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A BILL TO BE ENTITLED
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AN ACT
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relating to authorizing a children's health benefit plan for |
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certain small employers. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 1501.002, Insurance Code, is amended by |
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adding Subdivision (1-a) and amending Subdivision (15) to read as |
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follows: |
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(1-a) "Children's health benefit plan" means a health |
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benefit plan offered in accordance with Section 1501.2525. |
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(15) "Small employer health benefit plan" means a |
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health benefit plan developed by the commissioner under Subchapter |
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F or any other health benefit plan offered to a small employer in |
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accordance with Section 1501.252(c) or 1501.255. The term includes |
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a children's health benefit plan. |
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SECTION 2. Section 1501.003, Insurance Code, is amended to |
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read as follows: |
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Sec. 1501.003. APPLICABILITY: SMALL EMPLOYER HEALTH |
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BENEFIT PLANS. (a) An individual or group health benefit plan is a |
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small employer health benefit plan subject to Subchapters C-H if it |
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provides health care benefits covering two or more eligible |
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employees of a small employer and: |
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(1) the employer pays a portion of the premium or |
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benefits; |
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(2) the employer or a covered individual treats the |
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health benefit plan as part of a plan or program for purposes of |
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Section 106 or 162, Internal Revenue Code of 1986 (26 U.S.C. Section |
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106 or 162); or |
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(3) the health benefit plan is an employee welfare |
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benefit plan under 29 C.F.R. Section 2510.3-1(j). |
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(b) A children's health benefit plan is a small employer |
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benefit plan and, except as specifically provided by Section |
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1501.2525, is subject to Subchapters C-H in the same manner as any |
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other small employer health benefit plan. |
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SECTION 3. Section 1501.154(b), Insurance Code, is amended |
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to read as follows: |
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(b) If a small employer offers multiple health benefit |
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plans, the collective participation in those plans, including any |
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children's health benefit plan, must be at least: |
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(1) 75 percent of the employer's eligible employees; |
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or |
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(2) if applicable, the lower participation level |
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offered by the small employer health benefit plan issuer under |
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Section 1501.155. |
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SECTION 4. Subchapter F, Chapter 1501, Insurance Code, is |
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amended by adding Section 1501.2525 to read as follows: |
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Sec. 1501.2525. CHILDREN'S HEALTH BENEFIT PLAN. (a) A |
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small employer health benefit plan issuer may offer to a small |
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employer a children's health benefit plan in accordance with this |
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section. |
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(b) A children's health benefit plan provides coverage to |
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children younger than 25 years of age: |
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(1) who are dependents of eligible employees; and |
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(2) whose family income is at or below 400 percent of |
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the federal poverty level as determined by rules adopted by the |
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commissioner. |
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(c) A children's health benefit plan may not provide |
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coverage to an eligible employee or the spouse of an eligible |
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employee. |
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(d) The commissioner by rule shall adopt minimum benefits |
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required to be provided under a children's health benefit plan. |
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This subchapter applies to a children's health benefit plan except |
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to the extent the commissioner by rule determines that a provision |
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of this subchapter is inappropriate as applied to a children's |
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health benefit plan. |
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SECTION 5. Subchapter B, Chapter 1502, Insurance Code, is |
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amended by adding Section 1502.054 to read as follows: |
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Sec. 1502.054. INAPPLICABILITY OF OTHER LAW. A children's |
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health benefit plan offered under this chapter is not subject to |
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Section 1501.2525. |
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SECTION 6. The commissioner of insurance shall adopt any |
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rules necessary to implement the change in law made by this Act not |
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later than December 1, 2009. A small employer health benefit plan |
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issuer may not offer a children's health benefit plan under Section |
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1501.2525, Insurance Code, as added by this Act, before January 1, |
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2010. |
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SECTION 7. This Act takes effect September 1, 2009. |