|
|
|
A BILL TO BE ENTITLED
|
|
AN ACT
|
|
relating to a requirement that certain health benefit plans cover |
|
certain mental disorders. |
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
SECTION 1. Section 1355.002, Insurance Code, is amended to |
|
read as follows: |
|
Sec. 1355.002. APPLICABILITY OF SUBCHAPTER. (a) This |
|
subchapter applies only to a group health benefit plan that |
|
provides benefits for medical or surgical expenses incurred as a |
|
result of a health condition, accident, or sickness, including: |
|
(1) a group insurance policy, group insurance |
|
agreement, group hospital service contract, or group evidence of |
|
coverage that is offered by: |
|
(A) an insurance company; |
|
(B) a group hospital service corporation |
|
operating under Chapter 842; |
|
(C) a fraternal benefit society operating under |
|
Chapter 885; |
|
(D) a stipulated premium company operating under |
|
Chapter 884; or |
|
(E) a health maintenance organization operating |
|
under Chapter 843; and |
|
(2) to the extent permitted by the Employee Retirement |
|
Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.), a plan |
|
offered under: |
|
(A) a multiple employer welfare arrangement as |
|
defined by Section 3 of that Act; or |
|
(B) another analogous benefit arrangement. |
|
(b) Notwithstanding any provision in Chapter 1575 or 1579 or |
|
any other law, this chapter applies to: |
|
(1) a basic plan under Chapter 1575; and |
|
(2) a primary care coverage plan under Chapter 1579. |
|
SECTION 2. Section 1355.015(a), Insurance Code, is amended |
|
to read as follows: |
|
(a) At a minimum, a health benefit plan must provide |
|
coverage as provided by this section to an enrollee older than two |
|
years of age and younger than 11 [six] years of age who is diagnosed |
|
with autism spectrum disorder. If an enrollee who is being treated |
|
for autism spectrum disorder becomes 11 [six] years of age or older |
|
and continues to need treatment, this subsection does not preclude |
|
coverage of treatment and services described by Subsection (b). |
|
SECTION 3. This Act applies only to a health benefit plan |
|
delivered, issued for delivery, or renewed on or after January 1, |
|
2010. A health benefit plan delivered, issued for delivery, or |
|
renewed before January 1, 2010, is governed by the law as it existed |
|
immediately before the effective date of this Act, and that law is |
|
continued in effect for that purpose. |
|
SECTION 4. This Act takes effect September 1, 2009. |