Texas 2009 - 81st Regular

Texas House Bill HB3183 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	81R6165 PB-D
2	2	By: Thompson H.B. No. 3183
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to requirements regarding employer liability for certain
8	8	group health benefit plan premiums.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 843.210, Insurance Code, is amended to
11	11	read as follows:
12	12	Sec. 843.210. TERMS OF ENROLLEE ELIGIBILITY. (a) A
13	13	contract between a health maintenance organization and a group
14	14	contract holder must provide that:
15	15	(1) in addition to any other premiums for which the
16	16	group contract holder is liable, the group contract holder is
17	17	liable for an enrollee's premiums from the time the enrollee is no
18	18	longer part of the group eligible for coverage under the contract
19	19	until the end of the month in which the contract holder notifies the
20	20	health maintenance organization that the enrollee is no longer part
21	21	of the group eligible for coverage by the contract; and
22	22	(2) the enrollee remains covered by the contract until
23	23	the end of that period.
24	24	(b) Each health maintenance organization that enters into a
25	25	contract described by Subsection (a) shall notify the group
26	26	contract holder periodically as provided by this section that the
27	27	contract holder is liable for premiums on an enrollee who is no
28	28	longer part of the group eligible for coverage under the contract
29	29	until the health maintenance organization receives notification of
30	30	termination of the enrollee's eligibility for that coverage.
31	31	(c) If the health maintenance organization charges the
32	32	group contract holder on a monthly basis for the coverage premiums,
33	33	the health maintenance organization shall include the notice
34	34	required by Subsection (b) in each monthly statement sent to the
35	35	group contract holder. If the health maintenance organization
36	36	charges the group contract holder on other than a monthly basis for
37	37	the premiums, the health maintenance organization shall notify the
38	38	group contract holder periodically in the manner prescribed by the
39	39	commissioner by rule.
40	40	(d) The notice required by Subsection (b) must include a
41	41	description of methods preferred by the health maintenance
42	42	organization for notification by a group contract holder of an
43	43	enrollee's termination from coverage eligibility.
44	44	SECTION 2. Section 1301.0061, Insurance Code, is amended to
45	45	read as follows:
46	46	Sec. 1301.0061. TERMS OF ENROLLEE ELIGIBILITY. (a) A
47	47	contract between an insurer and a group policyholder under a
48	48	preferred provider benefit plan must provide that:
49	49	(1) in addition to any other premiums for which the
50	50	group policyholder is liable, the group policyholder is liable for
51	51	an individual insured's premiums from the time the individual is no
52	52	longer part of the group eligible for coverage under the policy
53	53	until the end of the month in which the policyholder notifies the
54	54	insurer that the individual is no longer part of the group eligible
55	55	for coverage under the policy; and
56	56	(2) the individual remains covered under the policy
57	57	until the end of that period.
58	58	(b) Each insurer that enters into a contract described by
59	59	Subsection (a) shall notify the group policyholder periodically as
60	60	provided by this section that the policyholder is liable for
61	61	premiums on an individual who is no longer part of the group
62	62	eligible for coverage until the insurer receives notification of
63	63	termination of the individual's eligibility for coverage.
64	64	(c) If the insurer charges the group policyholder on a
65	65	monthly basis for the premiums, the insurer shall include the
66	66	notice required by Subsection (b) in each monthly statement sent to
67	67	the group policyholder. If the insurer charges the group
68	68	policyholder on other than a monthly basis for the premiums, the
69	69	insurer shall notify the group policyholder periodically in the
70	70	manner prescribed by the commissioner by rule.
71	71	(d) The notice required by Subsection (b) must include a
72	72	description of methods preferred by the insurer for notification by
73	73	a group policyholder of an individual's termination from coverage
74	74	eligibility.
75	75	SECTION 3. The change in law made by this Act applies only
76	76	to a contract between an insurer or health maintenance organization
77	77	and a group policy or contract holder that is entered into or
78	78	renewed on or after January 1, 2010. A contract entered into or
79	79	renewed before January 1, 2010, is governed by the law in effect
80	80	immediately before the effective date of this Act, and that law is
81	81	continued in effect for that purpose.
82	82	SECTION 4. This Act takes effect September 1, 2009.