81R8339 TJS-D
By: Lucio III H.B. No. 1847
A BILL TO BE ENTITLED
AN ACT
relating to a requirement that certain health benefit plans cover
certain mental disorders.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 1355.002, Insurance Code, is amended to
read as follows:
Sec. 1355.002. APPLICABILITY OF SUBCHAPTER. (a) This
subchapter applies only to a group health benefit plan that
provides benefits for medical or surgical expenses incurred as a
result of a health condition, accident, or sickness, including:
(1) a group insurance policy, group insurance
agreement, group hospital service contract, or group evidence of
coverage that is offered by:
(A) an insurance company;
(B) a group hospital service corporation
operating under Chapter 842;
(C) a fraternal benefit society operating under
Chapter 885;
(D) a stipulated premium company operating under
Chapter 884; or
(E) a health maintenance organization operating
under Chapter 843; and
(2) to the extent permitted by the Employee Retirement
Income Security Act of 1974 (29 U.S.C. Section 1001 et seq.), a plan
offered under:
(A) a multiple employer welfare arrangement as
defined by Section 3 of that Act; or
(B) another analogous benefit arrangement.
(b) Notwithstanding any provision in Chapter 1575 or 1579 or
any other law, this chapter applies to:
(1) a basic plan under Chapter 1575; and
(2) a primary care coverage plan under Chapter 1579.
SECTION 2. Section 1355.015(a), Insurance Code, is amended
to read as follows:
(a) At a minimum, a health benefit plan must provide
coverage as provided by this section to an enrollee older than two
years of age and younger than 11 [six] years of age who is diagnosed
with autism spectrum disorder. If an enrollee who is being treated
for autism spectrum disorder becomes 11 [six] years of age or older
and continues to need treatment, this subsection does not preclude
coverage of treatment and services described by Subsection (b).
SECTION 3. This Act applies only to a health benefit plan
delivered, issued for delivery, or renewed on or after January 1,
2010. A health benefit plan delivered, issued for delivery, or
renewed before January 1, 2010, 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, 2009.