Texas 2009 - 81st Regular

Texas Senate Bill SB2370 Compare Versions

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

Old	New	Differences
1	1	81R9805 TJS-D
2	2	By: Uresti S.B. No. 2370
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to eligibility of certain dependents for health insurance
8	8	coverage.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 846.260, Insurance Code, is amended to
11	11	read as follows:
12	12	Sec. 846.260. LIMITING AGE APPLICABLE TO UNMARRIED CHILD.
13	13	If children are eligible for coverage under the terms of a multiple
14	14	employer welfare arrangement's plan document, any limiting age
15	15	applicable to an unmarried child of an enrollee is 29 [25] years of
16	16	age.
17	17	SECTION 2. Section 1201.053(b), Insurance Code, is amended
18	18	to read as follows:
19	19	(b) On the application of an adult member of a family, an
20	20	individual accident and health insurance policy may, at the time of
21	21	original issuance or by subsequent amendment, insure two or more
22	22	eligible members of the adult's family, including a spouse,
23	23	unmarried children younger than 29 [25] years of age, including a
24	24	grandchild of the adult as described by Section 1201.062(a)(1), a
25	25	child the adult is required to insure under a medical support order
26	26	issued under Chapter 154, Family Code, or enforceable by a court in
27	27	this state, and any other individual dependent on the adult.
28	28	SECTION 3. Section 1201.062(a), Insurance Code, is amended
29	29	to read as follows:
30	30	(a) An individual or group accident and health insurance
31	31	policy that is delivered, issued for delivery, or renewed in this
32	32	state, including a policy issued by a corporation operating under
33	33	Chapter 842, or a self-funded or self-insured welfare or benefit
34	34	plan or program, to the extent that regulation of the plan or
35	35	program is not preempted by federal law, that provides coverage for
36	36	a child of an insured or group member, on payment of a premium, must
37	37	provide coverage for:
38	38	(1) each grandchild of the insured or group member if
39	39	the grandchild is:
40	40	(A) unmarried;
41	41	(B) younger than 29 [25] years of age; and
42	42	(C) a dependent of the insured or group member
43	43	for federal income tax purposes at the time application for
44	44	coverage of the grandchild is made; and
45	45	(2) each child for whom the insured or group member
46	46	must provide medical support under an order issued under Chapter
47	47	154, Family Code, or enforceable by a court in this state.
48	48	SECTION 4. Section 1201.065(a), Insurance Code, is amended
49	49	to read as follows:
50	50	(a) An individual or group accident and health insurance
51	51	policy may contain criteria relating to a maximum age or enrollment
52	52	in school to establish continued eligibility for coverage of a
53	53	child 29 [25] years of age or older.
54	54	SECTION 5. Section 1251.151(a), Insurance Code, is amended
55	55	to read as follows:
56	56	(a) A group policy or contract of insurance for hospital,
57	57	surgical, or medical expenses incurred as a result of accident or
58	58	sickness, including a group contract issued by a group hospital
59	59	service corporation, that provides coverage under the policy or
60	60	contract for a child of an insured must, on payment of a premium,
61	61	provide coverage for any grandchild of the insured if the
62	62	grandchild is:
63	63	(1) unmarried;
64	64	(2) younger than 29 [25] years of age; and
65	65	(3) a dependent of the insured for federal income tax
66	66	purposes at the time the application for coverage of the grandchild
67	67	is made.
68	68	SECTION 6. Section 1251.152(a), Insurance Code, is amended
69	69	to read as follows:
70	70	(a) For purposes of this section, "dependent" includes:
71	71	(1) a child of an employee or member who is:
72	72	(A) unmarried; and
73	73	(B) younger than 29 [25] years of age; and
74	74	(2) a grandchild of an employee or member who is:
75	75	(A) unmarried;
76	76	(B) younger than 29 [25] years of age; and
77	77	(C) a dependent of the insured for federal income
78	78	tax purposes at the time the application for coverage of the
79	79	grandchild is made.
80	80	SECTION 7. Section 1271.006(a), Insurance Code, is amended
81	81	to read as follows:
82	82	(a) If children are eligible for coverage under the terms of
83	83	an evidence of coverage, any limiting age applicable to an
84	84	unmarried child of an enrollee, including an unmarried grandchild
85	85	of an enrollee, is 29 [25] years of age. The limiting age
86	86	applicable to a child must be stated in the evidence of coverage.
