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A BILL TO BE ENTITLED
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AN ACT
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relating to health benefit coverage for children and grandchildren. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 846.260, Insurance Code, is amended to |
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read as follows: |
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Sec. 846.260. LIMITING AGE APPLICABLE TO [UNMARRIED] CHILD. |
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[If children] Children are eligible for coverage under the terms of |
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a multiple employer welfare arrangement's plan document, [any] and |
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there is no limiting age applicable to [an unmarried] a child of an |
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enrollee [is 25 years of age]. |
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SECTION 2. Section 1201.062, Insurance Code, is amended to |
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read as follows: |
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Sec. 1201.062. COVERAGE FOR CERTAIN CHILDREN IN INDIVIDUAL |
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OR GROUP POLICY OR IN PLAN OR PROGRAM. (a) An individual or group |
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accident and health insurance policy that is delivered, issued for |
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delivery, or renewed in this state, including a policy issued by a |
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corporation operating under Chapter 842, or a self-funded or |
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self-insured welfare or benefit plan or program, to the extent that |
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regulation of the plan or program is not preempted by federal law, |
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[that provides] must provide coverage for a child of an insured or |
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group member, on payment of a premium, and must provide coverage |
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for: |
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(1) each grandchild of the insured or group member [if
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the grandchild is :
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[(A)unmarried;
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[(B)younger than 25 years of age; and
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[(C) a dependent of the insured or group member
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for federal income tax purposes at the time application for
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coverage of the grandchild is made]; and |
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(2) each child for whom the insured or group member |
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must provide medical support under an order issued under Chapter |
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154, Family Code, or enforceable by a court in this state. |
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(b) Coverage for a grandchild of the insured or group member |
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may not be terminated solely because the grandchild is no longer a |
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dependent of the insured or group member for federal income tax |
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purposes. |
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SECTION 3. Section 1251.151, Insurance Code, is amended to |
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read as follows: |
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Sec. 1251.151. COVERAGE FOR CERTAIN GRANDCHILDREN. (a) A |
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group policy or contract of insurance for hospital, surgical, or |
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medical expenses incurred as a result of accident or sickness, |
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including a group contract issued by a group hospital service |
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corporation, that provides coverage under the policy or contract |
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for a child of an insured must, on payment of a premium, provide |
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coverage for any grandchild of the insured [if the grandchild is:
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[(1)unmarried;
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[(2)younger than 25 years of age; and
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[(3) a dependent of the insured for federal income tax
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purposes at the time the application for coverage of the grandchild
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is made]. |
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(b) Coverage for a grandchild of the insured under this |
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section may not be terminated solely because the covered grandchild |
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is no longer a dependent of the insured for federal income tax |
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purposes. |
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SECTION 4. Section 1251.152, Insurance Code, is amended to |
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read as follows: |
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Sec. 1251.152. OPTIONAL COVERAGE FOR SPOUSES AND |
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DEPENDENTS. (a) For purposes of this section, "dependent" |
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includes: |
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(1) a child of an employee or member [who is;
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[(A)unmarried; and
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[(B)younger than 25 years of age]; and |
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(2) a grandchild of an employee or member [who is;
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[(A)unmarried;
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[(B)younger than 25 years of age; and
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[(C) a dependent of the insured for federal
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income tax purposes at the time the application for coverage of the
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grandchild is made]. |
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(b) A group accident and health insurance policy [may] must |
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provide coverage for the spouse or a dependent of an employee or |
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member. |
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SECTION 5. Section 1271.006, Insurance Code, is amended to |
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read as follows: |
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Sec. 1271.006. BENEFITS TO DEPENDENT CHILD AND GRANDCHILD. |
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[(a) If children] Children are eligible for coverage under the |
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terms of an evidence of coverage, [any] and there is no limiting age |
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applicable to [an unmarried] a child of an enrollee, including [an
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unmarried] a grandchild of an enrollee [, is 25 years of age. The
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limiting age applicable to a child must be stated in the evidence of
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coverage.
