| |
|
|
A BILL TO BE ENTITLED
|
|
|
AN ACT
|
|
|
relating to a small employer health benefit plan premium assistance |
|
|
program. |
|
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
|
SECTION 1. Chapter 1501, Insurance Code, is amended by |
|
|
adding Subchapter I to read as follows: |
|
|
SUBCHAPTER I. SMALL EMPLOYER PREMIUM ASSISTANCE PROGRAM |
|
|
Sec. 1501.401. DEFINITIONS. In this subchapter: |
|
|
(1) "Commission" means the Health and Human Services |
|
|
Commission. |
|
|
(2) "Program" means the small employer premium |
|
|
assistance program. |
|
|
Sec. 1501.402. PROGRAM DEVELOPMENT. The department and the |
|
|
commission shall jointly develop a small employer premium |
|
|
assistance program designed to provide financial assistance for the |
|
|
purchase of small employer health benefit plans by small employers. |
|
|
Sec. 1501.403. CONSOLIDATION OF PROGRAM DESIGN. In |
|
|
developing the program, the department and the commission shall |
|
|
consider: |
|
|
(1) targeting small employers; |
|
|
(2) provisions to limit employers and others from |
|
|
electing to discontinue other private coverage for employees; |
|
|
(3) establishing a minimum percentage of premium that |
|
|
a small employer must pay for the premium of each eligible |
|
|
employee's coverage; |
|
|
(4) limiting the eligibility of enrollees for whom |
|
|
financial assistance is provided to individuals at or below 300 |
|
|
percent of the federal poverty level based on the federal Office of |
|
|
Management and Budget poverty index; |
|
|
(5) allocating available opportunities for enrollment |
|
|
in the program to geographic regions of the state, based on the |
|
|
percentage of the state's small employers that are located in each |
|
|
region; |
|
|
(6) establishing that enrollment in the program is |
|
|
valid for one year and may be renewed in accordance with procedures |
|
|
established by the department and the commission; |
|
|
(7) a process to verify that small employers |
|
|
participating in the program use premium assistance to purchase and |
|
|
maintain a small employer health benefit plan; and |
|
|
(8) programs and efforts undertaken by other states to |
|
|
provide premium assistance to small employers. |
|
|
Sec. 1501.404. COORDINATION WITH OTHER EFFORTS. The |
|
|
department and the commission shall ensure that efforts to develop |
|
|
a small employer premium assistance program are consistent with any |
|
|
other premium assistance effort operated, under development, or |
|
|
under consideration by either agency. |
|
|
SECTION 2. Subdivision (16), Section 1501.002, Insurance |
|
|
Code, is amended to read as follows: |
|
|
(16) "Small employer health benefit plan issuer" means |
|
|
a health benefit plan issuer, to the extent that the issuer is |
|
|
offering, delivering, issuing for delivery, or renewing health |
|
|
benefit plans subject to Subchapters C-I [C-H]. |
|
|
SECTION 3. Section 1501.003, Insurance Code, is amended to |
|
|
read as follows: |
|
|
Sec. 1501.003. APPLICABILITY: SMALL EMPLOYER HEALTH |
|
|
BENEFIT PLANS. An individual or group health benefit plan is a |
|
|
small employer health benefit plan subject to Subchapters C-I [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). |
|
|
SECTION 4. This Act takes effect immediately if it receives |
|
|
a vote of two-thirds of all the members elected to each house, as |
|
|
provided by Section 39, Article III, Texas Constitution. If this |
|
|
Act does not receive the vote necessary for immediate effect, this |
|
|
Act takes effect September 1, 2007. |