87	87	SECTION 8. Section 1501.002(2), Insurance Code, is amended
88	88	to read as follows:
89	89	(2) "Dependent" means:
90	90	(A) a spouse;
91	91	(B) a child younger than 29 [25] years of age,
92	92	including a newborn child;
93	93	(C) a child of any age who is:
94	94	(i) medically certified as disabled; and
95	95	(ii) dependent on the parent;
96	96	(D) an individual who must be covered under:
97	97	(i) Section 1251.154; or
98	98	(ii) Section 1201.062; and
99	99	(E) any other child eligible under an employer's
100	100	health benefit plan, including a child described by Section
101	101	1503.003.
102	102	SECTION 9. Section 1501.609(b), Insurance Code, is amended
103	103	to read as follows:
104	104	(b) Any limiting age applicable under a large employer
105	105	health benefit plan to an unmarried child of an enrollee is 29 [25]
106	106	years of age.
107	107	SECTION 10. Sections 1503.003(a) and (b), Insurance Code,
108	108	are amended to read as follows:
109	109	(a) A health benefit plan may not condition coverage for a
110	110	child younger than 29 [25] years of age on the child's being
111	111	enrolled at an educational institution.
112	112	(b) A health benefit plan that requires as a condition of
113	113	coverage for a child 29 [25] years of age or older that the child be
114	114	a full-time student at an educational institution must provide the
115	115	coverage:
116	116	(1) for the entire academic term during which the
117	117	child begins as a full-time student and remains enrolled,
118	118	regardless of whether the number of hours of instruction for which
119	119	the child is enrolled is reduced to a level that changes the child's
120	120	academic status to less than that of a full-time student; and
121	121	(2) continuously until the 10th day of instruction of
122	122	the subsequent academic term, on which date the health benefit plan
123	123	may terminate coverage for the child if the child does not return to
124	124	full-time student status before that date.
125	125	SECTION 11. Section 1506.003, Insurance Code, is amended to
126	126	read as follows:
127	127	Sec. 1506.003. DEFINITION OF DEPENDENT. In this chapter,
128	128	"dependent" means:
129	129	(1) a resident spouse or unmarried child younger than
130	130	29 [25] years of age; or
131	131	(2) a child who is:
132	132	(A) a full-time student younger than 29 [25]
133	133	years of age who is financially dependent on the parent;
134	134	(B) 18 years of age or older and is an individual
135	135	for whom a person may be obligated to pay child support; or
136	136	(C) disabled and dependent on the parent
137	137	regardless of the age of the child.
138	138	SECTION 12. Section 1506.158(a), Insurance Code, is amended
139	139	to read as follows:
140	140	(a) An individual's pool coverage ends:
141	141	(1) on the date the individual ceases to be a legally
142	142	domiciled resident of this state, unless the individual:
143	143	(A) is a student younger than 29 [25] years of age
144	144	and is financially dependent on a parent covered by the pool;
145	145	(B) is a child for whom an individual covered by
146	146	the pool may be obligated to pay child support; or
147	147	(C) is a child who is disabled and dependent on a
148	148	parent covered by the pool, regardless of the age of the child;
149	149	(2) on the first day of the month following the date
150	150	the individual requests coverage to end;
151	151	(3) on the date the individual covered by the pool
152	152	dies;
153	153	(4) on the date state law requires cancellation of the
154	154	coverage;
155	155	(5) at the option of the pool, on the 31st day after
156	156	the date the pool sends to the individual any inquiry concerning the
157	157	individual's eligibility, including an inquiry concerning the
158	158	individual's residence, to which the individual does not reply;
159	159	(6) on the 31st day after the date a premium payment
160	160	for pool coverage becomes due if the payment is not made before that
161	161	day;
162	162	(7) on the date the individual is 65 years of age and
163	163	eligible for coverage under Medicare, unless the coverage received
164	164	from the pool is Medicare supplement coverage issued by the pool; or
165	165	(8) at the time the individual ceases to meet the
166	166	eligibility requirements for coverage.
167	167	SECTION 13. Section 1551.004(a), Insurance Code, is amended
168	168	to read as follows:
169	169	(a) In this chapter, "dependent" with respect to an
170	170	individual eligible to participate in the group benefits program
171	171	under Section 1551.101 or 1551.102 means the individual's:
172	172	(1) spouse;
173	173	(2) unmarried child younger than 29 [25] years of age;
174	174	(3) child of any age who the board of trustees
175	175	determines lives with or has the child's care provided by the
176	176	individual on a regular basis if:
177	177	(A) the child is mentally retarded or physically
178	178	incapacitated to the extent that the child is dependent on the
179	179	individual for care or support, as determined by the board of
180	180	trustees;
181	181	(B) the child's coverage under this chapter has
182	182	not lapsed; and
183	183	(C) the child is at least 29 [25] years old and
184	184	was enrolled as a participant in the health benefits coverage under
185	185	the group benefits program on the date of the child's 29th [25th]
186	186	birthday; and
187	187	(4) child of any age who is unmarried, for purposes of
188	188	health benefit coverage under this chapter, on expiration of the
189	189	child's continuation coverage under the Consolidated Omnibus
190	190	Budget Reconciliation Act of 1985 (Pub. L. No. 99-272) and its
191	191	subsequent amendments.
