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A BILL TO BE ENTITLED
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AN ACT
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relating to consumer protections for accident and health insurance |
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that excludes coverage for preexisting conditions. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subtitle A, Title 8, Insurance Code, is amended |
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by adding Chapter 1223 to read as follows: |
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CHAPTER 1223. PREEXISTING CONDITION COVERAGE EXCLUSIONS |
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SUBCHAPTER A. GENERAL PROVISIONS |
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Sec. 1223.001. APPLICABILITY OF CHAPTER. This chapter |
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applies to an individual or group accident and health insurance |
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policy that excludes coverage for preexisting conditions, |
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including: |
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(1) an individual accident and health insurance policy |
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governed by Chapter 1201; |
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(2) a group accident and health insurance policy |
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governed by Chapter 1251; or |
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(3) a short-term limited-duration insurance policy |
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governed by Chapter 1509. |
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Sec. 1223.002. RULES. The commissioner may adopt rules |
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necessary to implement this chapter. |
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SUBCHAPTER B. DISCLOSURE AND TERMINATION REQUIREMENTS |
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Sec. 1223.051. HEALTH INFORMATION DISCLOSURE REQUIRED. (a) |
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An insurance policy governed by this chapter may not exclude |
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coverage for a preexisting condition unless the application or |
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enrollment form for the policy requires disclosure of prior |
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illness, disease, or physical conditions or of prior medical care |
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and treatment. |
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(b) An insurer may not require a disclosure of the health |
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information of an applicant's or enrollee's family member in an |
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application or enrollment form for an insurance policy governed by |
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this chapter unless the family member is also seeking coverage |
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under the policy. |
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Sec. 1223.052. TERMINATION REQUIREMENTS. (a) An insurer |
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may not terminate an insurance policy governed by this chapter |
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before the expiration date except for: |
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(1) failure to pay the premium or other applicable |
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charges for coverage; |
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(2) material failure to abide by rules, policies, or |
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procedures of the plan; |
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(3) fraud or misrepresentation affecting coverage; |
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(4) a request from the policyholder to cancel |
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coverage; or |
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(5) a cause for termination the commissioner |
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determines is not objectionable. |
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(b) If an insurer terminates an insurance policy governed by |
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this chapter before the policy expiration date, the insurer must |
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send written notice to the insured that includes: |
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(1) the specific reason the policy was terminated; and |
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(2) notice that the insured may file a complaint with |
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the department if the insured believes that the policy was |
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inappropriately terminated. |
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SECTION 2. Not later than January 1, 2024, the commissioner |
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of insurance shall adopt rules necessary to implement Chapter 1223, |
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Insurance Code, as added by this Act. |
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SECTION 3. Chapter 1223, Insurance Code, as added by this |
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Act, applies only to an insurance policy delivered, issued for |
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delivery, or renewed on or after January 1, 2024. |
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SECTION 4. This Act takes effect September 1, 2023. |