By: Nelson S.B. No. 23
 
 
A BILL TO BE ENTITLED
AN ACT
relating to promoting the purchase and availability of health
coverage.
       BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
ARTICLE 1.  TEXLINK TO HEALTH COVERAGE PROGRAM
       SECTION 1.01.  Chapter 524, Insurance Code, is amended to
read as follows:
CHAPTER 524.  TEXLINK TO HEALTH COVERAGE [AWARENESS AND EDUCATION]
PROGRAM
SUBCHAPTER A.  GENERAL PROVISIONS
       Sec. 524.001.  DEFINITIONS.  In this chapter:
             (1)  "Division" means the division of the department
that administers the TexLink to Health Coverage Program.
             (2)  "Program" means the TexLink to Health Coverage
Program established in accordance with this chapter.
       Sec. 524.002.  DIVISION RESPONSIBILITIES.  Under the
direction of the commissioner, the division implements this
chapter.
       Sec. 524.003.  TEXLINK TO HEALTH COVERAGE PROGRAM
ESTABLISHED.  (a)  The department shall develop and implement a
health coverage [public awareness and education] program that
complies with this chapter. The program must:
             (1)  educate the public about the importance and value
of health coverage;
             (2)  promote personal responsibility for health care
through the purchase of health coverage;
             (3)  assist small employers, individuals, and others
seeking to purchase health coverage with technical information
necessary to understand available health coverage products;
             (4)  promote and facilitate the development and
availability of new health coverage options;
             (5)  increase public awareness of health coverage
options available in this state; and
             (6) [(2)  educate the public on the value of health
coverage; and
             [(3)]  provide information on health coverage options,
including health savings accounts and compatible high deductible
health benefit plans.
       (b)  The program must include a public awareness and
education component.
[Sections 524.004-524.050 reserved for expansion]
SUBCHAPTER B.  PUBLIC AWARENESS AND EDUCATION
       Sec. 524.051.  INFORMATION ABOUT SPECIFIC HEALTH BENEFIT
PLAN ISSUERS.  In materials produced for the program, the division
[(b) The department] may include information about specific health
benefit plan [coverage] issuers but may not favor or endorse one
particular issuer over another.
       Sec. 524.052.  [524.002.] PUBLIC SERVICE ANNOUNCEMENTS.  The
division [department] shall develop and make public service
announcements to educate consumers and employers about the
availability of health coverage in this state.
       Sec. 524.053.  [524.003.] INTERNET WEBSITE; PRINTED
MATERIALS; NEWSLETTER [PUBLIC EDUCATION].  (a)  The division
[department] shall develop an Internet website and printed
materials designed to educate small employers, individuals, and
others seeking to purchase health coverage [the public] about [the
availability of] health coverage in accordance with Section
524.003(a) [this state, including information about health savings
accounts and compatible high deductible health benefit plans].
       (b)  The division shall make the printed materials produced
under the program available to small employers, individuals, and
others seeking to purchase health coverage.  The division may:
             (1)  distribute the printed materials through
facilities such as libraries, health care facilities, and schools
as well as other venues the division selects; and
             (2)  use other distribution methods the division
selects.
       (c)  The division may produce a newsletter to provide updated
information about health coverage to subscribers who elect to
receive the newsletter.  The division may:
             (1)  produce a newsletter under this subsection for
small employers, for individuals, or for other purchasers of health
coverage;
             (2)  distribute the newsletter on a monthly, quarterly,
or other basis; and
             (3)  distribute the newsletter as a printed document or
electronically.
       Sec. 524.054.  TOLL-FREE TELEPHONE HOTLINE; ACCESS TO
INFORMATION.  (a)  The division may operate a toll-free telephone
hotline to respond to inquiries and provide information and
technical assistance concerning health coverage products.
       (b)  The Health and Human Services Commission, through its
2-1-1 telephone number for access to human services, may
disseminate information regarding health coverage products
provided to the commission by the department and may refer
inquiries regarding health coverage products to the toll-free
telephone hotline.  The department may provide information to the
Health and Human Services Commission as necessary to implement this
subsection.
