87R23046 RDS-D
 
  By: Capriglione, Oliverson, Smithee H.B. No. 3742
 
  Substitute the following for H.B. No. 3742:
 
  By:  Oliverson C.S.H.B. No. 3742
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to a prohibition on the use of genetic information
  gathered from direct-to-consumer genetic tests by a long-term care
  benefit plan issuer or a life insurance company.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subtitle C, Title 5, Insurance Code, is amended
  by adding Chapter 564 to read as follows:
  CHAPTER 564. USE OF GENETIC INFORMATION GATHERED FROM
  DIRECT-TO-CONSUMER GENETIC TEST
         Sec. 564.001.  APPLICABILITY OF CHAPTER. (a) This chapter
  applies only to:
               (1)  an individual long-term care benefit plan that is
  delivered or issued for delivery in this state;
               (2)  a group long-term care benefit plan that is:
                     (A)  delivered or issued for delivery in this
  state; and
                     (B)  issued to an eligible group as described by
  Subchapter B, Chapter 1251;
               (3)  an evidence of coverage delivered or issued for
  delivery in this state for long-term care; and
               (4)  a life insurance policy issued or delivered in
  this state.
         (b)  This chapter applies only to a policy, certificate, or
  evidence of coverage that is issued by:
               (1)  a capital stock insurance company, including a
  life, health and accident, or general casualty insurance company;
               (2)  a mutual life insurance company;
               (3)  a mutual assessment life insurance company,
  including a statewide mutual assessment corporation, local mutual
  aid association, and burial association;
               (4)  a mutual or mutual assessment association,
  including an association subject to Section 887.101;
               (5)  a mutual insurance company other than a life
  insurance company;
               (6)  a mutual or natural premium life or casualty
  insurance company;
               (7)  a fraternal benefit society;
               (8)  a Lloyd's plan insurer;
               (9)  a reciprocal or interinsurance exchange;
               (10)  a nonprofit medical, hospital, or dental service
  corporation, including a company subject to Chapter 842;
               (11)  a stipulated premium company;
               (12)  a health maintenance organization under Chapter
  843; or
               (13)  another insurer required to be licensed by the
  department.
         Sec. 564.002.  EXEMPTIONS. This chapter does not apply to:
               (1)  a group policy or certificate that is delivered or
  issued for delivery in this state under a single employer or labor
  union group policy that is delivered or issued for delivery outside
  this state; or
               (2)  a benefit plan, including a health benefit plan,
  that is not advertised, marketed, or offered as a long-term care
  benefit plan or nursing home benefit plan.
         Sec. 564.003.  LONG-TERM CARE BENEFIT PLAN DEFINED. (a) In
  this chapter, "long-term care benefit plan" means an insurance
  policy or group certificate, or rider to the policy or certificate,
  or evidence of coverage issued by a health maintenance organization
  subject to Chapter 843, that is advertised or marketed as
  providing, or offered or designed to provide, coverage for not less
  than 12 consecutive months for each covered individual on an
  expense-incurred, indemnity, prepaid, or other basis for one or
  more necessary or medically necessary diagnostic, preventive,
  therapeutic, rehabilitative, maintenance, or personal care
  services provided in a setting other than an acute care unit of a
  hospital.
         (b)  The term includes a plan or rider, other than a group or
  individual annuity or life insurance policy, that provides for
  payment of benefits based on cognitive impairment or the loss of
  functional capacity.
         (c)  The term does not include an insurance policy, group
  certificate, or evidence of coverage that is offered primarily to
  provide:
               (1)  basic Medicare supplement coverage, basic
  hospital expense coverage, basic medical-surgical expense
  coverage, hospital confinement indemnity coverage, major medical
  expense coverage, disability income protection coverage,
  accident-only coverage, specified disease or specified accident
  coverage, or limited benefit health coverage; or
               (2)  basic or single health care services.
         Sec. 564.004.  USE OF INFORMATION GATHERED FROM
  DIRECT-TO-CONSUMER GENETIC TESTS PROHIBITED. (a) In this section,
  "direct-to-consumer genetic test" means a genetic test that is
  marketed directly to consumers using television, print
  advertisements, or the Internet and that may be purchased directly
  by a consumer.
         (b)  Without written consent from an individual applying for
  coverage under a long-term care benefit plan or life insurance
  policy, a long-term care benefit plan issuer or life insurance
  company may not:
               (1)  require the individual to furnish genetic
  information gathered from a direct-to-consumer genetic test; or 
               (2)  use genetic information gathered from a
  direct-to-consumer genetic test to reject, deny, limit, increase
  the premiums for, or otherwise adversely affect eligibility for or
  coverage under the plan or policy.
         (c)  Nothing in this section may be construed to prohibit or
  limit the ability of an insurer to request and obtain medical
  information from an individual applying for insurance.
         SECTION 2.  Chapter 564, Insurance Code, as added by this
  Act, applies only to an insurance policy, contract, or evidence of
  coverage that is delivered, issued for delivery, or renewed on or
  after January 1, 2022. A policy, contract, or evidence of coverage
  delivered, issued for delivery, or renewed before January 1, 2022,
  is governed by the law as it existed immediately before the
  effective date of this Act, and that law is continued in effect for
  that purpose.
         SECTION 3.  This Act takes effect September 1, 2021.