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