       Sec. 524.055.  EDUCATION FOR HIGH SCHOOL STUDENTS.  (a)  The
division may develop educational materials and a curriculum to be
used in high school classes that educate students about:
             (1)  the importance and value of health coverage;
             (2)  comparing health benefit plans; and
             (3)  understanding basic provisions contained in
health benefit plans.
       (b)  The division may consult with the Texas Education Agency
in developing educational materials and a curriculum under this
section.
       Sec. 524.056.  HEALTH COVERAGE FAIRS.  (a)  The division may
conduct health coverage fairs to provide small employers,
individuals, and others seeking to purchase health coverage the
opportunity to obtain information about health coverage from
division employees and from health benefit plan issuers and agents
that elect to participate.
       (b)  The division shall seek to obtain funding for health
coverage fairs conducted under this section through gifts and
grants obtained in accordance with Subchapter D.
       Sec. 524.057.  COMMUNITY EVENTS.  The division may
participate in events held in this state to promote awareness of the
importance and value of health coverage and to educate small
employers, individuals, and others seeking to purchase health
coverage about health coverage in accordance with Section
524.003(a).
       Sec. 524.058.  HEALTH COVERAGE PROVIDED THROUGH COLLEGES AND
UNIVERSITIES.  The division may cooperate with a public or private
college or university to promote enrollment in health coverage
programs sponsored by or through the college or university.
       Sec. 524.059.  SUPPORT FOR COMMUNITY-BASED PROJECTS.  The
division may provide support and assistance to individuals and
organizations seeking to develop community-based health coverage
plans for uninsured individuals.
       Sec. 524.060. OTHER EDUCATION.  The division may [department
shall] provide other appropriate education to the public regarding
health coverage and the importance and value of health coverage in
accordance with Section 524.003(a).
       Sec. 524.061.  [524.004.] TASK FORCE.  (a)  The commissioner
may [shall] appoint a task force to make recommendations regarding
the division's duties under this subchapter [health coverage public
awareness and education program]. If appointed, the [The] task
force must be [is] composed of:
             (1)  one representative from each of the following
groups or entities:
                   (A)  health [benefit] coverage consumers;
                   (B)  small employers;
                   (C)  employers generally;
                   (D)  insurance agents;
                   (E)  the office of public insurance counsel;
                   (F)  the Texas Health Insurance Risk Pool;
                   (G)  physicians;
                   (H)  advanced practice nurses;
                   (I)  hospital trade associations; and
                   (J)  medical units of institutions of higher
education;
             (2)  a representative of the Health and Human Services
Commission responsible for programs under Medicaid and the
children's health insurance program; and
             (3)  one or more representatives of health benefit plan
issuers.
       (b)  In addition to the individuals listed in Subsection (a),
the commissioner may select to serve on any task force one or more
individuals with experience in public relations, marketing, or
another related field of professional services.
       (c)  The division may [department shall] consult the task
force regarding the content for the public service announcements,
Internet website, printed materials, and other educational
materials required or authorized by this subchapter [chapter]. The
commissioner has authority to make final decisions as to what the
program's materials will contain.
[Sections 524.062-524.100 reserved for expansion]
SUBCHAPTER C.  ASSISTANCE FOR CERTAIN BUSINESSES
       Sec. 524.101.  FEDERAL TAX "TOOL KIT" FOR CERTAIN
BUSINESSES.  The division may produce materials that provide
information about obtaining health coverage in a manner that
qualifies for favorable treatment under federal tax laws.
       Sec. 524.102.  ASSISTANCE FOR SMALL EMPLOYERS AND
SINGLE-EMPLOYEE BUSINESSES.  Division staff may respond to
telephone inquiries regarding health coverage options for small
employers and single-employee businesses and may speak at events to
provide information about health coverage options for small
employers and single-employee businesses and about the importance
and value of health coverage.
       Sec. 524.103.  COOPERATIVES FOR SMALL AND LARGE EMPLOYERS.  
The division may provide information regarding the formation of or
participation in private purchasing cooperatives and health group
cooperatives in accordance with Subchapter B, Chapter 1501.
       Sec. 524.104.  ACCOUNTANT.  The division may consult an
accountant with experience in federal tax law and the purchase of
group health coverage as necessary to implement this subchapter.
