Texas 2009 - 81st Regular

Texas House Bill HB1176 Compare Versions

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1	1	81R6242 KCR-D
2	2	By: Crownover, Zerwas, Berman, Hancock, H.B. No. 1176
3	3	Patrick, et al.
4	4
5	5
6	6	A BILL TO BE ENTITLED
7	7	AN ACT
8	8	relating to the creation of a voluntary consumer-directed health
9	9	plan for certain individuals eligible to participate in the
10	10	insurance coverage provided under the Texas Employees Group
11	11	Benefits Act and their qualified dependents.
12	12	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
13	13	SECTION 1. Chapter 1551, Insurance Code, is amended by
14	14	adding Subchapter J to read as follows:
15	15	SUBCHAPTER J. STATE CONSUMER-DIRECTED HEALTH PLAN
16	16	Sec. 1551.451. DEFINITIONS. In this subchapter:
17	17	(1) "High deductible health plan" means a health
18	18	benefit plan that complies with Section 223(c), Internal Revenue
19	19	Code of 1986, and other federal law.
20	20	(2) "Participant" means an individual who is:
21	21	(A) eligible to participate in the group benefits
22	22	program; and
23	23	(B) enrolled in the plan established under this
24	24	subchapter.
25	25	(3) "Qualified medical expense" means an expense paid
26	26	by a participant for medical care, as defined by Section 213(d),
27	27	Internal Revenue Code of 1986, for the participant or the
28	28	participant's dependents as defined by Section 152, Internal
29	29	Revenue Code of 1986.
30	30	Sec. 1551.452. ESTABLISHMENT OF STATE CONSUMER-DIRECTED
31	31	HEALTH PLAN. (a) The state consumer-directed health plan is
32	32	established for the benefit of individuals eligible to participate
33	33	in the group benefits program and those individuals' eligible
34	34	dependents.
35	35	(b) After the board of trustees adopts rules necessary to
36	36	administer this subchapter, the board shall:
37	37	(1) establish health savings accounts under this
38	38	subchapter and administer or select an administrator for the
39	39	accounts;
40	40	(2) finance or purchase a high deductible health plan
41	41	that:
42	42	(A) is an integral part of the state
43	43	consumer-directed health plan; and
44	44	(B) provides health benefit coverage, including
45	45	preventative health care, to a participant enrolled in the state
46	46	consumer-directed health plan and to the dependents of an enrolled
47	47	participant in accordance with Section 1551.456; and
48	48	(3) provide to individuals eligible to participate in
49	49	the group benefits program information regarding the option to
50	50	participate in and operation of the state consumer-directed health
51	51	plan established under this subchapter.
52	52	(c) If the board of trustees purchases a high deductible
53	53	health plan under this subchapter, Sections 1551.215-1551.218
54	54	apply to the high deductible health plan.
55	55	(d) In adopting rules and administering health savings
56	56	accounts or selecting administrators for health savings accounts
57	57	under this subchapter, the board of trustees shall ensure that the
58	58	health savings accounts are qualified for appropriate federal tax
59	59	exemptions.
60	60	Sec. 1551.453. PARTICIPATION IN STATE CONSUMER-DIRECTED
61	61	HEALTH PLAN; EFFECT OF PARTICIPATION. (a) The board of trustees
62	62	shall give individuals eligible to participate in the basic
63	63	coverage plan the option of waiving participation in the basic
64	64	coverage plan and participating in the state consumer-directed
65	65	health plan instead.
66	66	(b) For purposes of this chapter, participation in the state
67	67	consumer-directed health plan is considered participation in the
68	68	group benefits program, and Sections 1551.301, 1551.303, 1551.305,
69	69	and 1551.306 apply to participation in the state consumer-directed
70	70	health plan in the same manner that those sections apply to the
71	71	basic coverage plan.
72	72	Sec. 1551.454. ACCOUNT ADMINISTRATOR. (a) The account
73	73	administrator selected to administer a health savings account
74	74	established under this subchapter must be a person:
75	75	(1) qualified to serve as trustee under Section
76	76	223(d)(1)(B), Internal Revenue Code of 1986, and the rules adopted
77	77	under that section; and
78	78	(2) experienced in administering health savings
79	79	accounts or other similar trust accounts.