192	192	SECTION 14. Section 1551.158(a), Insurance Code, is amended
193	193	to read as follows:
194	194	(a) A dependent child who is unmarried and whose coverage
195	195	under this chapter ends when the child becomes 29 [25] years of age
196	196	may, on expiration of continuation coverage under the Consolidated
197	197	Omnibus Budget Reconciliation Act of 1985 (Pub. L. No. 99-272),
198	198	reinstate health benefit plan coverage under this chapter if the
199	199	child, or the child's participating parent, pays the full cost of
200	200	the health benefit plan coverage.
201	201	SECTION 15. Section 1575.003(1), Insurance Code, is amended
202	202	to read as follows:
203	203	(1) "Dependent" means:
204	204	(A) the spouse of a retiree;
205	205	(B) an unmarried child of a retiree or deceased
206	206	active member if the child is younger than 29 [25] years of age,
207	207	including:
208	208	(i) an adopted child;
209	209	(ii) a foster child, stepchild, or other
210	210	child who is in a regular parent-child relationship; or
211	211	(iii) a recognized natural child;
212	212	(C) a retiree's recognized natural child,
213	213	adopted child, foster child, stepchild, or other child who is in a
214	214	regular parent-child relationship and who lives with or has his or
215	215	her care provided by the retiree or surviving spouse on a regular
216	216	basis regardless of the child's age, if the child is mentally
217	217	retarded or physically incapacitated to an extent that the child is
218	218	dependent on the retiree or surviving spouse for care or support, as
219	219	determined by the trustee; or
220	220	(D) a deceased active member's recognized
221	221	natural child, adopted child, foster child, stepchild, or other
222	222	child who is in a regular parent-child relationship, without regard
223	223	to the age of the child, if, while the active member was alive, the
224	224	child:
225	225	(i) lived with or had the child's care
226	226	provided by the active member on a regular basis; and
227	227	(ii) was mentally retarded or physically
228	228	incapacitated to an extent that the child was dependent on the
229	229	active member or surviving spouse for care or support, as
230	230	determined by the trustee.
231	231	SECTION 16. Section 1579.004, Insurance Code, is amended to
232	232	read as follows:
233	233	Sec. 1579.004. DEFINITION OF DEPENDENT. In this chapter,
234	234	"dependent" means:
235	235	(1) a spouse of a full-time employee or part-time
236	236	employee;
237	237	(2) an unmarried child of a full-time or part-time
238	238	employee if the child is younger than 29 [25] years of age,
239	239	including:
240	240	(A) an adopted child;
241	241	(B) a foster child, stepchild, or other child who
242	242	is in a regular parent-child relationship; and
243	243	(C) a recognized natural child;
244	244	(3) a full-time or part-time employee's recognized
245	245	natural child, adopted child, foster child, stepchild, or other
246	246	child who is in a regular parent-child relationship and who lives
247	247	with or has his or her care provided by the employee or the
248	248	surviving spouse on a regular basis, regardless of the child's age,
249	249	if the child is mentally retarded or physically incapacitated to an
250	250	extent that the child is dependent on the employee or surviving
251	251	spouse for care or support, as determined by the board of trustees;
252	252	and
253	253	(4) notwithstanding any other provision of this code,
254	254	any other dependent of a full-time or part-time employee specified
255	255	by rules adopted by the board of trustees.
256	256	SECTION 17. Section 1601.004(a), Insurance Code, is amended
257	257	to read as follows:
258	258	(a) In this chapter, "dependent," with respect to an
259	259	individual eligible to participate in the uniform program under
260	260	Section 1601.101 or 1601.102, means the individual's:
261	261	(1) spouse;
262	262	(2) unmarried child younger than 29 [25] years of age;
263	263	and
264	264	(3) child of any age who lives with or has the child's
265	265	care provided by the individual on a regular basis if the child is
266	266	mentally retarded or physically incapacitated to the extent that
267	267	the child is dependent on the individual for care or support, as
268	268	determined by the system.
269	269	SECTION 18. The change in law made by this Act applies only
270	270	to a health benefit plan that is delivered, issued for delivery, or
271	271	renewed on or after January 1, 2010. A policy delivered, issued for
272	272	delivery, or renewed before January 1, 2010, is governed by the law
273	273	as it existed immediately before the effective date of this Act, and
274	274	that law is continued in effect for that purpose.
275	275	SECTION 19. This Act takes effect September 1, 2009.