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[(b) A health maintenance organization may provide benefits
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under a health care plan to an enrollee's dependent grandchild who
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is living with and in the household of the enrollee]. |
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SECTION 6. Section 1501.002, Insurance Code, is amended to |
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read as follows: |
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Sec. 1501.002. DEFINITIONS. In this chapter: |
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(1) "Agent" means a person who may act as an agent for |
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the sale of a health benefit plan under a license issued under Title |
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13. |
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(2) "Dependent" means: |
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(A) a spouse; |
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(B) a child [younger than 25 years of age], |
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including a newborn child; |
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(C) a child of any age who is: |
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(i) medically certified as disabled; and |
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(ii) dependent on the parent; |
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(D) an individual who must be covered under: |
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(i) Section 1251.154; or |
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(ii) Section 1201.062; and |
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(E) any other child eligible under an employer's |
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health benefit plan, including a child described by Section |
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1503.003. |
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SECTION 7. Section 1501.609, Insurance Code, is amended to |
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read as follows: |
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Sec. 1501.609. COVERAGE FOR [UNMARRIED] CHILDREN. [(a) |
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This section applies only if children] Children are eligible for |
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coverage under a large employer health benefit plan. |
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[(b) Any limiting age applicable under a large employer
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health benefit plan to an unmarried child of an enrollee is 25 years
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of age.] |
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SECTION 8. Section 1575.003, Insurance Code, is amended to |
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read as follows: |
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Sec. 1575.003. DEFINITION OF DEPENDENT AND RELATED TERMS. |
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In this chapter: |
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(1) "Dependent" means: |
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(A) the spouse of a retiree; |
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(B) [an unmarried] a child of a retiree or |
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deceased active member [ if the child is younger than 25 years of
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age], including: |
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(i) an adopted child; |
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(ii) a foster child, stepchild, or other |
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child who is in a regular parent-child relationship; or |
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(iii) a recognized natural child; |
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(C) a retiree's recognized natural child, |
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adopted child, foster child, stepchild, or other child who is in a |
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regular parent-child relationship and who lives with or has his or |
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her care provided by the retiree or surviving spouse on a regular |
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basis regardless of the child's age, if the child is mentally |
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retarded or physically incapacitated to an extent that the child is |
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dependent on the retiree or surviving spouse for care or support, as |
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determined by the trustee; or |
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(D) a deceased active member's recognized |
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natural child, adopted child, foster child, stepchild, or other |
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child who is in a regular parent-child relationship, without regard |
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to the age of the child, if, while the active member was alive, the |
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child: |
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(i) lived with or had the child's care |
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provided by the active member on a regular basis; and |
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(ii) was mentally retarded or physically |
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incapacitated to an extent that the child was dependent on the |
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active member or surviving spouse for care or support, as |
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determined by the trustee. |
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SECTION 9. Section 1601.004, Insurance Code, is amended to |
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read as follows: |
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Sec. 1601.004. DEFINITION OF DEPENDENT. (a) In this |
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chapter, "dependent," with respect to an individual eligible to |
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participate in the uniform program under Section 1601.101 or |
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1601.102, means the individual's: |
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(1) spouse; |
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(2) [unmarried] a child [younger than 25 years of
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age]; and |
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(3) child of any age who lives with or has the child's |
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care provided by the individual on a regular basis if the child is |
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mentally retarded or physically incapacitated to the extent that |
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the child is dependent on the individual for care or support, as |
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determined by the system. |
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SECTION 10. Sections 1201.065 and 1503.003, Insurance Code, |
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are repealed. |
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SECTION 11. The changes in law made by this Act apply only |
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to a health benefit plan, the contract or evidence of coverage for |
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which is delivered, issued for delivery, or renewed on or after the |
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effective date of this Act. A health benefit plan, the contract or |
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evidence of coverage for which is delivered, issued for delivery, |
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or renewed before the effective date of this Act, is covered by the |
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law in effect at the time the contract or evidence of coverage is |
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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 12. This Act takes effect September 1, 2007. |