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A BILL TO BE ENTITLED
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AN ACT
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relating to the Texas Health Insurance Risk Pool. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter A, Chapter 1506, Insurance Code, is |
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amended by adding Sections 1506.008 and 1506.009 to read as |
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follows: |
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Sec. 1506.008. EXEMPTION FROM STATE TAXES AND FEES. The |
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pool is not subject to any state tax, regulatory fee, or surcharge, |
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including a premium or maintenance tax or fee. |
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Sec. 1506.009. STUDY; REPORT. (a) The commissioner shall |
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conduct a study concerning a program under which the pool would |
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offer coverage to an individual who is also covered under a group |
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health benefit plan that is provided or offered to the individual |
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through an employer. Under the proposed program, pool coverage |
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would be secondary to coverage provided under the group health |
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benefit plan. |
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(b) The commissioner, using existing resources, may |
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contract with actuaries and other experts as necessary to conduct |
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the study. |
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(c) The commissioner shall report the results of the study |
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in the biennial report under Section 32.022. The report must: |
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(1) include an analysis of the advantages and |
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disadvantages of the proposed program and recommended minimum |
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standards applicable to group health benefit plans that may be |
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included in the program; and |
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(2) identify program components, requirements, or |
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restrictions necessary for successful implementation of the |
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program. |
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(d) This section expires September 1, 2009. |
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SECTION 2. Section 1506.251, Insurance Code, is amended by |
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adding Subsection (c) to read as follows: |
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(c) The regular assessment is the amount determined by the |
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board under Section 1506.252 and recovered from health benefit plan |
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issuers under Section 1506.253. |
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SECTION 3. Subchapter F, Chapter 1506, Insurance Code, is |
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amended by adding Section 1506.2523 to read as follows: |
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Sec. 1506.2523. ANNUAL REPORT TO BOARD: GROSS PREMIUMS. |
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(a) Each health benefit plan issuer shall report to the board the |
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gross premiums collected for the preceding calendar year for health |
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benefit plans. |
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(b) For purposes of this section, gross health benefit plan |
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premiums do not include premiums collected for: |
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(1) coverage under a Medicare supplement benefit plan |
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subject to Chapter 1652; |
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(2) coverage under a small employer health benefit |
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plan subject to Subchapters A-H, Chapter 1501; or |
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(3) coverage or insurance listed in Section |
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1506.002(b). |
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SECTION 4. Section 1506.253(b), Insurance Code, is amended |
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to read as follows: |
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(b) The board shall use the total number of enrolled |
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individuals reported by all health benefit plan issuers under |
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Section 1506.2522 as of the preceding December 31 to [To] compute |
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the amount of a health benefit plan issuer's assessment, if any, in |
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accordance with this subsection. The [the] board shall allocate [:
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[(1) divide] the total amount to be assessed based on |
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[by] the total number of enrolled individuals covered by excess |
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loss, stop-loss, or reinsurance policies and on the total number of |
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other enrolled individuals as determined [reported by all health
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benefit plan issuers] under Section 1506.2522. To compute the |
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amount of a health benefit plan issuer's assessment: |
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(1) for the issuer's enrolled individuals covered by |
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an excess loss, stop-loss, or reinsurance policy, the board shall: |
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(A) divide the allocated amount to be assessed by |
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the total number of enrolled individuals covered by excess loss, |
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stop-loss, or reinsurance policies, as determined under Section |
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1506.2522, [as of the preceding December 31] to determine the per |
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capita amount; and |
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(B) multiply the number of a health benefit plan |
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issuer's enrolled individuals covered by an excess loss, stop-loss, |
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or reinsurance policy, as determined under Section 1506.2522, by |
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the per capita amount to determine the amount assessed to that |
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health benefit plan issuer; and |
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(2) for the issuer's enrolled individuals not covered |
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by excess loss, stop-loss, or reinsurance policies, the board, |
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using the gross health benefit plan premiums reported for the |
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preceding calendar year by health benefit plan issuers under |
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Section 1506.2523, shall: |
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(A) divide the gross premium collected by a |
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health benefit plan issuer by the gross premium collected by all |
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health benefit plan issuers; and |
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(B) multiply the allocated amount to be assessed |
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by the fraction computed under Paragraph (A) [number of enrolled
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individuals reported by the health benefit plan issuer under
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Section 1506.2522 as of the preceding December 31 by the per capita
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amount] to determine the amount assessed to that health benefit |
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plan issuer. |
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SECTION 5. Section 1506.008, Insurance Code, as added by |
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this Act, applies only to a state tax, regulatory fee, or surcharge |
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that becomes due on or after the effective date of this Act. |
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SECTION 6. The change in law made by this Act to Section |
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1506.253, Insurance Code, applies to an assessment under Subchapter |
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F, Chapter 1506, Insurance Code, for a calendar year or portion of a |
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calendar year beginning on the effective date of this Act. An |
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assessment for any portion of a calendar year before the effective |
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date of this Act is governed by the law in effect during the period |
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for which the assessment is made, and the former law is continued in |
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effect for that purpose. |
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SECTION 7. This Act takes effect June 30, 2007, if it |
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receives a vote of two-thirds of all the members elected to each |
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house, as provided by Section 39, Article III, Texas Constitution. |
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If this Act does not receive the vote necessary to take effect on |
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that date, this Act takes effect September 30, 2007. |
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