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A BILL TO BE ENTITLED
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AN ACT
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relating to the provision and use of health coverage information to |
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educate consumers purchasing individual health benefit coverage. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subtitle B, Title 5, Insurance Code, is amended |
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by adding Chapter 526 to read as follows: |
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CHAPTER 526. CONSUMER HEALTH COVERAGE EDUCATION |
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Sec. 526.001. DEFINITIONS. In this chapter: |
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(1) "Agent" means a person who may act as an agent for |
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the sale of a health benefit plan under a license issued under Title |
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13. |
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(2) "Individual health benefit plan" means: |
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(A) an individual accident and health insurance |
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policy to which Chapter 1201 applies; or |
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(B) individual health maintenance organization |
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coverage. |
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Sec. 526.002. PROVISION OF REQUIRED INFORMATION. (a) A |
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health benefit plan issuer that offers an individual health benefit |
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plan shall provide health coverage information adopted by the |
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commissioner under Section 526.003 to each agent who acts on behalf |
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of the health benefit plan issuer with respect to the sale of the |
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individual health benefit plan. |
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(b) An agent who receives health coverage information |
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described by Subsection (a) from a health benefit plan issuer may |
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not sell or receive an application for an individual health benefit |
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plan issued by the health benefit plan issuer until the agent |
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provides the health coverage information to the prospective |
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purchaser of the individual health benefit plan. |
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Sec. 526.003. RULES. (a) The commissioner by rule shall |
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adopt the form and content of the health coverage information |
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required under Section 526.002. |
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(b) The health coverage information adopted under |
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Subsection (a) must be designed to educate a prospective purchaser |
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of an individual health benefit plan about policy and coverage |
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provisions, including copayments, deductibles, and coinsurance, |
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provider networks, and financial responsibilities for in-network |
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and out-of-network services. |
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SECTION 2. This Act takes effect January 1, 2020. |