By: Carona S.B. No. 1479
(In the Senate - Filed March 9, 2009; March 17, 2009, read
first time and referred to Committee on State Affairs;
April 20, 2009, reported adversely, with favorable Committee
Substitute by the following vote: Yeas 7, Nays 0; April 20, 2009,
sent to printer.)
COMMITTEE SUBSTITUTE FOR S.B. No. 1479 By: Ellis
A BILL TO BE ENTITLED
AN ACT
relating to benefits payable under certain health coverages.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle E, Title 8, Insurance Code, is amended
by adding Chapter 1425 to read as follows:
CHAPTER 1425. APPLICATION OF SUBTITLE TO CERTAIN COVERAGE
Sec. 1425.001. EXEMPTION FROM APPLICATION OF SUBTITLE.
(a) Except as provided by Section 1425.002, a provision of this
subtitle that becomes effective on or after January 2, 2010, does
not apply to:
(1) a plan that provides coverage only:
(A) for a specified disease or diseases or under
an individual limited benefit policy;
(B) for accidental death or dismemberment;
(C) as a supplement to a liability insurance
policy; or
(D) for dental or vision care;
(2) disability income insurance coverage or a
combination of accident-only and disability income insurance
coverage;
(3) credit insurance coverage;
(4) a hospital confinement indemnity policy;
(5) a Medicare supplemental policy as defined by
Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);
(6) a workers' compensation insurance policy;
(7) medical payment insurance coverage provided under
a motor vehicle insurance policy;
(8) a long-term care insurance policy, including a
nursing home fixed indemnity policy, except as provided by
Subsection (b); or
(9) an occupational accident policy.
(b) A long-term care insurance policy, including a nursing
home fixed indemnity policy, is subject to this subtitle if the
commissioner determines that the policy provides benefits so
comprehensive that it is a health benefit plan and should not be
subject to the exemption provided under this section.
Sec. 1425.002. SPECIFIC LANGUAGE CONTROLS. A provision of
this subtitle that becomes effective on or after January 2, 2010,
and that requires coverage or the offer of coverage of a health care
service or benefit applies to a plan or policy described by Section
1425.001(a) only to the extent expressly and specifically provided
by law.
SECTION 2. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2009.
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