Texas 2009 - 81st Regular

Texas Senate Bill SR1101 Compare Versions

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1	1	By: Nelson S.R. No. 1101
2	2
3	3
4	4	SENATE RESOLUTION
5	5	BE IT RESOLVED by the Senate of the State of Texas, 81st
6	6	Legislature, Regular Session, 2009, That Senate Rule 12.03 be
7	7	suspended in part as provided by Senate Rule 12.08 to enable the
8	8	conference committee appointed to resolve the differences on
9	9	Senate Bill No. 78, relating to promoting awareness and education
10	10	about the purchase and availability of health coverage, to
11	11	consider and take action on the following matter:
12	12	Senate Rule 12.03(4) is suspended to permit the committee
13	13	to add text that is not in disagreement to Subtitle G, Title 8,
14	14	Insurance Code, by adding Chapter 1508 to read as follows:
15	15	ARTICLE 2. HEALTHY TEXAS PROGRAM
16	16	SECTION 2.01. Subtitle G, Title 8, Insurance Code, is
17	17	amended by adding Chapter 1508 to read as follows:
18	18	CHAPTER 1508. HEALTHY TEXAS PROGRAM
19	19	SUBCHAPTER A. GENERAL PROVISIONS
20	20	Sec. 1508.001. PURPOSE. (a) The purposes of the Healthy
21	21	Texas Program are to:
22	22	(1) provide access to quality small employer health
23	23	benefit plans at an affordable price;
24	24	(2) encourage small employers to offer health
25	25	benefit plan coverage to employees and the dependents of
26	26	employees; and
27	27	(3) maximize reliance on proven managed care
28	28	strategies and procedures.
29	29	(b) The Healthy Texas Program is not intended to diminish
30	30	the availability of traditional small employer health benefit
31	31	plan coverage under Chapter 1501.
32	32	Sec. 1508.002. DEFINITIONS. In this chapter:
33	33	(1) "Dependent" has the meaning assigned by Section
34	34	1501.002(2).
35	35	(2) "Eligible employee" has the meaning assigned by
36	36	Section 1501.002(3).
37	37	(3) "Fund" means the healthy Texas small employer
38	38	premium stabilization fund established under Subchapter F.
39	39	(4) "Health benefit plan" and "health benefit plan
40	40	issuer" have the meanings assigned by Sections 1501.002(5) and
41	41	1501.002(6), respectively.
42	42	(5) "Program" means the Healthy Texas Program
43	43	established under this chapter.
44	44	(6) "Qualifying health benefit plan" means a health
45	45	benefit plan that provides benefits for health care services in
46	46	the manner described by this chapter.
47	47	(7) "Small employer" has the meaning assigned by
48	48	Section 1501.002(14).
49	49	Sec. 1508.003. RULES. The commissioner may adopt rules
50	50	as necessary to implement this chapter.
51	51	[Sections 1508.004-1508.050 reserved for expansion]
52	52	SUBCHAPTER B. EMPLOYER ELIGIBILITY; CONTRIBUTIONS
53	53	Sec. 1508.051. EMPLOYER ELIGIBILITY TO PARTICIPATE.
54	54	(a) A small employer may participate in the program if:
55	55	(1) during the 12-month period immediately
56	56	preceding the date of application for a qualifying health benefit
57	57	plan, the small employer does not offer employees group health
58	58	benefits on an expense-reimbursed or prepaid basis; and
59	59	(2) at least 30 percent of the small employer's
60	60	eligible employees receive annual wages from the employer in an
61	61	amount that is equal to or less than 300 percent of the poverty
62	62	guidelines for an individual, as defined and updated annually by
63	63	the United States Department of Health and Human Services.
64	64	(b) A small employer ceases to be eligible to participate
65	65	in the program if any health benefit plan that provides employee
66	66	benefits on an expense-reimbursed or prepaid basis, other than
67	67	another qualifying health benefit plan, is purchased or
68	68	otherwise takes effect after the purchase of a qualifying health
69	69	benefit plan.
70	70	Sec. 1508.052. COMMISSIONER ADJUSTMENTS AUTHORIZED.
