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A BILL TO BE ENTITLED
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AN ACT
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relating to the operation of health care sharing organizations. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Participants of a health care sharing |
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organization voluntarily assist fellow participants with the |
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payment of medical expenses. In many instances, participants of a |
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health care sharing organization provide assistance to individuals |
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who are without health insurance coverage and, in doing so, provide |
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important services that the state would otherwise have to provide. |
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Due to their beneficial work and religious nature, health care |
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sharing organizations should be statutorily recognized as |
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religious organizations helping to fulfill the religious beliefs of |
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organization participants and should not be treated in the same |
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manner as secular health care coverages, including insurance. |
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SECTION 2. Title 8, Insurance Code, is amended by adding |
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Subtitle K to read as follows: |
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SUBTITLE K. NONINSURANCE HEALTH COVERAGES |
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CHAPTER 1680. HEALTH CARE SHARING ORGANIZATIONS |
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Sec. 1680.001. SHORT TITLE. This chapter may be cited as |
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the Health Care Sharing Organizations Freedom to Share Act. |
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Sec. 1680.002. DEFINITION. In this chapter, "health care |
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sharing organization" means an organization qualified as a |
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religious organization under Section 11.20, Tax Code, that |
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administers a health care sharing arrangement among individuals of |
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the same religion based on the individuals' sincerely held |
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religious beliefs. |
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Sec. 1680.003. POWERS. A health care sharing organization |
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may: |
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(1) act as a facilitator among participants who have |
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financial or medical-related needs and participants with the |
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present ability to assist those with financial or medical-related |
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needs, all in accordance with the health care sharing |
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organization's criteria, through payments from one participant to |
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another; |
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(2) notify a participant of sharing amounts; |
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(3) establish additional qualifications of |
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participation in the health care sharing arrangement; |
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(4) limit the financial or medical-related needs that |
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may be eligible for payment among the participants; |
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(5) cancel a participant's participation in the health |
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care sharing arrangement if the participant fails to make a |
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specific payment to another participant before the 60th day after |
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the date the payment is due; and |
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(6) provide a written monthly statement to all |
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participants listing the total dollar amount of qualified needs |
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submitted to the organization as well as the total dollar amount |
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actually assigned to participants for sharing. |
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Sec. 1680.004. NOTICE. Each application for participation |
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in a health care sharing arrangement distributed directly or on |
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behalf of the health care sharing organization must include a |
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notice that is printed in no smaller than 12-point font and that |
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reads substantially as follows: |
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"This health care sharing organization is not offering |
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an insurance product and the health care sharing |
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arrangement is not being offered by or through an |
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insurance company. This health care sharing |
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organization is also not offering a discount health |
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care program. Whether anyone chooses to assist you |
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with your medical bills is voluntary, as no other |
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participant may be compelled to share payment of your |
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medical bills. This health care sharing arrangement |
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is not insurance or a substitute for insurance. |
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Whether you receive any payments for medical expenses |
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and whether this health care sharing organization or |
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arrangement continues to operate, you remain, to the |
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extent allowable under law, personally and fully |
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responsible for the payment of your own medical |
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bills." |
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Sec. 1680.005. DUTIES. (a) A health care sharing |
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organization shall require any adult member to sign on behalf of the |
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participant or, in the case of a minor or dependent child, on behalf |
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of the minor or dependent child, an acknowledgment that the member |
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has read and understands the notice described by Section 1680.004. |
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(b) A health care sharing organization shall retain the |
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signed acknowledgment described by Subsection (a) until the second |
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anniversary of the last date of the participant's participation in |
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the health care sharing arrangement. |
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Sec. 1680.006. CONSTRUCTION WITH OTHER LAW. (a) Chapter |
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76, Health and Safety Code, does not apply to a health care sharing |
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organization. |
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(b) Notwithstanding any other provision of this code, a |
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health care sharing organization is exempt from the operation of |
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the insurance laws of this state and is not subject to the |
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commissioner's oversight. |
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Sec. 1680.007. ENFORCEMENT BY ATTORNEY GENERAL. |
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Notwithstanding any other law, the office of the attorney general |
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has jurisdiction over health care sharing organizations to ensure |
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compliance with this chapter and for: |
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(1) the prevention and prosecution of deceptive trade |
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practices and fraud; and |
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(2) consumer protection. |
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Sec. 1680.008. NO ASSUMPTION OF RISK. Participants in a |
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health care sharing arrangement and the health care sharing |
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organization do not assume any risk or make any promise to pay the |
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financial or medical-related needs of other participants, and none |
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of the activities in this chapter give rise to an assumption of risk |
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or promise to pay by either the participants or the health care |
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sharing organization. |
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Sec. 1680.009. PAYMENT AMONG PARTICIPANTS. The means of |
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payment among participants may include an electronic transfer or a |
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distribution from a trust established solely for the participants' |
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benefit and that is audited annually by an independent auditing |
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firm. |
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Sec. 1680.010. COLLATERAL SHARING ACTIVITIES. A health |
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care sharing organization may: |
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(1) arrange for participants to share bills when a |
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participant experiences disability; and |
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(2) provide health counseling, education, and |
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resources to participants in the health care sharing arrangement. |
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Sec. 1680.011. CONTRACTUAL ARRANGEMENTS WITH OTHER |
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ENTITIES. A health care sharing organization may contract with an |
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administrator as defined by Chapter 4151, Insurance Code, or a |
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preferred provider organization or similar entity to facilitate the |
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operation of the organization. |
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SECTION 3. Section 101.055(a), Insurance Code, is amended |
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to read as follows: |
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(a) Section 101.051(b)(7) does not apply to: |
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(1) a program otherwise authorized by law that is |
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established: |
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(A) by a political subdivision of this state; |
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(B) by a state agency; or |
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(C) under Chapter 791, Government Code; [or] |
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(2) a multiple employer welfare arrangement that is |
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fully insured as defined by 29 U.S.C. Section 1144(b)(6); or |
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(3) a health care sharing organization operated under |
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Chapter 1680. |
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SECTION 4. Section 76.002, Health and Safety Code, is |
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amended to read as follows: |
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Sec. 76.002. CONSTRUCTION WITH [APPLICABILITY OF] OTHER |
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LAW. (a) In addition to the requirements of this chapter, a |
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program operator or marketer is subject to the applicable consumer |
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protection laws under Chapter 17, Business & Commerce Code. |
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(b) This chapter does not apply to a health care sharing |
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organization operated under Chapter 1680, Insurance Code. |
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SECTION 5. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2009. |