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A BILL TO BE ENTITLED
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AN ACT
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relating to disclosure of information about health care-related |
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services or access to health care information provided to persons |
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covered by health benefit plans. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 541.058, Insurance Code, is amended to |
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read as follows: |
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Sec. 541.058. CERTAIN PRACTICES NOT CONSIDERED |
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DISCRIMINATION OR INDUCEMENT. (a) In this section: |
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(1) "Health-related services" means services that are |
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available in connection with an accident and health insurance |
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policy or certificate or an evidence of coverage and that are |
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directed to an individual's health improvement or maintenance. |
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(2) "Health-related information" means that |
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information that is directed to an individual's health improvement |
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or maintenance or to costs associated with particular options |
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available in connection with an accident and health insurance |
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policy or certificate or an evidence of coverage. |
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(b) It is not a rebate or discrimination prohibited by |
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Section 541.056(a) or 541.057: |
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(1) for a life insurance or life annuity contract, to |
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pay a bonus to a policyholder or otherwise abate the policyholder's |
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premiums in whole or in part out of surplus accumulated from |
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nonparticipating insurance policies if the bonus or abatement: |
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(A) is fair and equitable to policyholders; and |
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(B) is in the best interests of the insurer and |
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its policyholders; |
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(2) for a life insurance policy issued on the |
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industrial debit plan, to make to a policyholder who has |
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continuously for a specified period made premium payments directly |
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to the insurer's office an allowance in an amount that fairly |
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represents the saving in collection expenses; |
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(3) for a group insurance policy, to readjust the rate |
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of premium based on the loss or expense experience under the policy |
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at the end of a policy year if the adjustment is retroactive for |
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only that policy year; [or] |
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(4) for a life annuity contract, to waive surrender |
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charges under the contract when the contract holder exchanges that |
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contract for another annuity contract issued by the same insurer if |
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the waiver and the exchange are fully, fairly, and accurately |
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explained to the contract holder in a manner that is not deceptive |
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or misleading; |
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(5) in connection with an accident and health |
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insurance policy, to provide to policy or certificate holders, in |
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addition to benefits under the terms of the insurance contract, |
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health-related services or health-related information, or to |
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disclose the availability of those additional services and |
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information to prospective policy or certificate holders; or |
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(6) in connection with a health maintenance |
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organization evidence of coverage, to provide to enrollees, in |
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addition to benefits under the evidence of coverage, health-related |
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services or health-related information, or to disclose the |
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availability of those additional services and information to |
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prospective enrollees or contract holders. |
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SECTION 2. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2007. |