71	71	(a) The commissioner by rule may adjust the 12-month period
72	72	described by Section 1508.051(a)(1) to an 18-month period if the
73	73	commissioner determines that the 12-month period is insufficient
74	74	to prevent inappropriate substitution of other health benefit
75	75	plans for qualifying health benefit plan coverage under this
76	76	chapter.
77	77	(b) The commissioner by rule may adjust the percentage of
78	78	the poverty guidelines described by Section 1508.051(a)(2) to a
79	79	higher or lower percentage if the commissioner determines that
80	80	the adjustment is necessary to fulfill the purposes of this
81	81	chapter. An adjustment made by the commissioner under this
82	82	subsection takes effect on the first July 1 following the
83	83	adjustment.
84	84	Sec. 1508.053. MINIMUM EMPLOYER PARTICIPATION
85	85	REQUIREMENTS. A small employer that meets the eligibility
86	86	requirements described by Section 1508.051(a) may apply to
87	87	purchase a qualifying health benefit plan if 60 percent or more
88	88	of the employer's eligible employees elect to participate in the
89	89	plan.
90	90	Sec. 1508.054. EMPLOYER CONTRIBUTION REQUIREMENTS.
91	91	(a) A small employer that purchases a qualifying health benefit
92	92	plan must:
93	93	(1) pay 50 percent or more of the premium for each
94	94	employee covered under the qualifying health benefit plan;
95	95	(2) offer coverage to all eligible employees
96	96	receiving annual wages from the employer in an amount described
97	97	by Section 1508.051(a)(2) or 1508.052(b), as applicable; and
98	98	(3) contribute the same percentage of premium for
99	99	each covered employee.
100	100	(b) A small employer that purchases a qualifying health
101	101	benefit plan under the program may elect to pay, but is not
102	102	required to pay, all or any portion of the premium paid for
103	103	dependent coverage under the qualifying health benefit plan.
104	104	[Sections 1508.055-1508.100 reserved for expansion]
105	105	SUBCHAPTER C. PROGRAM PARTICIPATION; REQUIRED COVERAGE AND
106	106	BENEFITS
107	107	Sec. 1508.101. PARTICIPATING PLAN ISSUERS. (a) Subject
108	108	to Subsection (b), any health benefit plan issuer may participate
109	109	in the program.
110	110	(b) The commissioner by rule may limit which health
111	111	benefit plan issuers may participate in the program if the
112	112	commissioner determines that the limitation is necessary to
113	113	achieve the purposes of this chapter.
114	114	(c) If the commissioner limits participation in the
115	115	program under Subsection (b), the commissioner shall contract on
116	116	a competitive procurement basis with one or more health benefit
117	117	plan issuers to provide qualifying health benefit plan coverage
118	118	under the program.
119	119	(d) Nothing in this chapter prohibits a regional or local
120	120	health care program described by Chapter 75, Health and Safety
121	121	Code, from participating in the program. The commissioner by
122	122	rule shall establish participation requirements applicable to
123	123	regional and local health care programs that consider the unique
124	124	plan designs, benefit levels, and participation criteria of each
125	125	program.
126	126	Sec. 1508.102. PREEXISTING CONDITION PROVISION
127	127	REQUIRED. A health benefit plan offered under the program must
128	128	include a preexisting condition provision that meets the
129	129	requirements described by Section 1501.102.
130	130	Sec. 1508.103. EXCEPTION FROM MANDATED BENEFIT
131	131	REQUIREMENTS. Except as expressly provided by this chapter, a
132	132	small employer health benefit plan issued under the program is
133	133	not subject to a law of this state that requires coverage or the
134	134	offer of coverage of a health care service or benefit.
135	135	Sec. 1508.104. CERTAIN COVERAGE PROHIBITED OR REQUIRED.
136	136	(a) A qualifying health benefit plan may only provide coverage
137	137	for in-plan services and benefits, except for:
138	138	(1) emergency care; or
139	139	(2) other services not available through a plan
140	140	provider.