[Sections 524.105-524.150 reserved for expansion]
SUBCHAPTER D.  FUNDING
       Sec. 524.151 [524.005].  FUNDING.  The department may accept
gifts and grants from any party, including a health benefit plan
issuer or a foundation associated with a health benefit plan
issuer, to assist with funding the program. The department shall
adopt rules governing acceptance of donations that are consistent
with Chapter 575, Government Code. Before adopting rules under
this section [subsection], the department shall:
             (1)  submit the proposed rules to the Texas Ethics
Commission for review; and
             (2)  consider the commission's recommendations
regarding the regulations.
ARTICLE 2. CHILDREN'S HEALTH BENEFIT PLAN FOR SMALL EMPLOYERS
       SECTION 2.01.  Section 1501.002, Insurance Code, is amended
by adding Subdivision (1-a) and amending Subdivision (15) to read
as follows:
             (1-a)  "Children's health benefit plan" means a health
benefit plan offered in accordance with Section 1501.2525.
             (15)  "Small employer health benefit plan" means a
health benefit plan developed by the commissioner under Subchapter
F or any other health benefit plan offered to a small employer in
accordance with Section 1501.252(c) or 1501.255.  The term includes
a children's health benefit plan.
       SECTION 2.02.  Section 1501.003, Insurance Code, is amended
to read as follows:
       Sec. 1501.003.  APPLICABILITY: SMALL EMPLOYER HEALTH
BENEFIT PLANS.  (a)  An individual or group health benefit plan is a
small employer health benefit plan subject to Subchapters C-H if it
provides health care benefits covering two or more eligible
employees of a small employer and:
             (1)  the employer pays a portion of the premium or
benefits;
             (2)  the employer or a covered individual treats the
health benefit plan as part of a plan or program for purposes of
Section 106 or 162, Internal Revenue Code of 1986 (26 U.S.C. Section
106 or 162); or
             (3)  the health benefit plan is an employee welfare
benefit plan under 29 C.F.R. Section 2510.3-1(j).
       (b)  A children's health benefit plan is a small employer
benefit plan and, except as specifically provided by Section
1501.2525, is subject to Subchapters C-H in the same manner as any
other small employer health benefit plan.
       SECTION 2.03.  Subsection (b), Section 1501.154, Insurance
Code, is amended to read as follows:
       (b)  If a small employer offers multiple health benefit
plans, the collective participation in those plans, including any
children's health benefit plan, must be at least:
             (1)  75 percent of the employer's eligible employees;
or
             (2)  if applicable, the lower participation level
offered by the small employer health benefit plan issuer under
Section 1501.155.
       SECTION 2.04.  Subchapter F, Chapter 1501, Insurance Code,
is amended by adding Section 1501.2525 to read as follows:
       Sec. 1501.2525.  CHILDREN'S HEALTH BENEFIT PLAN.  (a)  A
small employer health benefit plan issuer may offer to a small
employer a children's health benefit plan in accordance with this
section.
       (b)  A children's health benefit plan provides coverage to
children younger than 25 years of age:
             (1)  who are dependents of eligible employees; and
             (2)  whose family income is at or below 400 percent of
the federal poverty level as determined by rules adopted by the
commissioner.
       (c)  A children's health benefit plan may not provide
coverage to an eligible employee or the spouse of an eligible
employee.
       (d)  The commissioner by rule shall adopt minimum benefits
required to be provided under a children's health benefit plan.  
This subchapter applies to a children's health benefit plan except
to the extent the commissioner by rule determines that a provision
of this subchapter is inappropriate as applied to a children's
health benefit plan.
       SECTION 2.05.  Subchapter B, Chapter 1502, Insurance Code,
is amended by adding Section 1502.054 to read as follows:
       Sec. 1502.054.  INAPPLICABILITY OF OTHER LAW.  A children's
health benefit plan offered under this chapter is not subject to
Section 1501.2525.
       SECTION 2.06.  The commissioner of insurance shall adopt any
rules necessary to implement the change in law made by this article
not later than December 1, 2007.  A small employer health benefit
plan issuer may not offer a children's health benefit plan under
Section 1501.2525, Insurance Code, as added by this article, before
January 1, 2008.
