Texas 2009 - 81st Regular

Texas Senate Bill SB77 Compare Versions

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

Old	New	Differences
1	1	81R2562 PMO-D
2	2	By: Nelson S.B. No. 77
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	business entity that:
14	14	(A) is owned and operated by a sole proprietor;
15	15	(B) employs an average of fewer than two
16	16	employees on business days during the preceding calendar year; and
17	17	(C) is eligible to participate in a cooperative
18	18	under this subchapter in accordance with Section 1501.066.
19	19	SECTION 2. Section 1501.0581, Insurance Code, is amended by
20	20	amending Subsections (a), (b), and (p) and adding Subsection (o-1)
21	21	to read as follows:
22	22	(a) The membership of a health group cooperative may consist
23	23	of only small employers, only large employers, or only eligible
24	24	single-employee businesses, but may not consist of a combination of
25	25	those types of entities [or both small and large employers]. To
26	26	participate as a member of a health group cooperative, an employer
27	27	must be a small or large employer as described by this chapter or an
28	28	eligible single-employee business as described by Section
29	29	1501.051(3-b).
30	30	(b) Subject to the requirements imposed on small employer
31	31	health benefit plan issuers under Section 1501.101 and subject to
32	32	Subsections (a-1) and (o), a health group cooperative:
33	33	(1) shall allow a small employer to join a health group
34	34	cooperative consisting of only small employers or both small and
35	35	large employers and enroll in health benefit plan coverage; [and]
36	36	(2) may allow an eligible single-employee business to
37	37	join a health group cooperative consisting of only eligible
38	38	single-employee businesses and enroll in health benefit plan
39	39	coverage; and
40	40	(3) may allow a large employer to join the health group
41	41	cooperative and enroll in health benefit plan coverage.
42	42	(o-1) A health group cooperative consisting only of
43	43	eligible single-employee businesses may elect to restrict
44	44	membership in the cooperative so that the total number of eligible
45	45	employees employed on business days during the preceding calendar
46	46	year by all eligible single-employee businesses participating in
47	47	the cooperative does not exceed 50.
48	48	(p) A health group cooperative must make the election
49	49	described by Subsection (o) or (o-1) at the time the cooperative is
50	50	initially formed. Evidence of the election must be filed in writing
51	51	with the commissioner in the form and at the time prescribed by the
52	52	commissioner by rule.
53	53	SECTION 3. Sections 1501.063(b-1) and (b-2), Insurance
54	54	Code, are amended to read as follows:
55	55	(b-1) Subject to Section 1501.066, a [A] health group
56	56	cooperative that is composed only of small employers or only of
57	57	eligible single-employee businesses and that has made the election
58	58	described by Section 1501.0581(o)(1) or (o-1), as applicable, in
59	59	accordance with Subsection (p) of that section shall be treated in
60	60	the same manner as a small employer for the purposes of this
61	61	chapter, including for the purposes of any provision relating to
62	62	premium rates and issuance and renewal of coverage.
63	63	(b-2) A health group cooperative that is composed only of
64	64	small employers or only of eligible single-employee businesses and
65	65	that has not made the election described by Section 1501.0581(o)(1)
66	66	or (o-1), as applicable, in accordance with Subsection (p) of that
67	67	section, or a health group cooperative that is composed of both
68	68	small and large employers, may be treated in the same manner as a
69	69	large employer for the purposes of this chapter, including for the
70	70	purposes of any provision relating to premium rates and issuance
71	71	and renewal of coverage.
72	72	SECTION 4. Subchapter B, Chapter 1501, Insurance Code, is
73	73	amended by adding Sections 1501.066 and 1501.067 to read as
74	74	follows:
75	75	Sec. 1501.066. ELIGIBLE SINGLE-EMPLOYEE BUSINESS. (a) The
76	76	commissioner by rule shall adopt rules governing the eligibility of
77	77	a single-employee business to participate in a health group
78	78	cooperative under this subchapter. The rules must include
79	79	provisions to ensure that each eligible single-employee business
80	80	has a business purpose and was not formed solely to obtain health
81	81	benefit plan coverage under this subchapter.
82	82	(b) The commissioner may specify additional requirements
83	83	for a health group cooperative composed solely of eligible
84	84	single-employee businesses to qualify for coverage as a small
85	85	employer under this chapter or, if the commissioner finds that
86	86	treatment of such a cooperative as a small employer is not
87	87	actuarially justified, may require that a health group cooperative
88	88	composed solely of eligible single-employee businesses be treated
89	89	as a large employer under this chapter.
90	90	Sec. 1501.067. COOPERATIVES FOR SMALL EMPLOYERS, LARGE
91	91	EMPLOYERS, AND SINGLE-EMPLOYEE BUSINESSES. The department may
92	92	develop a program to assist small employers, large employers, and
93	93	single-employee businesses to form or participate in private
94	94	purchasing cooperatives and health group cooperatives in
95	95	accordance with this subchapter.
96	96	SECTION 5. The commissioner of insurance shall adopt any
97	97	rules necessary to implement the change in law made by this Act not
98	98	later than December 1, 2009. A person may not form a health group
99	99	cooperative composed solely of eligible single-employee businesses
100	100	under Subchapter B, Chapter 1501, Insurance Code, as amended by
101	101	this Act, before January 1, 2010.
102	102	SECTION 6. This Act takes effect September 1, 2009.