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A BILL TO BE ENTITLED
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AN ACT
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relating to the creation of a temporary health insurance risk pool. |
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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 1510 to read as follows: |
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CHAPTER 1510. TEMPORARY HEALTH INSURANCE RISK POOL |
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Sec. 1510.001. DEFINITION. In this chapter, "pool" means a |
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temporary health insurance risk pool that is established and |
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administered by the commissioner under this chapter. |
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Sec. 1510.002. ESTABLISHMENT OF TEMPORARY HEALTH INSURANCE |
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RISK POOL. To the extent that federal funds become available under |
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federal law, regulation, or executive action after March 1, 2017, |
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the commissioner may: |
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(1) apply for such funds; and |
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(2) use such funds to establish and administer a |
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temporary health insurance risk pool for the purposes of this |
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chapter. |
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Sec. 1510.003. PURPOSE OF POOL. (a) The exclusive purpose |
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of the pool is to provide a temporary mechanism for maximizing |
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available federal funding to assist residents of this state in |
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obtaining access to quality health care at minimum cost to the |
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public. |
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(b) The pool may not be used to expand the Medicaid program, |
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including the program administered under Chapter 32, Human |
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Resources Code, and the program administered under Chapter 533, |
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Government Code. |
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Sec. 1510.004. PROVISION OF COVERAGE. Subject to any |
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requirements for obtaining federal funds held in the pool, the |
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commissioner may use pool funds: |
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(1) to provide alternative individual health |
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insurance coverage to eligible individuals that does not diminish |
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the availability of traditional commercial health care coverage; |
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(2) to provide funding to individual health benefit |
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plan issuers that cover individuals with certain health or cost |
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characteristics in exchange for lower enrollee premium rates; or |
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(3) to provide a reinsurance program for health |
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benefit plan issuers in the individual market in exchange for lower |
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enrollee premium rates. |
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Sec. 1510.005. CONTRACTS AND AGREEMENTS. (a) The |
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commissioner may enter into a contract or agreement that the |
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commissioner determines is appropriate to carry out this chapter, |
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including a contract or agreement with: |
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(1) a similar pool in another state for the joint |
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performance of common administrative functions; |
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(2) another organization for the performance of |
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administrative functions; or |
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(3) a federal agency. |
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(b) The commissioner may contract for stop-loss insurance |
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for risks incurred under this chapter. |
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Sec. 1510.006. FUNDING. (a) The commissioner may use |
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funds appropriated to the department to: |
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(1) apply for federal funding and grants; and |
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(2) administer this chapter. |
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(b) Notwithstanding Section 6(e)(2)(B), Chapter 615 (S.B. |
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1367), Acts of the 83rd Legislature, Regular Session, 2013, the |
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commissioner may use money appropriated to the department from the |
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healthy Texas small employer premium stabilization fund for the |
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exclusive purposes of this chapter, other than for paying salaries |
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and salary related benefits. |
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(c) Notwithstanding Section 6(e)(2)(B), Chapter 615 (S.B. |
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1367), Acts of the 83rd Legislature, Regular Session, 2013, the |
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commissioner shall transfer money from the healthy Texas small |
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employer premium stabilization fund to the Texas Department of |
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Insurance operating account in an amount equal to the amount of |
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money appropriated to the department from that fund, as described |
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by Subsection (b), for the direct and indirect costs of the |
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exclusive purposes of this chapter. |
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(d) Except as provided by Subsections (a) and (b), the |
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commissioner may not use any state funds to fund the pool unless the |
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funds are specifically appropriated for that purpose. |
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(e) The commissioner may use federal funds to administer |
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this chapter, as appropriate. |
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Sec. 1510.007. PUBLIC EDUCATION AND OUTREACH. (a) The |
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commissioner may use funds appropriated to the department for the |
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exclusive purposes of this chapter to develop and implement public |
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education, outreach, and facilitated enrollment strategies under |
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this chapter. |
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(b) The commissioner may contract with marketing |
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organizations to perform or provide assistance with the strategies |
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described by Subsection (a). |
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Sec. 1510.008. WAIVER. (a) The commissioner may apply to |
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the United States secretary of health and human services under 42 |
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U.S.C. Section 18052 for a waiver of applicable provisions of the |
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Patient Protection and Affordable Care Act (Pub. L. No. 111-148) |
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and any applicable regulations or guidance with respect to health |
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insurance coverage in this state for a plan year beginning on or |
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after January 1, 2017. |
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(b) The commissioner may take any action the commissioner |
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considers appropriate to make an application under this section. |
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(c) The commissioner may implement a state plan that meets |
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the requirements of a waiver granted in response to an application |
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under Subsection (a) if the plan is: |
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(1) consistent with state and federal law; and |
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(2) approved by the United States secretary of health |
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and human services. |
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Sec. 1510.009. ADDITIONAL AUTHORITY. In addition to the |
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powers granted to the commissioner under this chapter, the |
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commissioner may exercise any authority that may be exercised under |
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the law of this state by: |
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(1) a reinsurer; or |
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(2) a health benefit plan issuer authorized to write |
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health benefit plans in this state. |
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Sec. 1510.010. RULES. The commissioner may adopt rules |
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necessary to implement this chapter, including rules to administer |
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the pool and distribute money from the pool. |
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Sec. 1510.011. EXEMPTION FROM STATE TAXES AND FEES. |
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Notwithstanding any other law, a program created under this chapter |
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is not subject to any state tax, regulatory fee, or surcharge, |
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including a premium or maintenance tax or fee. |
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Sec. 1510.012. ANNUAL REPORT OF POOL ACTIVITIES. |
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(a) Beginning June 1, 2018, not later than June 1 of each year, the |
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department shall submit a report to the governor, the lieutenant |
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governor, and the speaker of the house of representatives. |
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(b) The report submitted under Subsection (a) must: |
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(1) summarize the activities conducted under this |
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chapter in the calendar year preceding the year in which the report |
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is submitted; and |
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(2) include information relating to: |
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(A) net written and earned premiums; |
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(B) plan enrollment; |
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(C) administration expenses; and |
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(D) paid and incurred losses. |
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Sec. 1510.013. EXPIRATION OF CHAPTER. This chapter expires |
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August 31, 2019. |
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SECTION 2. Notwithstanding Section 6(d)(2), Chapter 615 |
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(S.B. 1367), Acts of the 83rd Legislature, Regular Session, 2013, |
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on the effective date of this Act, the commissioner of insurance |
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shall transfer any money remaining outside the state treasury in |
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the Texas Treasury Safekeeping Trust Company account established |
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under Section 6(c), Chapter 615 (S.B. 1367), Acts of the 83rd |
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Legislature, Regular Session, 2013, to the healthy Texas small |
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employer premium stabilization fund. |
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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, 2017. |