|
|
A BILL TO BE ENTITLED
|
|
|
AN ACT
|
|
|
relating to modification of certain small and large employer health |
|
|
benefit plans. |
|
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
|
SECTION 1. Section 1501.108, Insurance Code, is amended by |
|
|
amending Subsection (a) and adding Subsection (d) to read as |
|
|
follows: |
|
|
(a) Except as provided by this section and Section 1501.109, |
|
|
a small or large employer health benefit plan issuer shall renew the |
|
|
small or large employer health benefit plan for any covered small or |
|
|
large employer, as applicable, at the employer's option, unless: |
|
|
(1) a premium has not been paid as required by the |
|
|
terms of the plan; |
|
|
(2) the employer has committed fraud or has |
|
|
intentionally misrepresented a material fact; |
|
|
(3) the employer has not complied with the terms of the |
|
|
plan; |
|
|
(4) no enrollee in the plan resides or works in the |
|
|
geographic service area of the small or large employer health |
|
|
benefit plan issuer or in the area for which the issuer is |
|
|
authorized to do business; or |
|
|
(5) membership of the employer in an association |
|
|
terminates, but only if coverage is terminated uniformly without |
|
|
regard to a health status related factor of a covered individual. |
|
|
(d) Notwithstanding Subsection (a), a small or large |
|
|
employer health benefit plan issuer may modify a small or large |
|
|
employer health benefit plan if: |
|
|
(1) the modification occurs at the time of coverage |
|
|
renewal; |
|
|
(2) the modification is effective uniformly among all |
|
|
small or large employers covered by that health benefit plan; and |
|
|
(3) the issuer notifies the commissioner and each |
|
|
affected covered small or large employer of the modification not |
|
|
later than the 60th day before the date the modification is |
|
|
effective. |
|
|
SECTION 2. This Act applies only to a small or large |
|
|
employer health benefit plan that is delivered, issued for |
|
|
delivery, or renewed on or after January 1, 2008. A health benefit |
|
|
plan that is delivered, issued for delivery, or renewed before |
|
|
January 1, 2008, is governed by the law as it existed immediately |
|
|
before the effective date of this Act, and that law is continued in |
|
|
effect for this purpose. |
|
|
SECTION 3. This Act takes effect September 1, 2007. |