141	141	(b) In-plan services and benefits provided under a
142	142	qualifying health benefit plan must include the following:
143	143	(1) inpatient hospital services;
144	144	(2) outpatient hospital services;
145	145	(3) physician services; and
146	146	(4) prescription drug benefits.
147	147	(c) The commissioner may approve in-plan benefits other
148	148	than those required under Subsection (b) or emergency care or
149	149	other services not available through a plan provider if the
150	150	commissioner determines the inclusion to be essential to achieve
151	151	the purposes of this chapter.
152	152	(d) The commissioner may, with respect to the categories
153	153	of services and benefits described by Subsections (b) and (c):
154	154	(1) prepare specifications for a coverage provided
155	155	under this chapter;
156	156	(2) determine the methods and procedures of claims
157	157	administration;
158	158	(3) establish procedures to decide contested cases
159	159	arising from coverage provided under this chapter;
160	160	(4) study, on an ongoing basis, the operation of all
161	161	coverages provided under this chapter, including gross and net
162	162	costs, administration costs, benefits, utilization of benefits,
163	163	and claims administration;
164	164	(5) administer the healthy Texas small employer
165	165	premium stabilization fund established under Subchapter F;
166	166	(6) provide the beginning and ending dates of
167	167	coverages for enrollees in a qualifying health benefit plan;
168	168	(7) develop basic group coverage plans applicable
169	169	to all individuals eligible to participate in the program;
170	170	(8) provide for optional group coverage plans in
171	171	addition to the basic group coverage plans described by
172	172	Subdivision (7);
173	173	(9) provide, as determined to be appropriate by the
174	174	commissioner, additional statewide optional coverage plans;
175	175	(10) develop specific health benefit plans that
176	176	permit access to high-quality, cost-effective health care;
177	177	(11) design, implement, and monitor health benefit
178	178	plan features intended to discourage excessive utilization,
179	179	promote efficiency, and contain costs for qualifying health
180	180	benefit plans;
181	181	(12) develop and refine, on an ongoing basis, a
182	182	health benefit strategy for the program that is consistent with
183	183	evolving benefits delivery systems;
184	184	(13) develop a funding strategy that efficiently
185	185	uses employer contributions to achieve the purposes of this
186	186	chapter; and
187	187	(14) modify the copayment and deductible amounts
188	188	for prescription drug benefits under a qualifying health benefit
189	189	plan, if the commissioner determines that the modification is
190	190	necessary to achieve the purposes of this chapter.
191	191	[Sections 1508.105-1508.150 reserved for expansion]
192	192	SUBCHAPTER D. PROGRAM ADMINISTRATION
193	193	Sec. 1508.151. EMPLOYER CERTIFICATION. (a) At the time
194	194	of initial application, a health benefit plan issuer shall obtain
195	195	from a small employer that seeks to purchase a qualifying health
196	196	benefit plan a written certification that the employer meets the
197	197	eligibility requirements described by Section 1508.051 and the
198	198	minimum employer participation requirements described by Section
199	199	1508.053.
200	200	(b) Not later than the 90th day before the renewal date of
201	201	a qualifying health benefit plan, a health benefit plan issuer
202	202	shall obtain from the small employer that purchased the
203	203	qualifying health benefit plan a written certification that the
204	204	employer continues to meet the eligibility requirements
205	205	described by Section 1508.051 and the minimum employer
206	206	participation requirements described by Section 1508.053.
207	207	(c) A participating health benefit plan issuer may
208	208	require a small employer to submit appropriate documentation in
209	209	support of a certification described by Subsection (a) or (b).
210	210	Sec. 1508.152. APPLICATION PROCESS. (a) Subject to
211	211	Subsection (b), a health benefit plan issuer shall accept
212	212	applications for qualifying health benefit plan coverage from
213	213	small employers at all times throughout the calendar year.
214	214	(b) The commissioner may limit the dates on which a
215	215	health benefit plan issuer must accept applications for
216	216	qualifying health benefit plan coverage if the commissioner
217	217	determines the limitation to be necessary to achieve the purposes
218	218	of this chapter.
