Bill Summary – FastDemocracy

   
      88(3) SB 46 - Introduced version - Bill Text
      
		By:  Hughes
            S.B.  No.  46
         
               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 
         
            Statutes affected: 
Introduced:  ()


	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
	Statutes affected: Introduced: ()