80	80	(b) An account administrator is the fiduciary of a
81	81	participant who has a health savings account established under this
82	82	subchapter.
83	83	(c) Section 1551.056(b) does not apply to the account
84	84	administrator.
85	85	Sec. 1551.455. PARTICIPATION IN PROGRAM. (a) Each
86	86	individual eligible to participate in the basic coverage may choose
87	87	instead to participate in the state consumer-directed health plan
88	88	if the participant is an eligible individual under Section
89	89	223(c)(1), Internal Revenue Code of 1986. The dependents of a
90	90	participant may participate in the state consumer-directed health
91	91	plan in accordance with Section 1551.456.
92	92	(b) A participant waives basic plan coverage and must be
93	93	enrolled in a high deductible health plan.
94	94	(c) Participation in the state consumer-directed health
95	95	plan qualifies a participant to receive a contribution to a health
96	96	savings account under Section 1551.458. An individual who elects
97	97	not to participate in the plan is not eligible to receive a
98	98	contribution under that section.
99	99	(d) A participant is subject to Subchapter H in the same
100	100	manner as an individual who participates in the basic coverage
101	101	offered under the group benefits program.
102	102	(e) Under this section, the board of trustees has exclusive
103	103	authority to determine an individual's eligibility to participate
104	104	in the state consumer-directed health plan and shall adopt rules
105	105	regarding eligibility to participate in the plan.
106	106	Sec. 1551.456. COVERAGE FOR DEPENDENTS; REQUIRED
107	107	CONTRIBUTIONS. (a) Subject to Subsection (d), a participant is
108	108	entitled to obtain for the participant's dependents coverage in the
109	109	state consumer-directed health plan in the manner determined by the
110	110	board of trustees.
111	111	(b) The participant shall make any required additional
112	112	contribution payments for the dependent coverage in the manner
113	113	prescribed by the board of trustees.
114	114	(c) Amounts contributed by a participant under this section
115	115	may be:
116	116	(1) used to pay the cost of coverage in the state
117	117	consumer-directed health plan not paid by the state under Section
118	118	1551.458(b)(1); or
119	119	(2) contributed as additional amounts to the health
120	120	savings account provided to the participant.
121	121	(d) A covered dependent of a participant:
122	122	(1) is subject to Subchapter H in the same manner as a
123	123	dependent who is covered by the basic coverage offered under the
124	124	group benefits program; and
125	125	(2) must be a dependent for purposes of:
126	126	(A) Section 152, Internal Revenue Code of 1986;
127	127	and
128	128	(B) Section 1551.004.
129	129	Sec. 1551.457. IDENTIFICATION CARDS FOR PARTICIPANTS. (a)
130	130	The board of trustees or the account administrator, as applicable,
131	131	shall issue to each participant an identification card.
132	132	(b) The board of trustees or the account administrator, as
133	133	applicable, shall issue a duplicate identification card to each
134	134	participant's dependent for whom qualified medical expenses may be
135	135	paid out of a health savings account established under this
136	136	subchapter.
137	137	Sec. 1551.458. STATE CONTRIBUTION. (a) For each
138	138	participant, from the state contribution that would otherwise be
139	139	made for basic coverage for the participant, the state shall
140	140	annually contribute:
141	141	(1) to a high deductible health plan provided under
142	142	this subchapter, the amount that is necessary to pay the cost of
143	143	coverage under the high deductible health plan and does not exceed
144	144	the amount the state annually contributes for a full-time or
145	145	part-time employee, as applicable, who is covered by the basic
146	146	coverage; and
147	147	(2) to the participant's health savings account, any
148	148	remainder of the state contribution after payment of coverage under
149	149	Subdivision (1).