219	219	Sec. 1508.153. EMPLOYEE ENROLLMENT; WAITING PERIOD.
220	220	(a) A qualifying health benefit plan must provide employees
221	221	with an initial enrollment period that is 31 days or longer, and
222	222	annually at least one open enrollment period that is 31 days or
223	223	longer. The commissioner by rule may require an additional open
224	224	enrollment period if the commissioner determines that the
225	225	additional open enrollment period is necessary to achieve the
226	226	purposes of this chapter.
227	227	(b) A small employer may establish a waiting period for
228	228	employees during which an employee is not eligible for coverage
229	229	under a qualifying health benefit plan. The last day of a waiting
230	230	period established under this subsection may not be later than
231	231	the 90th day after the date on which the employee begins
232	232	employment with the small employer.
233	233	(c) A health benefit plan issuer may not deny coverage
234	234	under a qualifying health benefit plan to a new employee of a
235	235	small employer that purchased the qualifying health benefit plan
236	236	if the health benefit plan issuer receives an application for
237	237	coverage from the employee not later than the 31st day after the
238	238	latter of:
239	239	(1) the first day of the employee's employment; or
240	240	(2) the first day after the expiration of a waiting
241	241	period established under Subsection (b).
242	242	(d) Subject to Subsection (e), a health benefit plan
243	243	issuer may deny coverage under a qualifying health benefit plan
244	244	to an employee of a small employer who applies for coverage after
245	245	the period described by Subsection (c).
246	246	(e) A health benefit plan issuer that denies an employee
247	247	coverage under Subsection (d):
248	248	(1) may only deny the employee coverage until the
249	249	next open enrollment period; and
250	250	(2) may subject the enrollee to a one-year
251	251	preexisting condition provision, as described by Section
252	252	1508.102, if the period during which the preexisting condition
253	253	provision applies does not exceed 18 months from the date of the
254	254	initial application for coverage under the qualifying health
255	255	benefit plan.
256	256	Sec. 1508.154. REPORTS. A health benefit plan issuer
257	257	that participates in the program shall submit reports to the
258	258	department in the form and at the time the commissioner
259	259	prescribes.
260	260	[Sections 1508.155-1508.200 reserved for expansion]
261	261	SUBCHAPTER E. RATING OF QUALIFIED HEALTH BENEFIT PLANS
262	262	Sec. 1508.201. RATING; PREMIUM PRACTICES IN GENERAL.
263	263	(a) A health benefit plan issuer participating in the program
264	264	must:
265	265	(1) use rating practices for qualifying health
266	266	benefit plans that are consistent with the purposes of this
267	267	chapter; and
268	268	(2) in setting premiums for qualifying health
269	269	benefit plans, consider the availability of reimbursement from
270	270	the fund.
271	271	(b) A health benefit plan issuer participating in the
272	272	program shall apply rating factors consistently with respect to
273	273	all small employers in a class of business.
274	274	(c) Differences in premium rates charged for qualifying
275	275	health benefit plans must be reasonable and reflect objective
276	276	differences in plan design.
277	277	Sec. 1508.202. PREMIUM RATE DEVELOPMENT AND CALCULATION.
278	278	(a) Rating factors used to underwrite qualifying health benefit
279	279	plans must produce premium rates for identical groups that:
280	280	(1) differ only by the amounts attributable to
281	281	health benefit plan design; and
282	282	(2) do not reflect differences because of the nature
283	283	of the groups assumed to select a particular health benefit plan.
284	284	(b) A health benefit plan issuer shall treat each
285	285	qualifying health benefit plan that is issued or renewed in a
286	286	calendar month as having the same rating period.
287	287	(c) A health benefit plan issuer may use only age and
288	288	gender as case characteristics, as defined by Section
289	289	1501.201(2), in setting premium rates for a qualifying health
290	290	benefit plan.
291	291	(d) The commissioner by rule may establish additional
292	292	rating criteria and requirements for qualifying health benefit
293	293	plans if the commissioner determines that the criteria and
294	294	requirements are necessary to achieve the purposes of this
295	295	chapter.
