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A BILL TO BE ENTITLED
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AN ACT
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relating to coverage for certain individuals under certain health |
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benefit plans offered to governmental employees. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subchapter A, Chapter 1551, Insurance Code, is |
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amended by adding Section 1551.0041 to read as follows: |
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Sec. 1551.0041. DEFINITION OF QUALIFIED INDIVIDUAL. In |
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this chapter, "qualified individual" means an individual who is at |
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least 18 years old and unmarried in this state and who is, with |
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respect to an individual eligible to participate in the group |
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benefits program under Section 1551.101, 1551.102, 1551.1021, or |
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1551.1022: |
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(1) not related to the eligible individual within the |
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third degree of consanguinity; |
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(2) financially interdependent with the eligible |
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individual; and |
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(3) cohabitating with the eligible individual. |
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SECTION 2. Section 1551.151, Insurance Code, is amended to |
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read as follows: |
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Sec. 1551.151. ENTITLEMENT TO COVERAGE. An individual who |
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is eligible to participate in the group benefits program under |
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Section 1551.101, 1551.102, 1551.1021, or 1551.1022 is entitled to |
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secure for a dependent of the individual or for a qualified |
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individual any group coverages provided under this chapter, as |
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determined by the board of trustees and subject to the exceptions |
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provided by this subchapter. |
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SECTION 3. Subchapter D, Chapter 1551, Insurance Code, is |
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amended by adding Section 1551.1511 to read as follows: |
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Sec. 1551.1511. PROOF OF QUALIFIED INDIVIDUAL STATUS. The |
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board of trustees may require an individual who secures coverage |
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under this chapter for a qualified individual to provide proof of |
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any two of the following documents: |
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(1) joint liability of the individuals for a mortgage, |
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lease, or loan; |
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(2) the designation of one of the individuals as the |
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primary beneficiary under a life insurance policy on the life of the |
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other individual or under a retirement plan of the other |
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individual; |
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(3) the designation of one of the individuals as the |
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primary beneficiary of the will of the other individual; |
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(4) a durable power of attorney for health care or |
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financial management granted by one of the individuals to the other |
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individual; |
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(5) joint ownership or lease by the individuals of a |
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motor vehicle; |
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(6) a joint checking account, joint investments, or a |
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joint credit account; |
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(7) a joint renter's or homeowner's insurance policy; |
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(8) joint responsibility for child care, such as |
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guardianship or school documents; or |
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(9) a relationship or cohabitation contract. |
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SECTION 4. Section 1551.310, Insurance Code, is amended to |
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read as follows: |
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Sec. 1551.310. STATE CONTRIBUTION REQUIRED. (a) The state |
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shall contribute to the cost of each participant's group coverages, |
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including dependents' group coverages, the amounts appropriated |
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for the coverages in the General Appropriations Act. |
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(b) The state shall pay the same portion of the cost of the |
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required contributions for a qualified individual as this state |
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pays for similar dependent coverage for an employee or annuitant |
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participating in the program. |
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SECTION 5. Subchapter A, Chapter 1575, Insurance Code, is |
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amended by adding Section 1575.0031 to read as follows: |
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Sec. 1575.0031. DEFINITION OF QUALIFIED INDIVIDUAL. In |
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this chapter, "qualified individual" means an individual who is at |
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least 18 years old and unmarried in this state and who is, with |
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respect to a retiree: |
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(1) not related to the retiree within the third degree |
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of consanguinity; |
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(2) financially interdependent with the retiree; and |
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(3) cohabitating with the retiree. |
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SECTION 6. Section 1575.155(a), Insurance Code, is amended |
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to read as follows: |
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(a) A retiree participating in the group program is entitled |
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to secure for the retiree's dependents or a qualified individual |
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group coverage provided for the retiree under this chapter, as |
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determined by the trustee. |
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SECTION 7. Subchapter D, Chapter 1575, Insurance Code, is |
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amended by adding Section 1575.1551 to read as follows: |
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Sec. 1575.1551. PROOF OF QUALIFIED INDIVIDUAL STATUS. The |
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trustee may require a retiree who secures coverage under this |
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chapter for a qualified individual to provide proof of any two of |