150	150	(b) For each participant's dependent covered under this
151	151	subchapter from the state contribution that would otherwise be made
152	152	for basic coverage for the dependent, the state shall annually
153	153	contribute:
154	154	(1) to a high deductible health plan provided under
155	155	this subchapter, the same percentage of the cost of coverage under
156	156	the high deductible health plan as the state annually contributes
157	157	for dependent coverage in the basic coverage; and
158	158	(2) to the participant's health savings account, as
159	159	allowed under federal law, any remainder of the state contribution
160	160	after payment for coverage under Subdivision (1).
161	161	(c) For a calendar year, the amount of state contributions
162	162	under Subsections (a)(2) and (b)(2), in the aggregate, may not
163	163	exceed the sum of the monthly limitations imposed by federal law for
164	164	health savings accounts.
165	165	Sec. 1551.459. PARTICIPANT CONTRIBUTIONS. (a) Each
166	166	participant, in accordance with Section 1551.305, shall contribute
167	167	any amount required to cover the selected participation in the
168	168	state consumer-directed health plan that exceeds the state
169	169	contribution amount under Section 1551.458.
170	170	(b) A participant may contribute any amount allowed under
171	171	federal law to the participant's health savings account in addition
172	172	to receiving the state contribution under Section 1551.458.
173	173	(c) A participant shall make contributions under this
174	174	section in the manner prescribed by the board of trustees.
175	175	Sec. 1551.460. COORDINATION WITH CAFETERIA PLAN. (a) The
176	176	board of trustees has exclusive authority to determine the
177	177	eligibility of a participant to participate in any medical flexible
178	178	savings account that is part of a cafeteria plan offered under this
179	179	chapter.
180	180	(b) The board of trustees shall adopt rules regarding:
181	181	(1) the eligibility of a participant to participate in
182	182	any medical flexible savings account that is part of a cafeteria
183	183	plan offered under this chapter; and
184	184	(2) the coordination of benefits provided under this
185	185	subchapter and any medical flexible savings account that is part of
186	186	a cafeteria plan offered under this chapter.
187	187	(c) The rules adopted by the board of trustees under
188	188	Subsection (b) must prohibit a participant from participating in
189	189	any medical flexible savings account that would disqualify the
190	190	participant's health savings account from favorable tax treatment
191	191	under federal law.
192	192	Sec. 1551.461. CONFIDENTIALITY OF RECORDS. To the extent
193	193	allowed under federal law and subject to Section 1551.063, the
194	194	board of trustees or the account administrator, as applicable, may
195	195	disclose to a carrier information in an individual's records that
196	196	the board of trustees or administrator determines is necessary to
197	197	administer the state consumer-directed health plan.
198	198	Sec. 1551.462. EXEMPTION FROM EXECUTION; UNASSIGNABILITY.
199	199	A state contribution to a health savings account or a high
200	200	deductible health plan is exempt from execution and is unassignable
201	201	in the same manner and to the same extent as is an amount described
202	202	by Section 1551.011.
203	203	Sec. 1551.463. ASSISTANCE. Any state agency that the board
204	204	of trustees considers appropriate shall assist the board in
205	205	implementing and administering this subchapter.
206	206	SECTION 2. The Employees Retirement System of Texas shall
207	207	develop the state consumer-directed health plan to be implemented
208	208	under Chapter 1551, Insurance Code, as amended by this Act,
209	209	including enrollment requirements, during the state fiscal
210	210	biennium beginning September 1, 2009, with coverage beginning
211	211	September 1, 2010.
212	212	SECTION 3. Not later than July 31, 2010, the Employees
213	213	Retirement System of Texas shall provide written information to
214	214	individuals eligible to participate in the state consumer-directed
215	215	health plan under Chapter 1551, Insurance Code, as amended by this
216	216	Act, that provides a general description of the requirements for
217	217	the plan as adopted under Chapter 1551, Insurance Code, as amended
218	218	by this Act.
219	219	SECTION 4. The Employees Retirement System of Texas shall
220	220	develop and implement the health savings account program under
221	221	Chapter 1551, Insurance Code, as amended by this Act, in a manner
222	222	that is as revenue neutral as is possible.
223	223	SECTION 5. Except as otherwise provided by this Act, this
224	224	Act takes effect September 1, 2009.