time basis and who usually works at least 30 hours a week.
The term does not include an employee who works on a part-time,
temporary, seasonal, or substitute basis.
(2) "Employee" means an individual employed by an
employer.
(3) "Employer" means a person engaged in an industry
affecting commerce who has 15 or more eligible employees for each
working day in each of 20 or more calendar weeks in the current or
preceding calendar year. The term includes this state or a
political subdivision of this state.
(4) "Health benefit plan" means a group, blanket, or
franchise insurance policy, a certificate issued under a group
policy, a group hospital service contract, or a group subscriber
contract or evidence of coverage issued by a health maintenance
organization that provides benefits for health care services. The
term does not include:
(A) accident-only or disability income insurance
coverage or a combination of accident-only and disability income
insurance coverage;
(B) credit-only insurance coverage;
(C) disability insurance coverage;
(D) coverage for a specified disease or illness;
(E) Medicare services under a federal contract;
(F) Medicare supplement and Medicare Select
benefit plans regulated in accordance with federal law;
(G) long-term care coverage or benefits, nursing
home care coverage or benefits, home health care coverage or
benefits, community-based care coverage or benefits, or any
combination of those coverages or benefits;
(H) coverage that provides limited-scope dental
or vision benefits;
(I) coverage provided by a single service health
maintenance organization;
(J) workers' compensation insurance coverage or
similar insurance coverage;
(K) hospital indemnity or other fixed indemnity
insurance coverage;
(L) reinsurance contracts issued on a stop-loss,
quota-share, or similar basis;
(M) short-term major medical contracts;
(N) liability insurance coverage, including
general liability insurance coverage and automobile liability
insurance coverage, and coverage issued as a supplement to
liability insurance coverage, including automobile medical payment
insurance coverage;
(O) coverage for on-site medical clinics;
(P) coverage that provides other limited
benefits specified by federal regulations; or
(Q) other coverage that:
(i) is similar to the coverage described by
this subdivision under which benefits for medical care are
secondary or incidental to other coverage benefits; and
(ii) is specified by federal regulations.
(5) "Program" means the data collection program
established under this subchapter.
(6) "Uninsured individual" means an individual who is
not eligible to receive and does not receive benefits for health
care services through:
(A) a health benefit plan;
(B) a federal health care program other than
Medicaid, including the TRICARE program or the Medicare program; or
(C) a benefit plan established in another
country.
Sec. 531.452. DATA COLLECTION PROGRAM; RULES. (a) The
commission shall develop and maintain a program to collect
statistical data and other information regarding uninsured
individuals in this state.
(b) The program must include appropriate demographic
information regarding uninsured individuals, and may include
information regarding employers who do not provide health benefit
plan coverage to their eligible employees.
(c) The commission shall adopt rules as necessary to
implement this subchapter, including rules relating to:
(1) any required reporting by employers or health
benefit plan issuers;
(2) reporting schedules;
(3) report forms;
(4) lists of data and information required to be
reported; and
(5) reporting procedures, guidelines, and criteria.
(d) The commission may obtain information from employers
and health benefit plan issuers as necessary to implement this
subchapter.
Sec. 531.453. COOPERATION WITH TEXAS DEPARTMENT OF
INSURANCE AND TEXAS WORKFORCE COMMISSION. (a) The commission may
enter into agreements with the Texas Department of Insurance and
Texas Workforce Commission as necessary to comply with this
subchapter.
(b) On request by the commission, the commissioner of
insurance and Texas Workforce Commission shall provide information
to the commission appropriate to the implementation of this
subchapter.
Sec. 531.454. COMPILATION OF DATA; PUBLIC REPORT. (a) The
commission shall compile the data and information derived from the
program on a composite basis by county.
(b) The commission shall prepare at least annually a written
report of the composite data and information collected under the
program.
(c) The commission shall make the report available to the
public on the commission's Internet website.
SECTION 2. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2005.