By: Nelson S.B. No. 76
A BILL TO BE ENTITLED
AN ACT
relating to authorizing a children's health benefit plan for
certain small employers.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 1501.002, Insurance Code, is amended by
adding Subdivision (1-a) and amending Subdivision (15) to read as
follows:
(1-a) "Children's health benefit plan" means a health
benefit plan offered in accordance with Section 1501.2525.
(15) "Small employer health benefit plan" means a
health benefit plan developed by the commissioner under Subchapter
F or any other health benefit plan offered to a small employer in
accordance with Section 1501.252(c) or 1501.255. The term includes
a children's health benefit plan.
SECTION 2. Section 1501.003, Insurance Code, is amended to
read as follows:
Sec. 1501.003. APPLICABILITY: SMALL EMPLOYER HEALTH
BENEFIT PLANS. (a) An individual or group health benefit plan is a
small employer health benefit plan subject to Subchapters C-H if it
provides health care benefits covering two or more eligible
employees of a small employer and:
(1) the employer pays a portion of the premium or
benefits;
(2) the employer or a covered individual treats the
health benefit plan as part of a plan or program for purposes of
Section 106 or 162, Internal Revenue Code of 1986 (26 U.S.C. Section
106 or 162); or
(3) the health benefit plan is an employee welfare
benefit plan under 29 C.F.R. Section 2510.3-1(j).
(b) A children's health benefit plan is a small employer
benefit plan and, except as specifically provided by Section
1501.2525, is subject to Subchapters C-H in the same manner as any
other small employer health benefit plan.
SECTION 3. Section 1501.154, Insurance Code, is amended by
amending Subsection (b) and adding Subsection (d) to read as
follows:
(b) If a small employer offers multiple health benefit
plans, the collective participation in those plans, including any
children's health benefit plan, must be at least:
(1) 75 percent of the employer's eligible employees;
or
(2) if applicable, the lower participation level
offered by the small employer health benefit plan issuer under
Section 1501.155.
(d) A children's health benefit plan is included for
collective participation purposes under this section if an employee
chooses to enroll one or more dependents in a children's health
benefit plan rather than in a health benefit plan described by
Section 1501.003(a).
SECTION 4. Subchapter F, Chapter 1501, Insurance Code, is
amended by adding Section 1501.2525 to read as follows:
Sec. 1501.2525. CHILDREN'S HEALTH BENEFIT PLAN. (a) A
small employer health benefit plan issuer may offer to a small
employer a children's health benefit plan in accordance with this
section.
(b) A children's health benefit plan provides coverage to
children younger than 25 years of age who are dependents of eligible
employees.
(c) A children's health benefit plan may not provide
coverage to an eligible employee or the spouse of an eligible
employee.
(d) The commissioner by rule shall adopt minimum benefits
required to be provided under a children's health benefit plan.
(e) This subchapter applies to a children's health benefit
plan except to the extent the commissioner by rule determines that a
provision of this subchapter is inappropriate as applied to a
children's health benefit plan.
SECTION 5. Subchapter B, Chapter 1502, Insurance Code, is
amended by adding Section 1502.054 to read as follows:
Sec. 1502.054. INAPPLICABILITY OF OTHER LAW. A children's
health benefit plan offered under this chapter is not subject to
Section 1501.2525.
SECTION 6. The commissioner of insurance shall adopt any
rules necessary to implement the change in law made by this Act not
later than December 1, 2009. A small employer health benefit plan
issuer may not offer a children's health benefit plan under Section
1501.2525, Insurance Code, as added by this Act, before January 1,
2010.
SECTION 7. This Act takes effect September 1, 2009.