ARTICLE 3.  SPECIALTY CERTIFICATION FOR CERTAIN LIFE, ACCIDENT, AND
HEALTH AGENTS
       SECTION 3.01.  Chapter 4054, Insurance Code, is amended by
adding Subchapter G to read as follows:
SUBCHAPTER G.  SPECIALTY CERTIFICATION FOR AGENTS SERVING CERTAIN
EMPLOYER GROUPS
       Sec. 4054.301.  CERTIFICATION PROGRAM.  The department shall
establish a voluntary specialty certification program for
individuals who market small employer health benefit plans in
accordance with Chapter 1501.
       Sec. 4054.302.  QUALIFICATIONS.  (a)  To be eligible to
receive a specialty certification under this subchapter, an
individual must:
             (1)  hold a general life, accident, and health license
under this chapter;
             (2)  satisfy the requirements of this subchapter; and
             (3)  submit evidence of completion of training to the
department in the manner prescribed by the commissioner.
       (b)  To maintain a specialty certification under this
subchapter, an individual must continue to hold a general life,
accident, and health license under this chapter.
       Sec. 4054.303.  TRAINING.  (a)  To be certified under this
subchapter, an individual must first complete training in the law,
including department rules, applicable to small employer health
benefit plans offered under Chapter 1501.
       (b)  An individual seeking specialty certification under
this subchapter must complete a course applicable to small employer
health benefit plans under Chapter 1501, as prescribed and approved
by the commissioner.  Except as provided by Subsection (c), an
individual is not eligible for the specialty certification unless,
on completion of the course, it is certified to the commissioner as
required by the department that the individual has:
             (1)  completed the course; and
             (2)  passed an examination testing the individual's
knowledge and qualification.
       (c)  An individual seeking specialty certification under
this chapter is not required to complete the course and examination
required by Subsection (b) if the individual demonstrates to the
department, in the manner prescribed by the department, that the
individual holds a designation as:
             (1)  a Registered Health Underwriter (RHU);
             (2)  a Certified Employee Benefit Specialist (CEBS); or
             (3)  a Registered Employee Benefits Consultant (REBC).
       Sec. 4054.304.  CONTINUING EDUCATION REQUIREMENTS.  (a)  To
renew a specialty certification under this subchapter, the
individual must complete five hours of continuing education
applicable to small employer health benefit plans during the
two-year certification period.
       (b)  Each hour of continuing education completed in
accordance with this section may be used to satisfy an hour of a
continuing education requirement otherwise applicable to the agent
under this title.
       Sec. 4054.305.  OFFER OF SERVICES TO ALL GROUP SIZES.  To
hold a specialty certification under this subchapter, an individual
must agree to market small employer health benefit plans to small
employers that satisfy the requirements of Chapter 1501 without
regard to the number of employees to be covered under the plan.
       Sec. 4054.306.  ADVERTISING.  An individual who holds a
specialty certification may advertise, in the manner specified by
department rule, that the individual is specially trained to serve
small employers.
       Sec. 4054.307.  LIST MAINTAINED BY DEPARTMENT; WEBSITE.  The
department shall maintain a list of all individuals who hold a
specialty certification under this chapter, together with the
business address and phone number of each individual and a general
description of the individual's service area.  The department shall
publish the list on the department website.
       Sec. 4054.308.  RULES. The commissioner, in accordance with
Section 36.001, may adopt rules as necessary to administer this
subchapter.
       SECTION 3.02.  Section 4001.002, Insurance Code, is amended
by adding Subsection (a-1) to read as follows:
       (a-1)  Except as otherwise provided by this code, this title
applies to each individual who holds a specialty certification
under Subchapter G, Chapter 4054.
       SECTION 3.03.  Not later than January 1, 2008, the Texas
Department of Insurance may begin issuing specialty certifications
under Subchapter G, Chapter 4054, Insurance Code, as added by this
article.
ARTICLE 4.  EFFECTIVE DATE
       SECTION 4.01.  This Act takes effect September 1, 2007.