By: Shapleigh  S.B. No. 206
         (In the Senate - Filed November 10, 2008; February 11, 2009,
  read first time and referred to Committee on State Affairs;
  May 1, 2009, reported adversely, with favorable Committee
  Substitute by the following vote:  Yeas 8, Nays 0; May 1, 2009, sent
  to printer.)
 
  COMMITTEE SUBSTITUTE FOR S.B. No. 206 By:  Deuell
 
 
A BILL TO BE ENTITLED
 
AN ACT
 
  relating to the reporting of information concerning the rescission
  of health benefit plans.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subtitle G, Title 8, Insurance Code, is amended
  by adding Chapter 1515 to read as follows:
  CHAPTER 1515. INFORMATION CONCERNING RESCINDED HEALTH BENEFIT
  PLANS
         Sec. 1515.001.  DEFINITION.  In this chapter, "coverage
  document" means a policy or certificate evidencing the coverage of
  an individual or group under a health benefit plan described by
  Section 1515.002.
         Sec. 1515.002.  APPLICABILITY. (a)  This chapter applies
  only to a health benefit plan, including a small or large employer
  health benefit plan written under Chapter 1501, that provides
  benefits for medical or surgical expenses incurred as a result of a
  health condition, accident, or sickness, including an individual,
  group, blanket, or franchise insurance policy or insurance
  agreement, a group hospital service contract, or an individual or
  group evidence of coverage or similar coverage document that is
  offered by:
               (1)  an insurance company;
               (2)  a group hospital service corporation operating
  under Chapter 842;
               (3)  a fraternal benefit society operating under
  Chapter 885;
               (4)  a stipulated premium company operating under
  Chapter 884;
               (5)  a reciprocal exchange operating under Chapter 942;
               (6)  a Lloyd's plan operating under Chapter 941;
               (7)  a health maintenance organization operating under
  Chapter 843;
               (8)  a multiple employer welfare arrangement that holds
  a certificate of authority under Chapter 846; or
               (9)  an approved nonprofit health corporation that
  holds a certificate of authority under Chapter 844.
         (b)  This chapter does not apply to:
               (1)  a health benefit plan that provides coverage only:
                     (A)  for a specified disease or diseases or under
  an individual limited benefit policy;
                     (B)  for accidental death or dismemberment;
                     (C)  as a supplement to a liability insurance
  policy; or
                     (D)  for dental or vision care;
               (2)  disability income insurance coverage or a
  combination of accident only and disability income insurance
  coverage;
               (3)  credit insurance coverage;
               (4)  a hospital confinement indemnity policy;
               (5)  a Medicare supplemental policy as defined by
  Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss),
  as amended;
               (6)  a workers' compensation insurance policy;
               (7)  medical payment insurance coverage provided under
  a motor vehicle insurance policy; or
               (8)  a long-term care insurance policy, including a
  nursing home fixed indemnity policy, unless the commissioner
  determines that the policy provides benefits so comprehensive that
  the policy is a health benefit plan described by Subsection (a) and
  is not exempted from the application of this chapter.
         Sec. 1515.003.  REPORT. (a)  Each health benefit plan
  issuer authorized to issue coverage documents in this state shall
  submit a report to the department containing the rescission rates
  of coverage documents issued by the issuer.
         (b)  In addition to the rescission rates described by
  Subsection (a), the report must contain:
               (1)  the number of individuals whose coverage document
  was rescinded by the health benefit plan issuer during the
  reporting period for each type of health benefit plan to which this
  chapter applies;
               (2)  the total number of enrollees that were covered by
  rescinded coverage documents before those documents were
  rescinded; and
               (3)  the reasons for rescission of rescinded coverage
  documents for each type of health benefit plan to which this chapter
  applies.
         (c)  The commissioner shall adopt rules necessary to
  implement this section, including rules concerning any applicable
  reporting period and the form of the report required under
  Subsection (a).
         Sec. 1515.004.  INTERNET POSTING; CONSUMER HOTLINE.
  (a)  The department shall post on the department's Internet
  website:
               (1)  the information contained in the reports received
  under Section 1515.003 that is not confidential or proprietary; and
               (2)  a form through which consumers may report
  rescission of a health benefit plan and complaints or suspected
  violations of the law governing the rescission of health benefit
  plans.
         (b)  For purposes of Subsection (a), aggregated information
  regarding a health benefit plan issuer's rescission rates is not
  confidential or proprietary.
         (c)  The department shall operate a toll-free telephone
  hotline to:
               (1)  respond to consumer inquiries concerning the
  rescission of health benefit plans; and
               (2)  provide information to consumers concerning the
  rescission of health benefit plans and technical assistance with
  the completion of the form described by Subsection (a)(2).
         SECTION 2.  The commissioner of insurance shall adopt rules
  under Subsection (c), Section 1515.003, Insurance Code, as added by
  this Act, not later than January 1, 2010.  The rules must require
  health benefit plan issuers to submit the first report under
  Section 1515.003, Insurance Code, as added by this Act, not later
  than April 1, 2010.
         SECTION 3.  This Act takes effect immediately if it receives
  a vote of two-thirds of all the members elected to each house, as
  provided by Section 39, Article III, Texas Constitution.  If this
  Act does not receive the vote necessary for immediate effect, this
  Act takes effect September 1, 2009.
 
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