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A BILL TO BE ENTITLED
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AN ACT
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relating to notice of premium increase for certain health benefit |
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plans. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter F, Chapter 843, Insurance Code, is |
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amended by adding Section 843.2071 to read as follows: |
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Sec. 843.2071. NOTICE OF INCREASE IN CHARGE FOR COVERAGE. |
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(a) Not less than 60 days before the date on which an increase in a |
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charge for coverage under this chapter takes effect, a health |
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maintenance organization shall: |
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(1) give to each enrollee under an individual evidence |
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of coverage written notice of the effective date of the increase; |
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and |
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(2) provide the enrollee a table that clearly lists: |
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(A) the actual dollar amount of the charge for |
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coverage on the date of the notice; |
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(B) the actual dollar amount of the charge for |
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coverage after the charge increase; and |
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(C) the percentage change between the amounts |
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described by Paragraphs (A) and (B). |
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(b) The notice required by this section must be based on |
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coverage in effect on the date of the notice. |
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(c) This section may not be construed to prevent a health |
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maintenance organization, at the request of an enrollee, from |
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negotiating a change in benefits or rates after delivery of the |
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notice required by this section. |
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(d) A health maintenance organization may not require an |
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enrollee entitled to notice under this section to respond to the |
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health maintenance organization to renew the coverage or take other |
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action relating to the renewal or extension of the coverage before |
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the 45th day after the date the notice described by Subsection (a) |
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is given. |
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(e) The notice required by this section must include: |
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(1) contact information for the department, including |
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information concerning how to file a complaint with the department; |
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(2) contact information for the Texas Consumer Health |
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Assistance Program, including information concerning how to |
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request from the program consumer protection information or |
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assistance with filing a complaint; and |
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(3) the addresses of Internet websites that provide |
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consumer information related to rate increase justifications, |
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including the websites of the department and the United States |
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Department of Health and Human Services. |
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SECTION 2. Subchapter C, Chapter 1201, Insurance Code, is |
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amended by adding Section 1201.109 to read as follows: |
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Sec. 1201.109. NOTICE OF RATE INCREASE. (a) Not less than |
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60 days before the date on which a premium rate increase takes |
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effect on an individual accident and health insurance policy |
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delivered or issued for delivery in this state by an insurer, the |
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insurer shall: |
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(1) give written notice to the insured of the |
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effective date of the increase; and |
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(2) provide the insured a table that clearly lists: |
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(A) the actual dollar amount of the premium on |
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the date of the notice; |
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(B) the actual dollar amount of the premium after |
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the premium rate increase; and |
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(C) the percentage change between the amounts |
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described by Paragraphs (A) and (B). |
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(b) The notice required by this section must be based on |
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coverage in effect on the date of the notice. |
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(c) This section may not be construed to prevent an insurer, |
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at the request of an insured, from negotiating a change in benefits |
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or rates after delivery of the notice required by this section. |
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(d) An insurer may not require an insured entitled to notice |
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under this section to respond to the insurer to renew the policy or |
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take other action relating to the renewal or extension of the policy |
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before the 45th day after the date the notice described by |
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Subsection (a) is given. |
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(e) The notice required by this section must include: |
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(1) contact information for the department, including |
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|
information concerning how to file a complaint with the department; |
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|
(2) contact information for the Texas Consumer Health |
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|
Assistance Program, including information concerning how to |
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|
request from the program consumer protection information or |
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assistance with filing a complaint; and |
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(3) the addresses of Internet websites that provide |
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consumer information related to rate increase justifications, |
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including the websites of the department and the United States |
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Department of Health and Human Services. |
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SECTION 3. Subchapter E, Chapter 1501, Insurance Code, is |
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amended by adding Section 1501.216 to read as follows: |
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Sec. 1501.216. PREMIUM RATES: NOTICE OF INCREASE. (a) Not |
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less than 60 days before the date on which a premium rate increase |
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takes effect on a small employer health benefit plan delivered or |
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issued for delivery in this state by an insurer, the insurer shall: |
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(1) give written notice to the small employer of the |
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effective date of the increase; and |
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(2) provide the small employer a table that clearly |
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lists: |
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(A) the actual dollar amount of the premium on |
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the date of the notice; |
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(B) the actual dollar amount of the premium after |
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|
the premium rate increase; and |
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(C) the percentage change between the amounts |
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described by Paragraphs (A) and (B). |
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(b) The notice required by this section must be based on |
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coverage in effect on the date of the notice. |
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(c) This section may not be construed to prevent an insurer, |
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at the request of a small employer, from negotiating a change in |
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benefits or rates after delivery of the notice required by this |
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section. |
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(d) An insurer may not require a small employer entitled to |
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notice under this section to respond to the insurer to renew the |
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policy or take other action relating to the renewal or extension of |
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the policy before the 45th day after the date the notice described |
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by Subsection (a) is given. |
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(e) The notice required by this section must include: |
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(1) contact information for the department, including |
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|
information concerning how to file a complaint with the department; |
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|
(2) contact information for the Texas Consumer Health |
|
|
Assistance Program, including information concerning how to |
|
|
request from the program consumer protection information or |
|
|
assistance with filing a complaint; and |
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|
(3) the addresses of Internet websites that provide |
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|
consumer information related to rate increase justifications, |
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including the websites of the department and the United States |
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Department of Health and Human Services. |
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SECTION 4. This Act applies to a health maintenance |
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organization individual evidence of coverage, an individual |
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accident and health insurance policy, or a small employer health |
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benefit plan that is delivered, issued for delivery, or renewed on |
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or after the effective date of this Act. An evidence of coverage, |
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policy, or plan delivered, issued for delivery, or renewed before |
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the effective date of this Act is governed by the law as it existed |
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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 5. This Act takes effect September 1, 2011. |