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A BILL TO BE ENTITLED
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AN ACT
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relating to helping employees and newly unemployed persons maintain |
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access to employer-sponsored health insurance. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 1251.253, Insurance Code, is amended to |
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read as follows: |
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Sec. 1251.253. REQUEST FOR CONTINUATION OF GROUP COVERAGE. |
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An employee, member, or dependent must request in writing the |
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continuation of group coverage not later than the 60th [31st] day |
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after the later of: |
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(1) the date the group coverage would otherwise |
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terminate; or |
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(2) the date the individual is given, in a format |
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prescribed by the commissioner, notice by either the employer or |
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the group policyholder of the right to continuation of group |
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coverage. |
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SECTION 2. Section 1251.254(b), Insurance Code, is amended |
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to read as follows: |
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(b) The employee's, member's, or dependent's written |
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election for continuation of group coverage, together with the |
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first contribution required to establish advance monthly |
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contributions, must be given to the employer or policyholder not |
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later than the later of: |
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(1) the 60th [31st] day after the date coverage would |
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otherwise terminate; or |
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(2) the date the individual is given notice by either |
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the employer or the group policyholder of the right to continuation |
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of group coverage. |
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SECTION 3. Section 1251.255, Insurance Code, is amended to |
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read as follows: |
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Sec. 1251.255. TERMINATION OF CONTINUED COVERAGE. (a) |
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Group coverage continued under this subchapter may not terminate |
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until the earliest of: |
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(1) 18 [six] months after the date the employee, |
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member, or dependent elects to continue the group coverage; |
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(2) the date failure to make timely payments would |
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terminate the group coverage, unless the insurer or the insurer's |
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agent receives the late payment not later than the 30th day after |
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the payment was due; |
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(3) the date the group coverage terminates in its |
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entirety; |
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(4) the date the insured is or could be covered under |
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Medicare; |
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(5) the date the insured is covered for similar |
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benefits by another plan or program, including: |
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(A) a hospital, surgical, medical, or major |
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medical expense insurance policy; |
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(B) a hospital or medical service subscriber |
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contract; or |
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(C) a medical practice or other prepayment plan; |
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(6) the date the insured is eligible for similar |
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benefits, whether or not covered for those benefits, under any |
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arrangement of coverage for individuals in a group, whether on an |
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insured or uninsured basis; or |
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(7) the date similar benefits are provided or |
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available to the insured under any state or federal law. |
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(b) Not later than the 30th day before the end of the 18 |
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[six] months after the date the employee, member, or dependent |
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elects to continue group coverage under the policy, the insurer |
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shall: |
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(1) notify the individual that the individual may be |
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eligible for coverage under the Texas Health Insurance Risk Pool as |
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provided by Chapter 1506; and |
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(2) provide to the individual the address for applying |
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to that pool. |
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SECTION 4. Sections 1251.256(a) and (b), Insurance Code, |
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are amended to read as follows: |
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(a) An insurer shall [may] offer a conversion policy to each |
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employee, member, or dependent who is covered under a group |
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accident and health insurance policy that is terminating. |
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(b) An [If offered, an] issuer shall issue a conversion |
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policy without evidence of insurability if a written application |
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for the policy and payment of the first premium are made not later |
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than the 31st day after the date of termination. |
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SECTION 5. Section 1506.153(b), Insurance Code, is amended |
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to read as follows: |
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(b) An individual eligible for benefits from the |
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continuation of coverage under Chapter 1251, or under Title X, |
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Consolidated Omnibus Budget Reconciliation Act of 1985 (29 U.S.C. |
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Section 1161 et seq.), as amended (COBRA), who did not elect |
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continuation of coverage during the election period, or whose |
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elected continuation of coverage lapsed or was cancelled without |
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reinstatement, is eligible for pool coverage. Eligibility under |
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this subsection is subject to a 180-day exclusion of coverage under |
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Section 1506.155(a-1). |
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SECTION 6. This Act applies to a conversion policy or |
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contract or evidence of coverage that was delivered, issued for |
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delivery, or renewed on or after September 1, 2008. A conversion |
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policy or contract or evidence of coverage delivered, issued for |
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delivery, or renewed before September 1, 2008, is governed by the |
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law as it existed immediately before that date, and that law is |
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continued in effect for that purpose. |
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SECTION 7. 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. |