Texas 2009 - 81st Regular

Texas House Bill HB3460 Compare Versions

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

Old	New	Differences
1	1	81R11786 BEF-D
2	2	By: Bolton H.B. No. 3460
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to group health benefit plan coverage for certain mental
8	8	illnesses and the amount of the franchise tax incentive for certain
9	9	small employers that provide health care benefits to employees.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Section 1355.003, Insurance Code, is amended to
12	12	read as follows:
13	13	Sec. 1355.003. EXCEPTION. [(a)] This subchapter does not
14	14	apply to coverage under:
15	15	(1) a blanket accident and health insurance policy, as
16	16	described by Chapter 1251;
17	17	(2) a short-term travel policy;
18	18	(3) an accident-only policy;
19	19	(4) a limited or specified-disease policy that does
20	20	not provide benefits for mental health care or similar services;
21	21	(5) [except as provided by Subsection (b), a plan
22	22	offered under Chapter 1551 or Chapter 1601;
23	23	[(6)] a plan offered in accordance with Section
24	24	1355.151; or
25	25	(6) [(7)] a Medicare supplement benefit plan, as
26	26	defined by Section 1652.002.
27	27	[(b) For the purposes of a plan described by Subsection
28	28	(a)(5), "serious mental illness" has the meaning assigned by
29	29	Section 1355.001.]
30	30	SECTION 2. Section 1355.004, Insurance Code, is amended to
31	31	read as follows:
32	32	Sec. 1355.004. REQUIRED COVERAGE FOR SERIOUS MENTAL
33	33	ILLNESS; COVERAGE PARITY. (a) A group health benefit plan:
34	34	(1) must provide coverage, based on medical necessity,
35	35	for the diagnosis and treatment of a serious mental illness under
36	36	terms at least as favorable as those provided for the diagnosis and
37	37	treatment of medical and surgical conditions, and in no case [not]
38	38	less than the following treatments [of serious mental illness] in
39	39	each calendar year:
40	40	(A) 45 days of inpatient treatment; and
41	41	(B) 60 visits for outpatient treatment,
42	42	including group and individual outpatient treatment;
43	43	(2) may not include a lifetime limitation on the
44	44	number of days of inpatient treatment or the number of visits for
45	45	outpatient treatment covered under the plan; [and]
46	46	(3) must include the same amount limitations,
47	47	deductibles, copayments, and coinsurance factors for serious
48	48	mental illness as the plan includes for physical illness; and
49	49	(4) may not impose treatment limitations or financial
50	50	requirements on the provision of benefits under this subchapter for
51	51	a serious mental illness if identical limitations or requirements
52	52	are not imposed on coverage of benefits for other medical
53	53	conditions.
54	54	(b) A group health benefit plan issuer:
55	55	(1) may not count an outpatient visit for medication
56	56	management against the number of outpatient visits required to be
57	57	covered under Subsection (a)(1)(B); and
58	58	(2) must provide coverage for an outpatient visit
59	59	described by Subsection (a)(1)(B) under the same terms as the
60	60	coverage the issuer provides for an outpatient visit for the
61	61	treatment of physical illness.
62	62	SECTION 3. Section 171.1013(b-1), Tax Code, is amended to
63	63	read as follows:
64	64	(b-1) This subsection applies to a taxable entity that is a
65	65	small employer, as that term is defined by Section 1501.002,
66	66	Insurance Code, and that has not provided health care benefits to
67	67	any of its employees in the calendar year preceding the beginning
68	68	date of its reporting period. Subject to Section 171.1014, a
69	69	taxable entity to which this subsection applies that elects to
70	70	subtract compensation for the purpose of computing its taxable
71	71	margin under Section 171.101 may subtract health care benefits as
72	72	provided under Subsection (b) and may also subtract:
73	73	(1) for the first 12-month period on which margin is
74	74	based and in which the taxable entity provides health care benefits
75	75	to all of its employees, an additional amount equal to:
76	76	(A) 50 percent of the cost of health care
77	77	benefits that do not meet the requirements of Section 1355.004,
78	78	Insurance Code, provided to its employees for that period; or
79	79	(B) 75 percent of the cost of health care
80	80	benefits that meet the requirements of Section 1355.004, Insurance
81	81	Code, provided to its employees for that period; [and]
82	82	(2) for the second 12-month period on which margin is
83	83	based and in which the taxable entity provides health care benefits
84	84	to all of its employees, an additional amount equal to:
85	85	(A) 25 percent of the cost of health care
86	86	benefits that do not meet the requirements of Section 1355.004,
87	87	Insurance Code, provided to its employees for that period; or
88	88	(B) 50 percent of the cost of health care
89	89	benefits that meet the requirements of Section 1355.004, Insurance
90	90	Code, provided to its employees for that period; and
91	91	(3) for the third 12-month period on which margin is
92	92	based and in which the taxable entity provides health care benefits
93	93	to all of its employees, an additional amount equal to 25 percent of
94	94	the cost of health care benefits that meet the requirements of
95	95	Section 1355.004, Insurance Code, provided to its employees for
96	96	that period.
97	97	SECTION 4. The changes in law made by this Act by the
98	98	amendment of Sections 1355.003 and 1355.004, Insurance Code, apply
99	99	only to a group health benefit plan delivered, issued for delivery,
100	100	or renewed on or after January 1, 2010. A group health benefit plan
101	101	delivered, issued for delivery, or renewed before January 1, 2010,
102	102	is governed by the law as it existed immediately before the
103	103	effective date of this Act, and that law is continued in effect for
104	104	that purpose.
105	105	SECTION 5. The change in law made by this Act by the
106	106	amendment of Section 171.1013(b-1), Tax Code, applies only to a
107	107	report originally due on or after the effective date of this Act.
108	108	SECTION 6. This Act takes effect January 1, 2010.