By: Duncan S.B. No. 1332
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to who is an employee for large and small employers for
  health benefit plans.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subdivisions (8), (13), and (14), Section
  1501.002, Insurance Code, are amended to read as follows:
               (8)  "Large employer" means a person who employed an
  average of at least 51 [eligible] employees on business days during
  the preceding calendar year and who employs at least two employees
  on the first day of the plan year.  The term includes a governmental
  entity subject to Article 3.51-1, 3.51-4, or 3.51-5, to Subchapter
  C, Chapter 1364, to Chapter 1578, or to Chapter 177, Local
  Government Code, that otherwise meets the requirements of this
  subdivision.  For purposes of this definition, a partnership is the
  employer of a partner.
               (13)  "Premium" means all amounts paid by a small or
  large employer and [eligible] employees as a condition of receiving
  coverage from a small or large employer health benefit plan issuer,
  including any fees or other contributions associated with a health
  benefit plan.
               (14)  "Small employer" means a person who employed an
  average of at least two employees but not more than 50 [eligible]
  employees on business days during the preceding calendar year and
  who employs at least two employees on the first day of the plan
  year.  The term includes a governmental entity subject to Article
  3.51-1, 3.51-4, or 3.51-5, to Subchapter C, Chapter 1364, to
  Chapter 1578, or to Chapter 177, Local Government Code, that
  otherwise meets the requirements of this subdivision.  For purposes
  of this definition, a partnership is the employer of a partner.
         SECTION 2.  Section 1501.003, Insurance Code, is amended to
  read as follows:
         Sec. 1501.003.  APPLICABILITY:  SMALL EMPLOYER HEALTH
  BENEFIT PLANS. An individual or group health benefit plan is a
  small employer health benefit plan subject to Subchapters C-H if it
  provides health care benefits covering two or more [eligible]
  employees of a small employer and:
               (1)  the employer pays a portion of the premium or
  benefits;
               (2)  the employer or a covered individual treats the
  health benefit plan as part of a plan or program for purposes of
  Section 106 or 162, Internal Revenue Code of 1986 (26 U.S.C. Section
  106 or 162); or
               (3)  the health benefit plan is an employee welfare
  benefit plan under 29 C.F.R. Section 2510.3-1(j).
         SECTION 3.  Section 1501.004, Insurance Code, is amended to
  read as follows:
         Sec. 1501.004.  APPLICABILITY: LARGE EMPLOYER HEALTH
  BENEFIT PLANS. An individual or group health benefit plan is a
  large employer health benefit plan subject to Subchapters C and M if
  the plan provides health care benefits to [eligible] employees of a
  large employer and:
               (1)  the employer pays a portion of the premium or
  benefits;
               (2)  the employer or a covered individual treats the
  health benefit plan as part of a plan or program for purposes of
  Section 106 or 162, Internal Revenue Code of 1986 (26 U.S.C. Section
  106 or 162); or
               (3)  the health benefit plan is an employee welfare
  benefit plan under 29 C.F.R. Section 2510.3-1(j).
         SECTION 4.  Subsection (a), Section 1501.009, Insurance
  Code, is amended to read as follows:
         (a)  An independent school district may elect to participate
  as a small employer without regard to the number of [eligible]
  employees in the district. An independent school district that
  makes the election is treated as a small employer under this chapter
  for all purposes.
         SECTION 5.  Subsections (a) and (b), Section 1501.011,
  Insurance Code, are amended to read as follows:
         (a)  For an employer that did not exist throughout the
  calendar year preceding the year in which the determination of
  whether the employer is a small employer is made, the determination
  is based on the average number of employees [and eligible
  employees] the employer reasonably expects to employ on business
  days in the calendar year in which the determination is made.
         (b)  For an employer that did not exist throughout the
  calendar year preceding the year in which the determination of
  whether the employer is a large employer is made, the determination
  is based on the average number of [eligible] employees the employer
  reasonably expects to employ on business days in the calendar year
  in which the determination is made.
         SECTION 6.  The change in law made by this Act applies only
  to a health benefit plan delivered, issued for delivery, or renewed
  on or after January 1, 2014. A plan that is delivered, issued for
  delivery, or renewed before January 1, 2014, is governed by the law
  in effect immediately before the effective date of this Act, and
  that law continues in effect for that purpose.
         SECTION 7.  This Act takes effect September 1, 2013.