The digital content on TLO has been updated to align with the accessibility standards required by WCAG 2.1.
Amend CSSB 1257 (Senate committee printing) by adding the
following appropriately numbered SECTIONS to ARTICLE 1 of the bill
and renumbering subsequent SECTIONS of that ARTICLE accordingly:
SECTION 1.__. Subtitle G, Title 8, Insurance Code, is
amended by adding Chapter 1515 to read as follows:
CHAPTER 1515. INFORMATION CONCERNING RESCINDED HEALTH BENEFIT
PLANS
Sec. 1515.001. DEFINITION. In this chapter, "coverage
document" means a policy or certificate evidencing the coverage of
an individual or group under a health benefit plan described by
Section 1515.002.
Sec. 1515.002. APPLICABILITY. (a) This chapter applies
only to a health benefit plan, including a small or large employer
health benefit plan written under Chapter 1501, that provides
benefits for medical or surgical expenses incurred as a result of a
health condition, accident, or sickness, including an individual,
group, blanket, or franchise insurance policy or insurance
agreement, a group hospital service contract, or an individual or
group evidence of coverage or similar coverage document that is
offered by:
(1) an insurance company;
(2) a group hospital service corporation operating
under Chapter 842;
(3) a fraternal benefit society operating under
Chapter 885;
(4) a stipulated premium company operating under
Chapter 884;
(5) a reciprocal exchange operating under Chapter 942;
(6) a Lloyd's plan operating under Chapter 941;
(7) a health maintenance organization operating under
Chapter 843;
(8) a multiple employer welfare arrangement that holds
a certificate of authority under Chapter 846; or
(9) an approved nonprofit health corporation that
holds a certificate of authority under Chapter 844.
(b) This chapter does not apply to:
(1) a health benefit plan that provides coverage only:
(A) for a specified disease or diseases or under
an individual limited benefit policy;
(B) for accidental death or dismemberment;
(C) as a supplement to a liability insurance
policy; or
(D) for dental or vision care;
(2) disability income insurance coverage or a
combination of accident only and disability income insurance
coverage;
(3) credit insurance coverage;
(4) a hospital confinement indemnity policy;
(5) a Medicare supplemental policy as defined by
Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss),
as amended;
(6) a workers' compensation insurance policy;
(7) medical payment insurance coverage provided under
a motor vehicle insurance policy; or
(8) a long-term care insurance policy, including a
nursing home fixed indemnity policy, unless the commissioner
determines that the policy provides benefits so comprehensive that
the policy is a health benefit plan described by Subsection (a) and
is not exempted from the application of this chapter.
Sec. 1515.003. REPORT. (a) Each health benefit plan issuer
authorized to issue coverage documents in this state shall submit a
report to the department containing the rescission rates of
coverage documents issued by the issuer.
(b) In addition to the rescission rates described by
Subsection (a), the report must contain:
(1) the number of individuals whose coverage document
was rescinded by the health benefit plan issuer during the
reporting period for each type of health benefit plan to which this
chapter applies;
(2) the total number of enrollees that were covered by
rescinded coverage documents before those documents were
rescinded; and
(3) the reasons for rescission of rescinded coverage
documents for each type of health benefit plan to which this chapter
applies.
(c) The commissioner shall adopt rules necessary to
implement this section, including rules concerning any applicable
reporting period and the form of the report required under
Subsection (a).
Sec. 1515.004. INTERNET POSTING; CONSUMER HOTLINE. (a)
The department shall post on the department's Internet website:
(1) the information contained in the reports received
under Section 1515.003 that is not confidential or proprietary; and
(2) a form through which consumers may report
rescission of a health benefit plan and complaints or suspected
violations of the law governing the rescission of health benefit
plans.
(b) For purposes of Subsection (a), aggregated information
regarding a health benefit plan issuer's rescission rates is not
confidential or proprietary.
(c) The department shall operate a toll-free telephone
hotline to:
(1) respond to consumer inquiries concerning the
rescission of health benefit plans; and
(2) provide information to consumers concerning the
rescission of health benefit plans and technical assistance with
the completion of the form described by Subsection (a)(2).
SECTION 1.__. The commissioner of insurance shall adopt
rules under Section 1515.003(c), Insurance Code, as added by this
Act, not later than January 1, 2010. The rules must require health
benefit plan issuers to submit the first report under Section
1515.003, Insurance Code, as added by this Act, not later than April
1, 2010.