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the following documents: |
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(1) joint liability of the individuals for a mortgage, |
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lease, or loan; |
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(2) the designation of one of the individuals as the |
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primary beneficiary under a life insurance policy on the life of the |
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other individual or under a retirement plan of the other |
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individual; |
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(3) the designation of one of the individuals as the |
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primary beneficiary of the will of the other individual; |
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(4) a durable power of attorney for health care or |
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financial management granted by one of the individuals to the other |
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individual; |
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(5) joint ownership or lease by the individuals of a |
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motor vehicle; |
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(6) a joint checking account, joint investments, or a |
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joint credit account; |
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(7) a joint renter's or homeowner's insurance policy; |
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(8) joint responsibility for child care, such as |
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guardianship or school documents; or |
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(9) a relationship or cohabitation contract. |
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SECTION 8. Section 1575.201, Insurance Code, is amended by |
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adding Subsection (a-1) and amending Subsection (b) to read as |
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follows: |
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(a-1) The state shall pay the same portion of the cost of the |
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required contributions for a qualified individual as this state |
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pays for similar dependent coverage for a retiree participating in |
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the group program. |
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(b) The trustee shall collect the amount of premium required |
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for basic coverage under the group program that exceeds the amount |
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contributed by the state for those individuals described by |
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Subsections [Subsection] (a)(2) and (a-1). |
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SECTION 9. Subchapter A, Chapter 1579, Insurance Code, is |
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amended by adding Section 1579.0041 to read as follows: |
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Sec. 1579.0041. DEFINITION OF QUALIFIED INDIVIDUAL. In |
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this chapter, "qualified individual" means an individual who is at |
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least 18 years old and unmarried in this state and who is, with |
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respect to a participating employee: |
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(1) not related to the participating employee within |
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the third degree of consanguinity; |
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(2) financially interdependent with the participating |
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employee; and |
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(3) cohabitating with the participating employee. |
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SECTION 10. Section 1579.101(a), Insurance Code, is amended |
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to read as follows: |
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(a) The trustee by rule shall establish plans of group |
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coverages for employees participating in the program, [and] their |
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dependents, and qualified individuals. |
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SECTION 11. Subchapter C, Chapter 1579, Insurance Code, is |
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amended by adding Section 1579.1011 to read as follows: |
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Sec. 1579.1011. PROOF OF QUALIFIED INDIVIDUAL STATUS. The |
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trustee may require an employee who secures coverage under this |
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chapter for a qualified individual to provide proof of any two of |
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the following documents: |
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(1) joint liability of the individuals for a mortgage, |
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lease, or loan; |
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(2) the designation of one of the individuals as the |
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primary beneficiary under a life insurance policy on the life of the |
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other individual or under a retirement plan of the other |
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individual; |
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(3) the designation of one of the individuals as the |
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primary beneficiary of the will of the other individual; |
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(4) a durable power of attorney for health care or |
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financial management granted by one of the individuals to the other |
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individual; |
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(5) joint ownership or lease by the individuals of a |
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motor vehicle; |
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(6) a joint checking account, joint investments, or a |
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joint credit account; |
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(7) a joint renter's or homeowner's insurance policy; |
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(8) joint responsibility for child care, such as |
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guardianship or school documents; or |
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(9) a relationship or cohabitation contract. |
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SECTION 12. Section 1579.203(c), Insurance Code, is amended |
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to read as follows: |
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(c) If the combined contributions received from the state |
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and the employing participating entity under Subchapter F exceed |
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the cost of a coverage plan selected by the employee, the employee |
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may use the excess amount of contributions to obtain coverage under |
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a higher tier coverage plan or to pay all or part of the cost of |
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coverage for the employee's dependents or a qualified individual. |
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SECTION 13. Subchapter A, Chapter 1601, Insurance Code, is |
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amended by adding Section 1601.0041 to read as follows: |
