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A BILL TO BE ENTITLED
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AN ACT
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relating to health benefit plan coverage for a hospital stay |
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following mastectomy and certain related procedures. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 1357.052, Insurance Code, is amended to |
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read as follows: |
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Sec. 1357.052. APPLICABILITY OF SUBCHAPTER. (a) This |
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subchapter applies only to a health benefit plan that: |
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(1) provides benefits for medical or surgical expenses |
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incurred as a result of a health condition, accident, or sickness, |
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including: |
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(A) an individual, group, blanket, or franchise |
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insurance policy or insurance agreement, a group hospital service |
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contract, or an individual or group evidence of coverage that is |
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offered by: |
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(i) an insurance company; |
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(ii) a group hospital service corporation |
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operating under Chapter 842; |
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(iii) a fraternal benefit society operating |
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under Chapter 885; |
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(iv) a stipulated premium company operating |
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under Chapter 884; or |
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(v) a health maintenance organization |
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operating under Chapter 843; and |
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(B) to the extent permitted by the Employee |
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Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et |
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seq.), a health benefit plan that is offered by: |
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(i) a multiple employer welfare arrangement |
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as defined by Section 3 of that Act; or |
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(ii) another analogous benefit |
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arrangement; |
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(2) is offered by an approved nonprofit health |
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corporation that holds a certificate of authority under Chapter |
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844; or |
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(3) provides coverage only for a specific disease or |
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condition or for hospitalization. |
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(b) Notwithstanding any other law, a standard health |
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benefit plan provided under Chapter 1507 must provide the coverage |
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required by this subchapter. |
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SECTION 2. The change in law made by this Act applies only |
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to a health benefit plan that is delivered, issued for delivery, or |
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renewed on or after January 1, 2008. A health benefit plan that is |
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delivered, issued for delivery, or renewed before January 1, 2008, |
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is covered by the law in effect at the time the health benefit plan |
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was delivered, issued for delivery, or renewed, and that law is |
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continued in effect for that purpose. |
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SECTION 3. This Act takes effect September 1, 2007. |