296	296	Sec. 1508.203. FILING; APPROVAL. (a) A health benefit
297	297	plan issuer shall file with the department, for review and
298	298	approval by the commissioner, premium rates to be charged for
299	299	qualifying health benefit plans.
300	300	(b) If the commissioner limits health benefit plan issuer
301	301	participation in the program under Section 1508.101(b), premium
302	302	rates proposed to be charged for each qualifying health benefit
303	303	plan will be considered as an element in the contract procurement
304	304	process required under that section.
305	305	[Sections 1508.204-1508.250 reserved for expansion]
306	306	SUBCHAPTER F. HEALTHY TEXAS SMALL EMPLOYER PREMIUM
307	307	STABILIZATION FUND
308	308	Sec. 1508.251. ESTABLISHMENT OF FUND. (a) To the extent
309	309	that funds appropriated to the department are available for this
310	310	purpose, the commissioner shall establish a fund from which
311	311	health benefit plan issuers may receive reimbursement for claims
312	312	paid by the health benefit plan issuers for individuals covered
313	313	under qualifying group health plans.
314	314	(b) The fund established under this section shall be
315	315	known as the healthy Texas small employer premium stabilization
316	316	fund.
317	317	(c) The commissioner shall adopt rules necessary to
318	318	implement and administer the fund, including rules that set out
319	319	the procedures for operation of the fund and distribution of
320	320	money from the fund.
321	321	Sec. 1508.252. OPERATION OF FUND; CLAIM ELIGIBILITY.
322	322	(a) A health benefit plan issuer is eligible to receive
323	323	reimbursement in an amount that is equal to 80 percent of the
324	324	dollar amount of claims paid between $5,000 and $75,000 in a
325	325	calendar year for an enrollee in a qualifying health benefit
326	326	plan.
327	327	(b) A health benefit plan issuer is eligible for
328	328	reimbursement from the fund only for the calendar year in which
329	329	claims are paid.
330	330	(c) Once the dollar amount of claims paid on behalf of a
331	331	covered individual reaches or exceeds $75,000 in a given calendar
332	332	year, a health benefit plan issuer may not receive reimbursement
333	333	for any other claims paid on behalf of the individual in that
334	334	calendar year.
335	335	Sec. 1508.253. REIMBURSEMENT REQUEST SUBMISSION. (a) A
336	336	health benefit plan issuer seeking reimbursement from the fund
337	337	shall submit a request for reimbursement in the form prescribed
338	338	by the commissioner by rule.
339	339	(b) A health benefit plan issuer must request
340	340	reimbursement from the fund annually, not later than the date
341	341	determined by the commissioner, following the end of the calendar
342	342	year for which the reimbursement requests are made.
343	343	(c) The commissioner may require a health benefit plan
344	344	issuer participating in the program to submit claims data in
345	345	connection with reimbursement requests as the commissioner
346	346	determines to be necessary to ensure appropriate distribution of
347	347	reimbursement funds and oversee the operation of the fund. The
348	348	commissioner may require that the data be submitted on a per
349	349	covered individual, aggregate, or categorical basis.
350	350	Sec. 1508.254. FUND AVAILABILITY. (a) The commissioner
351	351	shall compute the total claims reimbursement amount for all
352	352	health benefit plan issuers participating in the program for the
353	353	calendar year for which claims are reported and reimbursement
354	354	requested.
355	355	(b) If the total amount requested by health benefit plan
356	356	issuers participating in the program for reimbursement for a
357	357	calendar year exceeds the amount of funds available for
358	358	distribution for claims paid during that same calendar year, the
359	359	commissioner shall provide for the pro rata distribution of any
360	360	available funds. A health benefit plan issuer participating in
361	361	the program is eligible to receive a proportional amount of any
362	362	available funds that is equal to the proportion of total eligible
363	363	claims paid by all participating health benefit plan issuers that
364	364	the requesting health benefit plan issuer paid.
