| 1 | 1 | | 81R4887 KCR-D |
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| 2 | 2 | | By: Farrar H.B. No. 678 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to health benefit plan coverage for reconstructive surgery |
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| 8 | 8 | | following mastectomy. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. Section 1357.002, Insurance Code, is amended to |
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| 11 | 11 | | read as follows: |
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| 12 | 12 | | Sec. 1357.002. APPLICABILITY OF SUBCHAPTER. (a) This |
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| 13 | 13 | | subchapter applies only to a health benefit plan that provides |
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| 14 | 14 | | benefits for medical or surgical expenses incurred as a result of a |
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| 15 | 15 | | health condition, accident, or sickness, including an individual, |
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| 16 | 16 | | group, blanket, or franchise insurance policy or insurance |
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| 17 | 17 | | agreement, a group hospital service contract, or an individual or |
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| 18 | 18 | | group evidence of coverage or similar coverage document that is |
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| 19 | 19 | | offered by: |
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| 20 | 20 | | (1) an insurance company; |
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| 21 | 21 | | (2) a group hospital service corporation operating |
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| 22 | 22 | | under Chapter 842; |
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| 23 | 23 | | (3) a fraternal benefit society operating under |
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| 24 | 24 | | Chapter 885; |
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| 25 | 25 | | (4) a stipulated premium company operating under |
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| 26 | 26 | | Chapter 884; |
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| 27 | 27 | | (5) a reciprocal exchange operating under Chapter 942; |
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| 28 | 28 | | (6) a health maintenance organization operating under |
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| 29 | 29 | | Chapter 843; |
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| 30 | 30 | | (7) a multiple employer welfare arrangement that holds |
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| 31 | 31 | | a certificate of authority under Chapter 846; or |
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| 32 | 32 | | (8) an approved nonprofit health corporation that |
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| 33 | 33 | | holds a certificate of authority under Chapter 844. |
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| 34 | 34 | | (b) Notwithstanding any other law, a standard health |
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| 35 | 35 | | benefit plan provided under Chapter 1507 must provide the coverage |
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| 36 | 36 | | required by this subchapter. |
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| 37 | 37 | | SECTION 2. The change in law made by this Act applies only |
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| 38 | 38 | | to a health benefit plan that is delivered, issued for delivery, or |
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| 39 | 39 | | renewed on or after January 1, 2010. A health benefit plan that is |
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| 40 | 40 | | delivered, issued for delivery, or renewed before January 1, 2010, |
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| 41 | 41 | | is covered by the law in effect at the time the health benefit plan |
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| 42 | 42 | | was delivered, issued for delivery, or renewed, and that law is |
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| 43 | 43 | | continued in effect for that purpose. |
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| 44 | 44 | | SECTION 3. This Act takes effect September 1, 2009. |
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