81R4286 PMO-F
By: Averitt S.B. No. 842
A BILL TO BE ENTITLED
AN ACT
relating to the operation of health care sharing organizations.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Participants of a health care sharing
organization voluntarily assist fellow participants with the
payment of medical expenses. In many instances, participants of a
health care sharing organization provide assistance to individuals
who are without health insurance coverage and, in doing so, provide
important services that the state would otherwise have to provide.
Due to their beneficial work and religious nature, health care
sharing organizations should be statutorily recognized as
religious organizations helping to fulfill the religious beliefs of
organization participants and should not be treated in the same
manner as secular health care coverages, including insurance.
SECTION 2. Title 8, Insurance Code, is amended by adding
Subtitle K to read as follows:
SUBTITLE K. NONINSURANCE HEALTH COVERAGES
CHAPTER 1680. HEALTH CARE SHARING ORGANIZATIONS
Sec. 1680.001. SHORT TITLE. This chapter may be cited as
the Health Care Sharing Organizations Freedom to Share Act.
Sec. 1680.002. DEFINITION. In this chapter, "health care
sharing organization" means an organization qualified as a
religious organization under Section 11.20, Tax Code, that
administers a health care sharing arrangement among individuals of
the same religion based on the individuals' sincerely held
religious beliefs.
Sec. 1680.003. POWERS. A health care sharing organization
may:
(1) act as a facilitator among participants who have
financial or medical-related needs and participants with the
present ability to assist those with financial or medical-related
needs, all in accordance with the health care sharing
organization's criteria, through payments from one participant to
another;
(2) notify a participant of sharing amounts;
(3) establish additional qualifications of
participation in the health care sharing arrangement;
(4) limit the financial or medical-related needs that
may be eligible for payment among the participants;
(5) cancel a participant's participation in the health
care sharing arrangement if the participant fails to make a
specific payment to another participant before the 60th day after
the date the payment is due; and
(6) provide a written monthly statement to all
participants listing the total dollar amount of qualified needs
submitted to the organization as well as the total dollar amount
actually assigned to participants for sharing.
Sec. 1680.004. NOTICE. Each application for participation
in a health care sharing arrangement distributed directly or on
behalf of the health care sharing organization must include a
notice that is printed in no smaller than 12-point font and that
reads substantially as follows:
"This health care sharing organization is not offering
an insurance product and the health care sharing
arrangement is not being offered by or through an
insurance company. This health care sharing
organization is also not offering a discount health
care program. Whether anyone chooses to assist you
with your medical bills is voluntary, as no other
participant may be compelled to share payment of your
medical bills. This health care sharing arrangement
is not insurance or a substitute for insurance.
Whether you receive any payments for medical expenses
and whether this health care sharing organization or
arrangement continues to operate, you remain, to the
extent allowable under law, personally and fully
responsible for the payment of your own medical
bills."
Sec. 1680.005. DUTIES. (a) A health care sharing
organization shall require any adult member to sign on behalf of the
participant or, in the case of a minor or dependent child, on behalf
of the minor or dependent child, an acknowledgment that the member
has read and understands the notice described by Section 1680.004.
(b) A health care sharing organization shall retain the
signed acknowledgment described by Subsection (a) until the second
anniversary of the last date of the participant's participation in
the health care sharing arrangement.
Sec. 1680.006. CONSTRUCTION WITH OTHER LAW. (a) Chapter
76, Health and Safety Code, does not apply to a health care sharing
organization.
(b) Notwithstanding any other provision of this code, a
health care sharing organization is exempt from the operation of
the insurance laws of this state and is not subject to the
commissioner's oversight.
Sec. 1680.007. ENFORCEMENT BY ATTORNEY GENERAL.
Notwithstanding any other law, the office of the attorney general
has jurisdiction over health care sharing organizations to ensure
compliance with this chapter and for:
(1) the prevention and prosecution of deceptive trade
practices and fraud; and
(2) consumer protection.
Sec. 1680.008. NO ASSUMPTION OF RISK. Participants in a
health care sharing arrangement and the health care sharing
organization do not assume any risk or make any promise to pay the
financial or medical-related needs of other participants, and none
of the activities in this chapter give rise to an assumption of risk
or promise to pay by either the participants or the health care
sharing organization.
Sec. 1680.009. PAYMENT AMONG PARTICIPANTS. The means of
payment among participants may include an electronic transfer or a
distribution from a trust established solely for the participants'
benefit and that is audited annually by an independent auditing
firm.
Sec. 1680.010. COLLATERAL SHARING ACTIVITIES. A health
care sharing organization may:
(1) arrange for participants to share bills when a
participant experiences disability; and
(2) provide health counseling, education, and
resources to participants in the health care sharing arrangement.
Sec. 1680.011. CONTRACTUAL ARRANGEMENTS WITH OTHER
ENTITIES. A health care sharing organization may contract with an
administrator as defined by Chapter 4151, Insurance Code, or a
preferred provider organization or similar entity to facilitate the
operation of the organization.
SECTION 3. Section 101.055(a), Insurance Code, is amended
to read as follows:
(a) Section 101.051(b)(7) does not apply to:
(1) a program otherwise authorized by law that is
established:
(A) by a political subdivision of this state;
(B) by a state agency; or
(C) under Chapter 791, Government Code; [or]
(2) a multiple employer welfare arrangement that is
fully insured as defined by 29 U.S.C. Section 1144(b)(6); or
(3) a health care sharing organization operated under
Chapter 1680.
SECTION 4. Section 76.002, Health and Safety Code, is
amended to read as follows:
Sec. 76.002. CONSTRUCTION WITH [APPLICABILITY OF] OTHER
LAW. (a) In addition to the requirements of this chapter, a
program operator or marketer is subject to the applicable consumer
protection laws under Chapter 17, Business & Commerce Code.
(b) This chapter does not apply to a health care sharing
organization operated under Chapter 1680, Insurance Code.
SECTION 5. 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.