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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 rescission |
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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 INFORMATION CONCERNING RESCINDED HEALTH BENEFIT |
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PLANS |
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Sec. 1515.001. DEFINITION. In this chapter, "coverage |
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document" means a policy or certificate evidencing the coverage of |
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an individual or group under a health benefit plan described by |
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Section 1515.002. |
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Sec. 1515.002. 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 only: |
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(A) for a specified disease or diseases or under |
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an individual limited benefit policy; |
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(B) for accidental death or dismemberment; |
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(C) as a supplement to a liability insurance |
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policy; or |
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(D) for dental or vision care; |
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(2) disability income insurance coverage or a |
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combination of accident only and disability income insurance |
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coverage; |
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(3) credit insurance coverage; |
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(4) a hospital confinement indemnity policy; |
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(5) 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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(6) a workers' compensation insurance policy; |
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(7) medical payment insurance coverage provided under |
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a motor vehicle insurance policy; or |
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(8) 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 benefits so comprehensive that |
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the policy is a health benefit plan described by Subsection (a) and |
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is not exempted from the application of this chapter. |
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Sec. 1515.003. REPORT. (a) Each health benefit plan |
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issuer authorized to issue coverage documents in this state shall |
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submit a report to the department containing the rescission rates |
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of coverage documents issued by the issuer. |
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(b) In addition to the rescission rates described by |
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Subsection (a), the report must contain: |
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(1) the number of individuals whose coverage document |
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was rescinded by the health benefit plan issuer during the |
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reporting period for each type of health benefit plan to which this |
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chapter applies; |
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(2) the total number of enrollees that were covered by |
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rescinded coverage documents before those documents were |
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rescinded; and |
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(3) the reasons for rescission of rescinded coverage |
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documents for each type of health benefit plan to which this chapter |
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applies. |
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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. 1515.004. INTERNET POSTING; CONSUMER HOTLINE. |
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(a) The department shall post on the department's Internet |
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website: |
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(1) the information contained in the reports received |
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under Section 1515.003 that is not confidential or proprietary; and |
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(2) a form through which consumers may report |
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rescission of a health benefit plan and complaints or suspected |
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violations of the law governing the rescission of health benefit |
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plans. |
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(b) For purposes of Subsection (a), aggregated information |
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regarding a health benefit plan issuer's rescission rates is not |
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confidential or proprietary. |
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(c) 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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rescission of health benefit plans; and |
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(2) provide information to consumers concerning the |
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rescission of health benefit plans and technical assistance with |
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the completion of the form described by Subsection (a)(2). |
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SECTION 2. The commissioner of insurance shall adopt rules |
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under Subsection (c), Section 1515.003, Insurance Code, as added by |
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this Act, not later than January 1, 2010. The rules must require |
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health benefit plan issuers to submit the first report under |
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Section 1515.003, Insurance Code, as added by this Act, not later |
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than April 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. |
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