365	365	(c) If the amount of funds available for distribution for
366	366	claims paid by all health benefit plan issuers participating in
367	367	the program during a calendar year exceeds the total amount
368	368	requested for reimbursement by all participating health benefit
369	369	plan issuers during that calendar year, the commissioner shall
370	370	carry forward any excess funds and make those excess funds
371	371	available for distribution in the next calendar year. Excess
372	372	funds carried over under this section are added to the fund in
373	373	addition to any other money appropriated for the fund for the
374	374	calendar year into which the funds are carried forward.
375	375	Sec. 1508.255. PROGRAM REPORTING. (a) Each health
376	376	benefit plan issuer participating in the program shall provide
377	377	the department, in the form prescribed by the commissioner,
378	378	monthly reports of total enrollment under qualifying health
379	379	benefit plans.
380	380	(b) On the request of the commissioner, each health
381	381	benefit plan issuer participating in the program shall furnish to
382	382	the department, in the form prescribed by the commissioner, data
383	383	other than data described by Subsection (a) that the commissioner
384	384	determines necessary to oversee the operation of the fund.
385	385	Sec. 1508.256. CLAIMS EXPERIENCE DATA. (a) Based on
386	386	available data and appropriate actuarial assumptions, the
387	387	commissioner shall separately estimate the per covered
388	388	individual annual cost of total claims reimbursement from the
389	389	fund for qualifying health benefit plans.
390	390	(b) On request, a health benefit plan issuer
391	391	participating in the program shall furnish to the department
392	392	claims experience data for use in the estimates described by
393	393	Subsection (a).
394	394	Sec. 1508.257. TOTAL ELIGIBLE ENROLLMENT DETERMINATION.
395	395	(a) The commissioner shall determine total eligible enrollment
396	396	under qualifying health benefit plans by dividing the total funds
397	397	available for distribution from the fund by the estimated per
398	398	covered individual annual cost of total claims reimbursement
399	399	from the fund.
400	400	(b) At the end of the first year of enrollment and
401	401	annually thereafter, the commissioner shall submit a report to
402	402	the governor and the legislature regarding enrollment for the
403	403	previous year and limitations on future enrollment that ensure
404	404	that the Healthy Texas Program does not necessitate a substantial
405	405	increase in funding to continue the program, as consistent with
406	406	Section 1508.001.
407	407	Sec. 1508.258. EVALUATION AND PROTECTION OF FUND;
408	408	EMPLOYER ENROLLMENT SUSPENSION. (a) The commissioner shall
409	409	suspend the enrollment of new employers in qualifying health
410	410	benefit plans if the commissioner determines that the total
411	411	enrollment reported by all health benefit plan issuers under
412	412	qualifying health benefit plans exceeds the total eligible
413	413	enrollment determined under Section 1508.257 and is likely to
414	414	result in anticipated annual expenditures from the fund in excess
415	415	of the total funds available for distribution from the fund.
416	416	(b) The commissioner shall provide a health benefit plan
417	417	issuer participating in the program with notification of any
418	418	enrollment suspension under Subsection (a) as soon as
419	419	practicable after:
420	420	(1) receipt of all enrollment data; and
421	421	(2) determination of the need to suspend
422	422	enrollment.
423	423	(c) A suspension of issuance of qualifying health benefit
424	424	plans to employers under Subsection (a) does not preclude the
425	425	addition of new employees of an employer already covered under a
426	426	qualifying health benefit plan or new dependents of employees
427	427	already covered under a qualifying health benefit plan.
428	428	Sec. 1508.259. EMPLOYER ENROLLMENT REACTIVATION. If, at
429	429	any point during a suspension of enrollment under Section
430	430	1508.258, the commissioner determines that funds are sufficient
431	431	to provide for the addition of new enrollments, the commissioner:
432	432	(1) may reactivate new enrollments; and
433	433	(2) shall notify all participating group health
434	434	benefit plan issuers that enrollment of new employers may be
435	435	resumed.
436	436	Sec. 1508.260. FUND ADMINISTRATOR. (a) The
437	437	commissioner may obtain the services of an independent
438	438	organization to administer the fund.
