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A BILL TO BE ENTITLED
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AN ACT
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relating to financial regulation of certain life, health, and |
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accident insurers and health maintenance organizations. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Sections 841.351(c) and (d), Insurance Code, are |
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amended to read as follows: |
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(c) A domestic insurance company may, at its option, |
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withdraw a deposit made under Subsection (a), or any portion of the |
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deposit[, after substituting a deposit of securities of a like |
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class and of an amount and value equal to the withdrawn deposit or |
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portion of deposit]. |
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(d) The commissioner must first approve any securities |
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deposited or withdrawn [being substituted] under this section. |
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SECTION 2. Section 843.082, Insurance Code, is amended to |
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read as follows: |
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Sec. 843.082. REQUIREMENTS FOR APPROVAL OF APPLICATION. |
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The commissioner shall issue a certificate of authority on payment |
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of the application fee prescribed by Section 843.154(c) if the |
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commissioner is satisfied that: |
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(1) with respect to health care services to be |
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provided, the applicant: |
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(A) has demonstrated the willingness and |
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potential ability to ensure that the health care services will be |
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provided in a manner to: |
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(i) ensure both availability and |
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accessibility of adequate personnel and facilities; and |
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(ii) enhance availability, accessibility, |
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quality of care, and continuity of services; |
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(B) has arrangements, established in accordance |
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with rules adopted by the commissioner, for a continuing quality of |
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health care assurance program concerning health care processes and |
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outcomes; and |
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(C) has a procedure, that is in accordance with |
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rules adopted by the commissioner, to develop, compile, evaluate, |
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and report statistics relating to the cost of operation, the |
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pattern of utilization of services, and availability and |
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accessibility of services; |
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(2) the person responsible for the conduct of the |
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affairs of the applicant is competent, is trustworthy, and has a |
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good reputation; |
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(3) the health care plan, limited health care service |
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plan, or single health care service plan is an appropriate |
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mechanism through which the health maintenance organization will |
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effectively provide or arrange for the provision of basic health |
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care services, limited health care services, or a single health |
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care service on a prepaid basis, through insurance or otherwise, |
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except to the extent of reasonable requirements for copayments; |
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(4) the health maintenance organization is fully |
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responsible and may reasonably be expected to meet its obligations |
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to enrollees and prospective enrollees, after considering: |
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(A) the financial soundness of the health care |
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plan's arrangement for health care services and the schedule of |
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charges used in connection with the arrangement; |
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(B) the adequacy of working capital; |
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(C) any agreement with an insurer, a group |
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hospital service corporation, a political subdivision of |
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government, or any other organization for insuring the payment of |
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the cost of health care services or providing for automatic |
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applicability of an alternative coverage in the event the plan is |
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discontinued; and |
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(D) any agreement that provides for the provision |
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of health care services; and |
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[(E) any deposit of cash or securities submitted |
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in accordance with Section 843.405 as a guarantee that the |
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obligations will be performed; and] |
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(5) the proposed plan of operation, as shown by the |
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information submitted under Section 843.078 and, if applicable, |
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Section 843.079, or by independent investigation, does not violate |
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state law. |
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SECTION 3. Subchapter L, Chapter 843, Insurance Code, is |
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amended by adding Section 843.4055 to read as follows: |
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Sec. 843.4055. DEPOSIT WITH OR WITHDRAWAL FROM COMPTROLLER. |
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(a) A health maintenance organization may, at its option and after |
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receiving commissioner approval, deposit with the comptroller |
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cash, securities, or any combination of cash, securities, and other |
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guarantees. |
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(b) A health maintenance organization may, at its option and |
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after receiving commissioner approval, withdraw a deposit made |
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under Subsection (a) or any portion of the deposit. |
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SECTION 4. Section 534.153, Health and Safety Code, is |
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amended to read as follows: |
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Sec. 534.153. APPLICATION OF LAWS AND RULES. A health |
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maintenance organization created and operating under this |
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subchapter is governed as, and is subject to the same laws and rules |
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of the Texas Department of Insurance as, any other health |
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maintenance organization of the same type. The commissioner of |
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insurance may adopt rules as necessary to accept funding sources |
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other than the sources specified by Section 843.4055 [843.405], |
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Insurance Code, from a nonprofit health maintenance organization |
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created and operating under this subchapter, to meet the minimum |
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surplus requirements of that section. |
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SECTION 5. The following provisions of the Insurance Code |
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are repealed: |
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(1) Section 841.355; |
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(2) Section 841.357; |
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(3) Sections 843.105(d), (e), (f), and (g); |
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(4) Section 843.402; and |
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(5) Section 843.405. |
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SECTION 6. On the effective date of this Act, the |
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comptroller of public accounts of the State of Texas shall release, |
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transfer, and deliver to the owner any deposits made by a health |
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maintenance organization under former Sections 843.105(g), |
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843.402, and 843.405, Insurance Code. |
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SECTION 7. This Act takes effect September 1, 2021. |