| H.B. No. 916 | ||
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| 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 [ |
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| 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; and | ||
| (7) the state Medicaid program, including the Medicaid | ||
| managed care program operated under Chapter 533, Government 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. | ||
| ______________________________ | ______________________________ | |
| President of the Senate | Speaker of the House | |
| I certify that H.B. No. 916 was passed by the House on April | ||
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Statutes affected: Introduced: Insurance Code 1369.102 (Insurance Code 1369) House Committee Report: Insurance Code 1369.102 (Insurance Code 1369) Engrossed: Insurance Code 1369.102 (Insurance Code 1369) Senate Committee Report: Insurance Code 1369.102 (Insurance Code 1369) Enrolled: Insurance Code 1369.102 (Insurance Code 1369) | ||