88S40270 KBB-D
 
  By: Hughes S.B. No. 34
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to a uniform coordination of benefits questionnaire for
  health benefit plans.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Chapter 1203, Insurance Code, is amended by
  adding Subchapter D to read as follows:
  SUBCHAPTER D. COORDINATION OF BENEFITS QUESTIONNAIRE
         Sec. 1203.151.  APPLICABILITY OF SUBCHAPTER. (a) This
  subchapter applies only to a health benefit plan that provides
  benefits for medical or surgical expenses incurred as a result of a
  health condition, accident, or sickness, including an individual,
  group, blanket, or franchise insurance policy or insurance
  agreement, a group hospital service contract, or an individual or
  group evidence of coverage or similar coverage document that is
  issued by:
               (1)  an insurance company;
               (2)  a group hospital service corporation operating
  under Chapter 842;
               (3)  a health maintenance organization operating under
  Chapter 843;
               (4)  an approved nonprofit health corporation that
  holds a certificate of authority under Chapter 844;
               (5)  a multiple employer welfare arrangement that holds
  a certificate of authority under Chapter 846;
               (6)  a stipulated premium company operating under
  Chapter 884;
               (7)  a Lloyd's plan operating under Chapter 941; or
               (8)  an exchange operating under Chapter 942.
         (b)  Notwithstanding any other law, this subchapter applies
  to:
               (1)  a small employer health benefit plan subject to
  Chapter 1501, including coverage provided through a health group
  cooperative under Subchapter B of that chapter;
               (2)  a standard health benefit plan issued under
  Chapter 1507;
               (3)  a basic coverage plan under Chapter 1551;
               (4)  a basic plan under Chapter 1575;
               (5)  a primary care coverage plan under Chapter 1579;
               (6)  a plan providing basic coverage under Chapter
  1601;
               (7)  alternative health benefit coverage offered by a
  subsidiary of the Texas Mutual Insurance Company under Subchapter
  M, Chapter 2054;
               (8)  group health coverage made available by a school
  district in accordance with Section 22.004, Education Code;
               (9)  the state Medicaid program, including the Medicaid
  managed care program operated under Chapter 533, Government Code;
               (10)  the child health plan program under Chapter 62,
  Health and Safety Code;
               (11)  a regional or local health care program operated
  under Section 75.104, Health and Safety Code; and
               (12)  a self-funded health benefit plan sponsored by a
  professional employer organization under Chapter 91, Labor Code.
         Sec. 1203.152.  CREATION OF UNIFORM COORDINATION OF BENEFITS
  QUESTIONNAIRE. In collaboration with appropriate stakeholders,
  the commissioner shall adopt rules establishing a uniform
  coordination of benefits questionnaire to be used by all health
  benefit plan issuers in this state.
         Sec. 1203.153.  UNIFORM COORDINATION OF BENEFITS
  QUESTIONNAIRE REQUIRED. Each health benefit plan issuer that
  issues a health benefit plan that includes a coordination of
  benefits provision shall use the uniform coordination of benefits
  questionnaire established under Section 1203.152 and make the
  questionnaire available to health care providers as appropriate.
         SECTION 2.  (a)  Not later than the 121st day after the
  effective date of this Act, the commissioner of insurance shall
  adopt rules establishing the uniform coordination of benefits
  questionnaire under Section 1203.152, Insurance Code, as added by
  this Act.
         (b)  The changes in law made by this Act apply only to the use
  of a coordination of benefits questionnaire on or after the 151st
  day after the effective date of this Act.
         SECTION 3.  This Act takes effect on the 91st day after the
  last day of the legislative session.