By: Frank, et al. (Senate Sponsor - Hancock) H.B. No. 3752
         (In the Senate - Received from the House May 5, 2021;
  May 10, 2021, read first time and referred to Committee on Business &
  Commerce; May 21, 2021, reported adversely, with favorable
  Committee Substitute by the following vote:  Yeas 9, Nays 0;
  May 21, 2021, sent to printer.)
Click here to see the committee vote
 
  COMMITTEE SUBSTITUTE FOR H.B. No. 3752 By:  Hancock
 
 
A BILL TO BE ENTITLED
 
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.
         Sec. 2054.608.  EXPIRATION OF SUBCHAPTER. This subchapter
  expires August 31, 2023.
         SECTION 3.  This Act takes effect September 1, 2021.
 
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