Texas 2009 - 81st Regular

Texas House Bill HB663 Compare Versions

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

Old	New	Differences
1	1	81R4364 PMO-D
2	2	By: King of Taylor H.B. No. 663
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to participation by single-employee businesses in private
8	8	purchasing cooperatives or health group cooperatives.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 1501.051, Insurance Code, is amended by
11	11	adding Subdivision (3-b) to read as follows:
12	12	(3-b) "Eligible single-employee business" means a
13	13	chamber of commerce or business association that:
14	14	(A) employs an average of fewer than two
15	15	employees on business days during the preceding calendar year; and
16	16	(B) is eligible to participate in a cooperative
17	17	under this subchapter in accordance with Section 1501.066.
18	18	SECTION 2. Section 1501.0581, Insurance Code, is amended by
19	19	amending Subsections (a), (b), and (p) and adding Subsection (o-1)
20	20	to read as follows:
21	21	(a) The membership of a health group cooperative may consist
22	22	of only small employers, only large employers, or only eligible
23	23	single-employee businesses, but may not consist of a combination of
24	24	those types of entities [or both small and large employers]. To
25	25	participate as a member of a health group cooperative, an employer
26	26	must be a small or large employer as described by this chapter or an
27	27	eligible single-employee business as described by Section
28	28	1501.051(3-b).
29	29	(b) Subject to the requirements imposed on small employer
30	30	health benefit plan issuers under Section 1501.101 and subject to
31	31	Subsections (a-1) and (o), a health group cooperative:
32	32	(1) shall allow a small employer to join a health group
33	33	cooperative consisting of only small employers or both small and
34	34	large employers and enroll in health benefit plan coverage; [and]
35	35	(2) may allow an eligible single-employee business to
36	36	join a health group cooperative consisting of only eligible
37	37	single-employee businesses and enroll in health benefit plan
38	38	coverage; and
39	39	(3) may allow a large employer to join the health group
40	40	cooperative and enroll in health benefit plan coverage.
41	41	(o-1) A health group cooperative consisting only of
42	42	eligible single-employee businesses may elect to restrict
43	43	membership in the cooperative so that the total number of eligible
44	44	employees employed on business days during the preceding calendar
45	45	year by all eligible single-employee businesses participating in
46	46	the cooperative does not exceed 50.
47	47	(p) A health group cooperative must make the election
48	48	described by Subsection (o) or (o-1) at the time the cooperative is
49	49	initially formed. Evidence of the election must be filed in writing
50	50	with the commissioner in the form and at the time prescribed by the
51	51	commissioner by rule.
52	52	SECTION 3. Sections 1501.063(b-1) and (b-2), Insurance
53	53	Code, are amended to read as follows:
54	54	(b-1) Subject to Section 1501.066, a [A] health group
55	55	cooperative that is composed only of small employers or only of
56	56	eligible single-employee businesses and that has made the election
57	57	described by Section 1501.0581(o)(1) or (o-1), as applicable, in
58	58	accordance with Subsection (p) of that section shall be treated in
59	59	the same manner as a small employer for the purposes of this
60	60	chapter, including for the purposes of any provision relating to
61	61	premium rates and issuance and renewal of coverage.
62	62	(b-2) A health group cooperative that is composed only of
63	63	small employers or only of eligible single-employee businesses and
64	64	that has not made the election described by Section 1501.0581(o)(1)
65	65	or (o-1), as applicable, in accordance with Subsection (p) of that
66	66	section, or a health group cooperative that is composed of both
67	67	small and large employers, may be treated in the same manner as a
68	68	large employer for the purposes of this chapter, including for the
69	69	purposes of any provision relating to premium rates and issuance
70	70	and renewal of coverage.
71	71	SECTION 4. Subchapter B, Chapter 1501, Insurance Code, is
72	72	amended by adding Sections 1501.066 and 1501.067 to read as
73	73	follows:
74	74	Sec. 1501.066. ELIGIBLE SINGLE-EMPLOYEE BUSINESS. (a) The
75	75	commissioner by rule shall adopt rules governing the eligibility of
76	76	a single-employee business to participate in a health group
77	77	cooperative under this subchapter. The rules must include
78	78	provisions to ensure that each eligible single-employee business
79	79	has a business purpose and was not formed solely to obtain health
80	80	benefit plan coverage under this subchapter.
81	81	(b) The commissioner may specify additional requirements
82	82	for a health group cooperative composed solely of eligible
83	83	single-employee businesses to qualify for coverage as a small
84	84	employer under this chapter or, if the commissioner finds that
85	85	treatment of such a cooperative as a small employer is not
86	86	actuarially justified, may require that a health group cooperative
87	87	composed solely of eligible single-employee businesses be treated
88	88	as a large employer under this chapter.
89	89	Sec. 1501.067. COOPERATIVES FOR SMALL EMPLOYERS, LARGE
90	90	EMPLOYERS, AND SINGLE-EMPLOYEE BUSINESSES. The department may
91	91	develop a program to assist small employers, large employers, and
92	92	single-employee businesses to form or participate in private
93	93	purchasing cooperatives and health group cooperatives in
94	94	accordance with this subchapter.
95	95	SECTION 5. The commissioner of insurance shall adopt any
96	96	rules necessary to implement the change in law made by this Act not
97	97	later than December 1, 2009. A person may not form a health group
98	98	cooperative composed solely of eligible single-employee businesses
99	99	under Subchapter B, Chapter 1501, Insurance Code, as amended by
100	100	this Act, before January 1, 2010.
101	101	SECTION 6. This Act takes effect September 1, 2009.