439	439	(b) The commissioner shall establish guidelines for the
440	440	submission of proposals by organizations for the purposes of
441	441	administering the fund and may approve, disapprove, or recommend
442	442	modification to the proposal of an applicant to administer the
443	443	fund.
444	444	(c) An organization approved to administer the fund shall
445	445	submit reports to the commissioner, in the form and at the times
446	446	required by the commissioner, as necessary to facilitate
447	447	evaluation and ensure orderly operation of the fund, including an
448	448	annual report of the affairs and operations of the fund. The
449	449	annual report must also be delivered to the governor, the
450	450	lieutenant governor, and the speaker of the house of
451	451	representatives.
452	452	(d) An organization approved to administer the fund shall
453	453	maintain records in the form prescribed by the commissioner and
454	454	make those records available for inspection by or at the request
455	455	of the commissioner.
456	456	(e) The commissioner shall determine the amount of
457	457	compensation to be allocated to an approved organization as
458	458	payment for fund administration. Compensation is payable only
459	459	from the fund.
460	460	(f) The commissioner may remove an organization approved
461	461	to administer the fund from fund administration. An organization
462	462	removed from fund administration under this subsection must
463	463	cooperate in the orderly transition of services to another
464	464	approved organization or to the commissioner.
465	465	Sec. 1508.261. STOP-LOSS INSURANCE; REINSURANCE.
466	466	(a) The administrator of the fund, on behalf of and with the
467	467	prior approval of the commissioner, may purchase stop-loss
468	468	insurance or reinsurance from an insurance company licensed to
469	469	write that coverage in this state.
470	470	(b) Stop-loss insurance or reinsurance may be purchased
471	471	to the extent that the commissioner determines funds are
472	472	available for the purchase of that insurance.
473	473	Sec. 1508.262. PUBLIC EDUCATION AND OUTREACH. (a) The
474	474	commissioner may use an amount of the fund, not to exceed eight
475	475	percent of the annual amount of the fund, for purposes of
476	476	developing and implementing public education, outreach, and
477	477	facilitated enrollment strategies targeted to small employers
478	478	who do not provide health insurance.
479	479	(b) The commissioner shall solicit and accept
480	480	recommendations concerning the development and implementation of
481	481	education, outreach, and enrollment strategies under Subsection
482	482	(a) from agents licensed under Title 13 to write health benefit
483	483	plans in this state.
484	484	(c) The commissioner may contract with marketing
485	485	organizations to perform or provide assistance with education,
486	486	outreach, and enrollment strategies described by Subsection (a).
487	487	SECTION 2.02. The commissioner of insurance shall adopt
488	488	any rules necessary to implement the change in law made by
489	489	Chapter 1508, Insurance Code, as added by this article, not later
490	490	than January 4, 2010.
491	491	SECTION 2.03. (a) The commissioner of insurance shall
492	492	make an initial determination concerning limitation of health
493	493	benefit plan issuer participation in the program established
494	494	under Chapter 1508, Insurance Code, as added by this article, not
495	495	later than January 18, 2010. If the commissioner determines that
496	496	limited participation is necessary to achieve the purposes of
497	497	Chapter 1508, Insurance Code, as added by this article, the
498	498	commissioner shall issue a request for proposal from health
499	499	benefit plan issuers to participate in the program not later than
500	500	May 1, 2010.
501	501	(b) The commissioner of insurance shall ensure that the
502	502	Healthy Texas Program is fully operational in a manner that
503	503	allows health benefit plan issuers participating in the program
504	504	to make the first annual request for reimbursement on January 1,
505	505	2011.
506	506	SECTION 2.04. This Act does not make an appropriation.
507	507	This Act takes effect only if a specific appropriation for the
508	508	implementation of the Act is provided in a general appropriations
509	509	act of the 81st Legislature.
510	510	Explanation: This addition is necessary to authorize the
511	511	creation of the Healthy Texas Program to enhance the availability
512	512	of health coverage.
513	513	_______________________________
514	514	President of the Senate
515	515	I hereby certify that the
516	516	above Resolution was adopted by
517	517	the Senate on June 1, 2009.
518	518	_______________________________
519	519	Secretary of the Senate