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Sec. 1601.0041. DEFINITION OF QUALIFIED INDIVIDUAL. In |
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this chapter, "qualified individual" means an individual who is at |
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least 18 years old and unmarried in this state and who is, with |
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respect to an individual eligible to participate in the group |
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benefits program under Section 1601.101, 1601.102, or 1601.1021: |
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(1) not related to the eligible individual within the |
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third degree of consanguinity; |
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(2) financially interdependent with the eligible |
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individual; and |
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(3) cohabitating with the eligible individual. |
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SECTION 14. Section 1601.107, Insurance Code, is amended to |
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read as follows: |
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Sec. 1601.107. COVERAGE FOR DEPENDENTS AND QUALIFIED |
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INDIVIDUALS. An individual who is eligible to participate in the |
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uniform program under Section 1601.101, 1601.102, or 1601.1021 is |
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entitled to secure for a dependent of the individual or for a |
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qualified individual any group coverages provided under this |
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chapter for dependents under rules adopted by the applicable |
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system. |
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SECTION 15. Subchapter C, Chapter 1601, Insurance Code, is |
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amended by adding Section 1601.1071 to read as follows: |
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Sec. 1601.1071. PROOF OF QUALIFIED INDIVIDUAL STATUS. A |
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system may require an individual who secures coverage under this |
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chapter for a qualified individual to provide proof of any two of |
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the following documents: |
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(1) joint liability of the individuals for a mortgage, |
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lease, or loan; |
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(2) the designation of one of the individuals as the |
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primary beneficiary under a life insurance policy on the life of the |
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other individual or under a retirement plan of the other |
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individual; |
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(3) the designation of one of the individuals as the |
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primary beneficiary of the will of the other individual; |
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(4) a durable power of attorney for health care or |
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financial management granted by one of the individuals to the other |
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individual; |
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(5) joint ownership or lease by the individuals of a |
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motor vehicle; |
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(6) a joint checking account, joint investments, or a |
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joint credit account; |
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(7) a joint renter's or homeowner's insurance policy; |
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(8) joint responsibility for child care, such as |
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guardianship or school documents; or |
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(9) a relationship or cohabitation contract. |
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SECTION 16. Section 1601.201, Insurance Code, is amended by |
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amending Subsections (b) and (c) and adding Subsection (e) to read |
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as follows: |
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(b) For an employee designated by the system as working 40 |
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or more hours a week, the system may contribute: |
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(1) the full cost of basic coverage for the employee; |
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and |
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(2) not more than 50 percent of the cost of dependent |
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coverage, including the cost of coverage of a qualified individual. |
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(c) For an employee designated by the system as working less |
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than 40 hours a week, including an individual employed by the system |
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in a position that as a condition of employment requires the |
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individual to be enrolled as a student in the system in |
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graduate-level courses, the system, from money appropriated from |
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the general revenue fund, may contribute: |
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(1) not more than 50 percent of the cost of basic |
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coverage for the employee; and |
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(2) not more than 25 percent of the cost of dependent |
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coverage, including the cost of coverage of a qualified individual. |
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(e) The state shall pay the same portion of the cost of the |
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required contributions for a qualified individual as this state |
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pays for similar dependent coverage for an employee participating |
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in the program. |
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SECTION 17. As soon as practicable after the effective date |
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of this Act, but not later than January 1, 2016, The University of |
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Texas System, The Texas A&M University System, the board of |
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trustees of the Teacher Retirement System of Texas, and the board of |
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trustees of the Employees Retirement System of Texas shall adopt |
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rules necessary to implement the changes in law made by this Act. |
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SECTION 18. The changes in law made by this Act apply only |
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to health benefit plans provided under Chapters 1551, 1575, 1579, |
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and 1601, Insurance Code, beginning with the 2016-2017 plan year. A |
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plan year before 2016-2017 is governed by the law as it existed |
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immediately before September 1, 2015, and that law is continued in |
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effect for that purpose. |
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SECTION 19. This Act takes effect September 1, 2015. |