|
|
|
|
AN ACT
|
|
relating to the offering of health benefit coverage by subsidiaries |
|
of the Texas Mutual Insurance Company. |
|
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|
SECTION 1. Section 2054.107, Insurance Code, is amended to |
|
read as follows: |
|
Sec. 2054.107. CERTAIN RELATIONSHIPS WITH OTHER INSURERS |
|
PROHIBITED. Except as provided by Section 2054.602, the [The] |
|
company may not have: |
|
(1) an affiliate, spin-off, or subsidiary that writes |
|
a line of insurance other than workers' compensation insurance; or |
|
(2) interlocking boards of directors with an insurer |
|
that writes a line of insurance other than workers' compensation |
|
insurance. |
|
SECTION 2. Chapter 2054, Insurance Code, is amended by |
|
adding Subchapter M to read as follows: |
|
SUBCHAPTER M. SUBSIDIARIES AUTHORIZED TO PROVIDE HEALTH BENEFIT |
|
COVERAGE |
|
Sec. 2054.601. DEFINITION. In this subchapter, |
|
"alternative health benefit coverage" means health benefit |
|
coverage: |
|
(1) provided by a subsidiary of the company that is not |
|
authorized to engage in the business of insurance in this state; |
|
(2) offered only to: |
|
(A) individuals; |
|
(B) small businesses with not more than 250 |
|
full-time equivalent employees; or |
|
(C) the company's policyholders or their |
|
employees; and |
|
(3) that is not: |
|
(A) provided through an insurance policy or other |
|
product the offering or issuance of which constitutes the business |
|
of insurance in this state; or |
|
(B) benefit coverage subject to the laws |
|
governing workers' compensation in this state. |
|
Sec. 2054.602. HEALTH BENEFIT COVERAGE OFFERED BY |
|
SUBSIDIARY AUTHORIZED. (a) The company may create, acquire, or |
|
otherwise own or operate one or more subsidiaries that offer |
|
accident or health insurance or another type of health benefit |
|
coverage or health benefit plan as provided by this subchapter. |
|
(b) A subsidiary of the company may offer in this state: |
|
(1) accident or health insurance or another type of |
|
health benefit plan authorized under this code, in accordance with |
|
a certificate of authority issued to the subsidiary under this |
|
code; or |
|
(2) alternative health benefit coverage as described |
|
by Section 2054.601. |
|
(c) A subsidiary of the company may not offer or issue an |
|
occupational policy for an employer or an employer's employees |
|
covering an occupational bodily injury, disease, or death that |
|
explicitly provides liability coverage to an employer that elects |
|
not to maintain workers' compensation insurance coverage under |
|
Chapter 406, Labor Code. |
|
(d) A subsidiary of the company may not offer or issue any |
|
policy, plan, or benefit coverage under this section before |
|
September 1, 2023. This subsection expires September 1, 2023. |
|
Sec. 2054.603. CONSIDERATIONS AND GUIDING PRINCIPLES FOR |
|
DEVELOPING HEALTH BENEFIT COVERAGE OFFERINGS. (a) In developing |
|
health benefit coverage or health benefit plan options to be |
|
offered through a subsidiary of the company, the company shall |
|
fully explore all health coverage options that may be offered under |
|
this subchapter and place emphasis on: |
|
(1) increasing competition in the health insurance |
|
market; |
|
(2) utilizing innovations that improve the quality of |
|
health care while lowering health care costs; |
|
(3) ensuring adequacy of benefits and access to care |
|
for individuals in this state with preexisting conditions; |
|
(4) issuing coverage in a manner that does not |
|
discriminate against individuals with preexisting conditions; |
|
(5) leveraging federal tax credits that may be |
|
available for private health benefit plans to the greatest extent |
|
possible to increase the affordability of health benefit plans; |
|
(6) ensuring transparency and coherence of costs and |
|
coverage to inform individuals shopping for health benefits; |
|
(7) reducing incidences of medical debt faced by |
|
individuals in this state and uncompensated care faced by providers |
|
in this state; and |
|
(8) ensuring equitable costs regardless of gender or |
|
prospects of pregnancy or childbirth. |
|
(b) Not later than September 1, 2022, the company shall |
|
submit to the legislature a report explaining how any anticipated |
|
health benefit coverage offerings would comply with all |
|
considerations and guiding principles for developing health |
|
benefit coverage offerings under Subsection (a). This subsection |
|
expires January 1, 2023. |
|
Sec. 2054.604. RULES. Except with respect to alternative |
|
health benefit coverage as described by Section 2054.601 or a |
|
subsidiary of the company offering alternative health benefit |
|
coverage, the commissioner may adopt rules as necessary to |
|
implement this subchapter. |
|
Sec. 2054.605. EXEMPTION FROM OTHER INSURANCE LAWS. A |
|
provision of this code, other than this chapter, does not apply to |
|
alternative health benefit coverage as described by Section |
|
2054.601 unless alternative health benefit coverage is expressly |
|
mentioned in the other law. |
|
Sec. 2054.606. SUBSIDIARY NOT ENGAGED IN BUSINESS OF |
|
INSURANCE. Notwithstanding any other provision of this code, for |
|
the purposes of offering alternative health benefit coverage as |
|
described by Section 2054.601, a subsidiary of the company that |
|
acts in accordance with this subchapter is not an insurer and is not |
|
engaging in the business of insurance in this state. |
|
Sec. 2054.607. RISK TRANSFER OR COVERAGE. A subsidiary of |
|
the company that offers health benefit coverage under this |
|
subchapter may contract with an outside company authorized to |
|
engage in the business of insurance in this state that is not under |
|
common control with the company or the subsidiary to: |
|
(1) transfer to the outside company all or a portion of |
|
the subsidiary's risks arising from health benefit coverage offered |
|
under this subchapter; or |
|
(2) obtain insurance coverage from the outside company |
|
guarantying the subsidiary's obligations arising from health |
|
benefit coverage offered under this subchapter. |
|
SECTION 3. This Act takes effect September 1, 2021. |
|
|
|
______________________________ |
______________________________ |
|
President of the Senate |
Speaker of the House |
|
|
|
I certify that H.B. No. 3752 was passed by the House on May 5, |
|
2021, by the following vote: Yeas 100, Nays 46, 1 present, not |
|
voting; that the House refused to concur in Senate amendments to |
|
H.B. No. 3752 on May 28, 2021, and requested the appointment of a |
|
conference committee to consider the differences between the two |
|
houses; and that the House adopted the conference committee report |
|
on H.B. No. 3752 on May 30, 2021, by the following vote: Yeas 89, |
|
Nays 53, 2 present, not voting. |
|
|
|
______________________________ |
|
Chief Clerk of the House |
|
|
I certify that H.B. No. 3752 was passed by the Senate, with |
|
amendments, on May 25, 2021, by the following vote: Yeas 31, Nays |
|
0; at the request of the House, the Senate appointed a conference |
|
committee to consider the differences between the two houses; and |
|
that the Senate adopted the conference committee report on H.B. No. |
|
3752 on May 30, 2021, by the following vote: Yeas 31, Nays 0. |
|
|
|
______________________________ |
|
Secretary of the Senate |
|
APPROVED: __________________ |
|
Date |
|
|
|
__________________ |
|
Governor |