| 1 | 1 | | 81R8339 TJS-D |
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| 2 | 2 | | By: Lucio III H.B. No. 1847 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to a requirement that certain health benefit plans cover |
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| 8 | 8 | | certain mental disorders. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. Section 1355.002, Insurance Code, is amended to |
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| 11 | 11 | | read as follows: |
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| 12 | 12 | | Sec. 1355.002. APPLICABILITY OF SUBCHAPTER. (a) This |
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| 13 | 13 | | subchapter applies only to a group health benefit plan that |
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| 14 | 14 | | provides benefits for medical or surgical expenses incurred as a |
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| 15 | 15 | | result of a health condition, accident, or sickness, including: |
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| 16 | 16 | | (1) a group insurance policy, group insurance |
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| 17 | 17 | | agreement, group hospital service contract, or group evidence of |
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| 18 | 18 | | coverage that is offered by: |
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| 19 | 19 | | (A) an insurance company; |
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| 20 | 20 | | (B) a group hospital service corporation |
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| 21 | 21 | | operating under Chapter 842; |
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| 22 | 22 | | (C) a fraternal benefit society operating under |
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| 23 | 23 | | Chapter 885; |
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| 24 | 24 | | (D) a stipulated premium company operating under |
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| 25 | 25 | | Chapter 884; or |
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| 26 | 26 | | (E) a health maintenance organization operating |
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| 27 | 27 | | under Chapter 843; and |
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| 28 | 28 | | (2) to the extent permitted by the Employee Retirement |
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| 29 | 29 | | Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.), a plan |
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| 30 | 30 | | offered under: |
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| 31 | 31 | | (A) a multiple employer welfare arrangement as |
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| 32 | 32 | | defined by Section 3 of that Act; or |
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| 33 | 33 | | (B) another analogous benefit arrangement. |
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| 34 | 34 | | (b) Notwithstanding any provision in Chapter 1575 or 1579 or |
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| 35 | 35 | | any other law, this chapter applies to: |
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| 36 | 36 | | (1) a basic plan under Chapter 1575; and |
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| 37 | 37 | | (2) a primary care coverage plan under Chapter 1579. |
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| 38 | 38 | | SECTION 2. Section 1355.015(a), Insurance Code, is amended |
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| 39 | 39 | | to read as follows: |
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| 40 | 40 | | (a) At a minimum, a health benefit plan must provide |
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| 41 | 41 | | coverage as provided by this section to an enrollee older than two |
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| 42 | 42 | | years of age and younger than 11 [six] years of age who is diagnosed |
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| 43 | 43 | | with autism spectrum disorder. If an enrollee who is being treated |
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| 44 | 44 | | for autism spectrum disorder becomes 11 [six] years of age or older |
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| 45 | 45 | | and continues to need treatment, this subsection does not preclude |
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| 46 | 46 | | coverage of treatment and services described by Subsection (b). |
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| 47 | 47 | | SECTION 3. This Act applies only to a health benefit plan |
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| 48 | 48 | | delivered, issued for delivery, or renewed on or after January 1, |
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| 49 | 49 | | 2010. A health benefit plan delivered, issued for delivery, or |
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| 50 | 50 | | renewed before January 1, 2010, is governed by the law as it existed |
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| 51 | 51 | | immediately before the effective date of this Act, and that law is |
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| 52 | 52 | | continued in effect for that purpose. |
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| 53 | 53 | | SECTION 4. This Act takes effect September 1, 2009. |
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