By: Nelson  S.B. No. 23
         (In the Senate - Filed November 13, 2006; January 23, 2007,
  read first time and referred to Committee on State Affairs;
  April 17, 2007, reported adversely, with favorable Committee
  Substitute by the following vote:  Yeas 7, Nays 0; April 17, 2007,
  sent to printer.)
 
  COMMITTEE SUBSTITUTE FOR S.B. No. 23 By:  Carona
 
 
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 speciality 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.
 
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