88R1293 MEW-D
 
  By: Paxton S.B. No. 807
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to health benefit plan coverage of prescription
  contraceptive drugs.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 1369.102, Insurance Code, is amended to
  read as follows:
         Sec. 1369.102.  APPLICABILITY OF SUBCHAPTER.  Except as
  otherwise provided by this subchapter, this [This] subchapter
  applies only to a health benefit plan, including a small employer
  health benefit plan written under Chapter 1501, 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
  offered by:
               (1)  an insurance company;
               (2)  a group hospital service corporation operating
  under Chapter 842;
               (3)  a fraternal benefit society operating under
  Chapter 885;
               (4)  a stipulated premium company operating under
  Chapter 884;
               (5)  a reciprocal exchange operating under Chapter 942;
               (6)  a health maintenance organization operating under
  Chapter 843;
               (7)  a multiple employer welfare arrangement that holds
  a certificate of authority under Chapter 846; or
               (8)  an approved nonprofit health corporation that
  holds a certificate of authority under Chapter 844.
         SECTION 2.  Subchapter C, Chapter 1369, Insurance Code, is
  amended by adding Section 1369.1031 to read as follows:
         Sec. 1369.1031.  CERTAIN COVERAGE REQUIRED. (a)  This
  section applies to a health benefit plan described by Section
  1369.102.
         (b)  Notwithstanding any other law, this section applies to:
               (1)  a standard health benefit plan issued under
  Chapter 1507;
               (2)  a basic coverage plan under Chapter 1551;
               (3)  a basic plan under Chapter 1575;
               (4)  a primary care coverage plan under Chapter 1579;
               (5)  a plan providing basic coverage under Chapter
  1601;
               (6)  group health coverage made available by a school
  district in accordance with Section 22.004, Education Code;
               (7)  the state Medicaid program, including the Medicaid
  managed care program operated under Chapter 533, Government Code;
  and
               (8)  the child health plan program under Chapter 62,
  Health and Safety Code.
         (c)  A health benefit plan that provides benefits for a
  prescription contraceptive drug must provide for an enrollee to
  obtain up to:
               (1)  a three-month supply of the covered prescription
  contraceptive drug at one time the first time the enrollee obtains
  the drug; and
               (2)  a 12-month supply of the covered prescription
  contraceptive drug at one time each subsequent time the enrollee
  obtains the same drug, regardless of whether the enrollee was
  enrolled in the health benefit plan the first time the enrollee
  obtained the drug.
         (d)  An enrollee may obtain only one 12-month supply of a
  covered prescription contraceptive drug during each 12-month
  period.
         SECTION 3.  The change in law made by this Act applies only
  to a health benefit plan that is delivered, issued for delivery, or
  renewed on or after January 1, 2024. A health benefit plan that is
  delivered, issued for delivery, or renewed before January 1, 2024,
  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 4.  This Act takes effect September 1, 2023.