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A BILL TO BE ENTITLED
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AN ACT
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relating to the reporting of information concerning the |
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cancellation or rescission of health benefit plans. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subtitle G, Title 8, Insurance Code, is amended |
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by adding Chapter 1515 to read as follows: |
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CHAPTER 1515. INFORMATION CONCERNING CANCELED OR RESCINDED HEALTH |
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BENEFIT PLANS |
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Sec. 1515.001. APPLICABILITY. (a) This chapter applies |
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only to a health benefit plan, including a small or large employer |
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health benefit plan written under Chapter 1501, that provides |
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benefits for medical or surgical expenses incurred as a result of a |
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health condition, accident, or sickness, including an individual, |
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group, blanket, or franchise insurance policy or insurance |
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agreement, a group hospital service contract, or an individual or |
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group evidence of coverage or similar coverage document that is |
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offered by: |
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(1) an insurance company; |
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(2) a group hospital service corporation operating |
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under Chapter 842; |
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(3) a fraternal benefit society operating under |
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Chapter 885; |
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(4) a stipulated premium company operating under |
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Chapter 884; |
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(5) a reciprocal exchange operating under Chapter 942; |
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(6) a Lloyd's plan operating under Chapter 941; |
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(7) a health maintenance organization operating under |
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Chapter 843; |
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(8) a multiple employer welfare arrangement that holds |
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a certificate of authority under Chapter 846; or |
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(9) an approved nonprofit health corporation that |
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holds a certificate of authority under Chapter 844. |
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(b) This chapter does not apply to: |
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(1) a health benefit plan that provides coverage: |
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(A) only for a specified disease or for another |
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limited benefit other than an accident policy; |
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(B) only for accidental death or dismemberment; |
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(C) for wages or payments in lieu of wages for a |
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period during which an employee is absent from work because of |
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sickness or injury; |
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(D) as a supplement to a liability insurance |
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policy; |
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(E) for credit insurance; |
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(F) only for dental or vision care; |
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(G) only for hospital expenses; or |
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(H) only for indemnity for hospital confinement; |
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(2) a Medicare supplemental policy as defined by |
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Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss), |
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as amended; |
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(3) a workers' compensation insurance policy; |
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(4) medical payment insurance coverage provided under |
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a motor vehicle insurance policy; or |
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(5) a long-term care insurance policy, including a |
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nursing home fixed indemnity policy, unless the commissioner |
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determines that the policy provides benefit coverage so |
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comprehensive that the policy is a health benefit plan described by |
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Subsection (a). |
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Sec. 1515.002. REPORT. (a) Each health benefit plan issuer |
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authorized to issue health benefit plans in this state shall submit |
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a report to the department containing the cancellation and |
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rescission rates of health benefit plans issued by the issuer. |
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(b) In addition to the cancellation and rescission rates |
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described by Subsection (a), the report must contain: |
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(1) the number of health benefit plans canceled or |
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rescinded by the health benefit plan issuer during the reporting |
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period, expressed both in the aggregate and individually for each |
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type of health benefit plan; |
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(2) the total number of enrollees that were covered by |
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canceled or rescinded health benefit plans before those plans were |
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canceled or rescinded; |
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(3) the reasons for cancellation or rescission of |
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canceled or rescinded health benefit plans, expressed both in the |
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aggregate and individually for each type of health benefit plan; |
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and |
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(4) if known by the health benefit plan issuer, |
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information concerning whether an enrollee covered by a health |
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benefit plan that was canceled or rescinded by the health benefit |
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plan issuer during the reporting period subsequently obtained |
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health benefit plan coverage under another health benefit plan, |
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including a health benefit plan issued by the Texas Health |
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Insurance Risk Pool under Chapter 1506. |
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(c) The commissioner shall adopt rules necessary to |
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implement this section, including rules concerning any applicable |
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reporting period and the form of the report required under |
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Subsection (a). |
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Sec. 1515.003. INTERNET POSTING; CONSUMER HOTLINE. (a) The |
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department shall post on the department's Internet website: |
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(1) the information contained in the reports received |
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under Section 1515.002; and |
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(2) a form through which consumers may report |
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cancellation or rescission of a health benefit plan and complaints |
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or suspected violations of the law governing the cancellation or |
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rescission of health benefit plans. |
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(b) The department shall operate a toll-free telephone |
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hotline to: |
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(1) respond to consumer inquiries concerning the |
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cancellation or rescission of health benefit plans; and |
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(2) provide information to consumers concerning the |
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cancellation or rescission of health benefit plans and technical |
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assistance with the completion of the form described by Subsection |
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(a)(2). |
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SECTION 2. The commissioner of insurance shall adopt rules |
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under Section 1515.002(c), Insurance Code, as added by this Act, |
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not later than January 1, 2010. The rules must require health |
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benefit plan issuers to submit the first report under Section |
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1515.002, Insurance Code, as added by this Act, not later than April |
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1, 2010. |
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SECTION 3. 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. |