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