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A BILL TO BE ENTITLED
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AN ACT
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relating to deceptive marketing of certain health plans, programs, |
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and arrangements; authorizing an administrative penalty. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subtitle C, Title 5, Insurance Code, is amended |
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by adding Chapter 564 to read as follows: |
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CHAPTER 564. PROHIBITED PRACTICES RELATING TO MARKETING OF CERTAIN |
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HEALTH PLANS, PROGRAMS, AND ARRANGEMENTS |
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SUBCHAPTER A. GENERAL PROVISIONS |
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Sec. 564.0001. APPLICABILITY. This chapter applies to a |
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health benefit plan, health care program, or health expense |
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arrangement that provides health benefit coverage or otherwise pays |
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for, reimburses, or discounts health care expenses and that |
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excludes or limits coverage for preexisting conditions, |
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discriminates based on health-status related factors, or does not |
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provide essential health benefits required under 42 U.S.C. Section |
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18022, including: |
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(1) an individual accident and health insurance policy |
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governed by Chapter 1201; |
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(2) a group accident and health insurance policy |
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governed by Chapter 1251; |
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(3) a short-tem limited-duration insurance policy |
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governed by Chapter 1509; |
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(4) a health care sharing ministry operated under |
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Chapter 1681; |
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(5) a discount health care program governed by Chapter |
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7001; or |
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(6) a direct primary care arrangement governed by |
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Subchapter F, Chapter 162, Occupations Code. |
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Sec. 564.0002. RULES. The commissioner may adopt rules |
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necessary to implement this chapter. |
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SUBCHAPTER B. DECEPTIVE MARKETING PROHIBITED |
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Sec. 564.0101. PROHIBITED MARKETING TECHNIQUES. A person |
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who issues or operates a plan, program, or arrangement to which this |
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chapter applies or an agent or third party marketing the plan, |
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program, or arrangement on behalf of the issuer or operator may not: |
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(1) represent that a plan, program, or arrangement |
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provides benefits that it does not provide; |
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(2) sell or offer multiple plans, programs, or |
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arrangements to an individual as part of a single transaction in a |
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manner that is false, misleading, or deceptive; |
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(3) use terms associated with health coverage |
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regulated under the Patient Protection and Affordable Care Act |
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(Pub. L. No. 111-148) in a manner that is false, misleading, or |
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deceptive; |
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(4) use terms associated with major medical coverage |
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in a manner that is false, misleading, or deceptive; |
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(5) represent that the federal open enrollment period |
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applies to an excepted benefit plan or discount health care |
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program; |
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(6) misrepresent that a health insurance rate will |
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change if the consumer does not make an immediate purchase; |
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(7) fail to explain the difference in an excepted |
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benefit plan and major medical coverage to a consumer; |
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(8) solicit the sale of an insurance product to which |
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this chapter applies through an Internet website, e-mail, printed |
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advertisement, text message, phone call, or other means without |
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identifying the agent's name and national producer number in a |
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visible manner; |
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(9) contact a prospective purchaser or participant |
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without disclosing the employee's, agent's, or third party's name |
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and national producer number, if applicable, at the start of the |
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contact; |
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(10) try to contact a prospective purchaser or |
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participant by phone and fail to leave a voice mail message if it is |
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possible to leave a voice mail message; or |
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(11) use marketing media that has not been filed with |
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the department. |
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Sec. 564.0102. DUTY TO RECORD MARKETING CALLS. (a) An agent |
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shall make an audio recording of each phone call marketing an |
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insurance product to which this chapter applies. |
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(b) An issuer of an insurance product to which this chapter |
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applies shall retain the recording made under Subsection (a) for a |
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time period determined by the department. |
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Sec. 564.0103. REQUIREMENT TO PROVIDE CERTAIN INFORMATION. |
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An issuer of an insurance product to which this chapter applies |
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shall provide to the department on request: |
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(1) a recording or a transcript of a recording made |
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under Section 564.0102; or |
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(2) a copy of a written communication soliciting the |
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sale of a product to which this chapter applies sent by e-mail, |
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text, Internet website, or other means. |
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Sec. 564.0104. ADVERTISING FILING REQUIREMENTS. An issuer |
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of an insurance product to which this chapter applies shall file for |
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informational purposes with the department a copy of any sales or |
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marketing materials for the product that the issuer intends to use |
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in this state. |
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Sec. 564.0105. VIOLATION. (a) If an issuer or operator |
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holding a certificate of authority or license under this code or an |
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agent or third party acting on behalf of the issuer or operator |
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violates this chapter or a rule adopted under this chapter, the |
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issuer or operator and the agent or third party commit an unfair |
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practice in violation of Chapter 541 and the issuer or operator is |
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subject to administrative penalties and other sanctions under |
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Chapter 82. |
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(b) If an issuer or operator that does not hold a |
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certificate of authority or license under this code or an agent or |
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third party acting on behalf of the issuer or operator violates this |
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chapter or a rule adopted under this chapter, the issuer or operator |
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and the agent or third party commit a false, misleading, or |
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deceptive act or practice under Section 17.46, Business & Commerce |
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Code. |
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SECTION 2. This Act takes effect September 1, 2021. |