| 1 | 1 | | 81R25505 PMO-D |
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| 2 | 2 | | By: Taylor H.B. No. 4410 |
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| 3 | 3 | | Substitute the following for H.B. No. 4410: |
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| 4 | 4 | | By: Taylor C.S.H.B. No. 4410 |
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| 5 | 5 | | |
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| 6 | 6 | | |
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| 7 | 7 | | A BILL TO BE ENTITLED |
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| 8 | 8 | | AN ACT |
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| 9 | 9 | | relating to benefits payable under certain health coverages. |
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| 10 | 10 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 11 | 11 | | SECTION 1. Subtitle E, Title 8, Insurance Code, is amended |
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| 12 | 12 | | by adding Chapter 1425 to read as follows: |
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| 13 | 13 | | CHAPTER 1425. APPLICATION OF SUBTITLE TO CERTAIN COVERAGE |
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| 14 | 14 | | Sec. 1425.001. EXEMPTION FROM APPLICATION OF SUBTITLE. (a) |
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| 15 | 15 | | Except as provided by Section 1425.002, a provision of this |
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| 16 | 16 | | subtitle that becomes effective on or after January 2, 2010, does |
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| 17 | 17 | | not apply to: |
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| 18 | 18 | | (1) a plan that provides coverage only: |
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| 19 | 19 | | (A) for a specified disease or diseases or under |
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| 20 | 20 | | an individual limited benefit policy; |
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| 21 | 21 | | (B) for accidental death or dismemberment; |
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| 22 | 22 | | (C) as a supplement to a liability insurance |
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| 23 | 23 | | policy; or |
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| 24 | 24 | | (D) for dental or vision care; |
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| 25 | 25 | | (2) disability income insurance coverage or a |
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| 26 | 26 | | combination of accident-only and disability income insurance |
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| 27 | 27 | | coverage; |
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| 28 | 28 | | (3) credit insurance coverage; |
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| 29 | 29 | | (4) a hospital confinement indemnity policy; |
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| 30 | 30 | | (5) a Medicare supplemental policy as defined by |
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| 31 | 31 | | Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss); |
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| 32 | 32 | | (6) a workers' compensation insurance policy; |
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| 33 | 33 | | (7) medical payment insurance coverage provided under |
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| 34 | 34 | | a motor vehicle insurance policy; |
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| 35 | 35 | | (8) a long-term care insurance policy, including a |
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| 36 | 36 | | nursing home fixed indemnity policy, except as provided by |
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| 37 | 37 | | Subsection (b); or |
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| 38 | 38 | | (9) an occupational accident policy. |
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| 39 | 39 | | (b) A long-term care insurance policy, including a nursing |
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| 40 | 40 | | home fixed indemnity policy, is subject to this subtitle if the |
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| 41 | 41 | | commissioner determines that the policy provides benefits so |
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| 42 | 42 | | comprehensive that it is a health benefit plan and should not be |
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| 43 | 43 | | subject to the exemption provided under this section. |
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| 44 | 44 | | Sec. 1425.002. SPECIFIC LANGUAGE CONTROLS. A provision of |
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| 45 | 45 | | this subtitle that becomes effective on or after January 2, 2010, |
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| 46 | 46 | | and that requires coverage or the offer of coverage of a health care |
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| 47 | 47 | | service or benefit applies to a plan or policy described by Section |
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| 48 | 48 | | 1425.001(a) only to the extent expressly and specifically provided |
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| 49 | 49 | | by law. |
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| 50 | 50 | | SECTION 2. This Act takes effect immediately if it receives |
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| 51 | 51 | | a vote of two-thirds of all the members elected to each house, as |
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| 52 | 52 | | provided by Section 39, Article III, Texas Constitution. If this |
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| 53 | 53 | | Act does not receive the vote necessary for immediate effect, this |
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| 54 | 54 | | Act takes effect September 1, 2009. |
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