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A BILL TO BE ENTITLED
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AN ACT
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relating to requirements regarding employer liability for certain |
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group health benefit plan premiums. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 843.210, Insurance Code, is amended to |
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read as follows: |
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Sec. 843.210. TERMS OF ENROLLEE ELIGIBILITY. (a) A |
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contract between a health maintenance organization and a group |
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contract holder must provide that: |
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(1) in addition to any other premiums for which the |
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group contract holder is liable, the group contract holder is |
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liable for an enrollee's premiums from the time the enrollee is no |
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longer part of the group eligible for coverage under the contract |
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until the end of the month in which the contract holder notifies the |
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health maintenance organization that the enrollee is no longer part |
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of the group eligible for coverage by the contract; and |
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(2) the enrollee remains covered by the contract until |
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the end of that period. |
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(b) A health maintenance organization shall refund premiums |
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paid by a group contract holder on behalf of an enrollee, from the |
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end of the month during which the enrollee is no longer part of the |
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group eligible for coverage, provided that the enrollee did not |
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incur any claims under the contract after no longer being part of |
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the group eligible for coverage. |
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(c) The commissioner shall adopt rules as necessary to |
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implement this section. |
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SECTION 2. Section 1301.0061, Insurance Code, is amended to |
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read as follows: |
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Sec. 1301.0061. TERMS OF ENROLLEE ELIGIBILITY. (a) A |
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contract between an insurer and a group policyholder under a |
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preferred provider benefit plan must provide that: |
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(1) in addition to any other premiums for which the |
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group policyholder is liable, the group policyholder is liable for |
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an individual insured's premiums from the time the individual is no |
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longer part of the group eligible for coverage under the policy |
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until the end of the month in which the policyholder notifies the |
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insurer that the individual is no longer part of the group eligible |
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for coverage under the policy; and |
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(2) the individual remains covered under the policy |
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until the end of that period. |
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(b) An insurer shall refund premiums paid by a group |
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policyholder on behalf of an individual, from the end of the month |
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during which the individual is no longer part of the group eligible |
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for coverage, provided that the individual did not incur any claims |
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under the policy after no longer being part of the group eligible |
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for coverage. |
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(c) The commissioner shall adopt rules as necessary to |
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implement this section. |
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SECTION 3. The change in law made by this Act applies only |
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to a contract between an insurer or health maintenance organization |
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and a group policy or contract holder that is entered into or |
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renewed on or after January 1, 2010. A contract entered into or |
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renewed before January 1, 2010, is governed by the law in effect |
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immediately before the effective date of this Act, and that law is |
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continued in effect for that purpose. |
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SECTION 4. This Act takes effect September 1, 2009. |