Texas 2011 - 82nd Regular

Texas House Bill HB1766 Compare Versions

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1	1	82R18811 KCR-F
2	2	By: Crownover, Truitt, Zerwas, Anchia, H.B. No. 1766
3	3	Taylor of Galveston, et al.
4	4	Substitute the following for H.B. No. 1766:
5	5	By: Anchia C.S.H.B. No. 1766
6	6
7	7
8	8	A BILL TO BE ENTITLED
9	9	AN ACT
10	10	relating to the creation of a voluntary consumer-directed health
11	11	plan for certain individuals eligible to participate in the
12	12	insurance coverage provided under the Texas Employees Group
13	13	Benefits Act and their qualified dependents.
14	14	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
15	15	SECTION 1. Chapter 1551, Insurance Code, is amended by
16	16	adding Subchapter J to read as follows:
17	17	SUBCHAPTER J. STATE CONSUMER-DIRECTED HEALTH PLAN
18	18	Sec. 1551.451. DEFINITIONS. In this subchapter:
19	19	(1) "High deductible health plan" means a health
20	20	benefit plan that complies with Section 223(c), Internal Revenue
21	21	Code of 1986, and other federal law.
22	22	(2) "Plan enrollee" means a participant who is
23	23	enrolled in the plan established under this subchapter.
24	24	(3) "Qualified medical expense" means an expense paid
25	25	by a plan enrollee for medical care, as defined by Section 213(d),
26	26	Internal Revenue Code of 1986, for the enrollee or the enrollee's
27	27	dependents as defined by Section 152, Internal Revenue Code of
28	28	1986.
29	29	Sec. 1551.452. ESTABLISHMENT OF STATE CONSUMER-DIRECTED
30	30	HEALTH PLAN. (a) The state consumer-directed health plan is
31	31	established for the benefit of individuals eligible to participate
32	32	in the group benefits program and those individuals' eligible
33	33	dependents.
34	34	(b) The board of trustees may adopt rules necessary to
35	35	administer this subchapter. In implementing this subchapter the
36	36	board shall:
37	37	(1) establish health savings accounts under this
38	38	subchapter and administer or select an administrator for the
39	39	accounts;
40	40	(2) finance or purchase a high deductible health plan
41	41	that:
42	42	(A) is an integral part of the state
43	43	consumer-directed health plan; and
44	44	(B) provides health benefit coverage, including
45	45	preventive health care, to a plan enrollee in the state
46	46	consumer-directed health plan and to the dependents of a plan
47	47	enrollee in accordance with Section 1551.456; and
48	48	(3) provide to individuals eligible to participate in
49	49	the group benefits program information regarding the option to
50	50	participate in and operation of the state consumer-directed health
51	51	plan established under this subchapter.
52	52	(c) If the board of trustees purchases a high deductible
53	53	health plan under this subchapter, Sections 1551.215-1551.218
54	54	apply to the high deductible health plan.
55	55	(d) In adopting rules and administering health savings
56	56	accounts or selecting administrators for health savings accounts
57	57	under this subchapter, the board of trustees shall ensure that the
58	58	health savings accounts are qualified for appropriate federal tax
59	59	exemptions.
60	60	Sec. 1551.453. PARTICIPATION IN STATE CONSUMER-DIRECTED
61	61	HEALTH PLAN; EFFECT OF PARTICIPATION. (a) The board of trustees
62	62	shall offer individuals eligible to participate in the basic
63	63	coverage plan the option of waiving participation in the basic
64	64	coverage plan and instead electing participation in the state
65	65	consumer-directed health plan.
66	66	(b) For purposes of this chapter, participation in the state
67	67	consumer-directed health plan is considered participation in the
68	68	group benefits program, and Sections 1551.301, 1551.303, 1551.305,
69	69	and 1551.306 apply to participation in the state consumer-directed
70	70	health plan in the same manner that those sections apply to the
71	71	basic coverage plan.
72	72	Sec. 1551.454. ACCOUNT ADMINISTRATOR. (a) The account
73	73	administrator selected to administer a health savings account
74	74	established under this subchapter must be a person:
75	75	(1) qualified to serve as trustee under Section
76	76	223(d)(1)(B), Internal Revenue Code of 1986, and the rules adopted
77	77	under that section; and
78	78	(2) experienced in administering health savings
79	79	accounts or other similar trust accounts.
80	80	(b) An account administrator is the fiduciary of a plan
81	81	enrollee who has a health savings account established under this
82	82	subchapter.
83	83	(c) Section 1551.056(b) does not apply to the account
84	84	administrator.
85	85	Sec. 1551.455. PARTICIPATION IN PROGRAM. (a) Each
86	86	individual eligible to participate in the basic coverage may choose
87	87	instead to participate in the state consumer-directed health plan
88	88	if the plan enrollee is an eligible individual under Section
89	89	223(c)(1), Internal Revenue Code of 1986. The dependents of a plan
90	90	enrollee may participate in the state consumer-directed health plan
91	91	in accordance with Section 1551.456.
92	92	(b) A plan enrollee waives basic plan coverage and must be
93	93	enrolled in a high deductible health plan.
94	94	(c) Participation in the state consumer-directed health
95	95	plan qualifies a plan enrollee to receive a contribution to a health
96	96	savings account under Section 1551.458. An individual who elects
97	97	not to participate in the plan is not eligible to receive a
98	98	contribution under that section.
99	99	(d) A plan enrollee is subject to Subchapter H in the same
100	100	manner as an individual who participates in the basic coverage
101	101	offered under the group benefits program.
102	102	(e) Under this section, the board of trustees has exclusive
103	103	authority to determine an individual's eligibility to participate
104	104	in the state consumer-directed health plan and shall adopt rules
105	105	regarding eligibility to participate in the plan.
106	106	Sec. 1551.456. COVERAGE FOR DEPENDENTS; REQUIRED
107	107	CONTRIBUTIONS. (a) Subject to Subsection (d), a plan enrollee is
108	108	entitled to obtain for the enrollee's dependents coverage in the
109	109	state consumer-directed health plan in the manner determined by the
110	110	board of trustees.
111	111	(b) The plan enrollee shall make any required additional
112	112	contribution payments for the dependent coverage in the manner
113	113	prescribed by the board of trustees.
114	114	(c) Amounts contributed by a plan enrollee under this
115	115	section may be:
116	116	(1) used to pay the cost of coverage in the state
117	117	consumer-directed health plan not paid by the state under Section
118	118	1551.458(b); or
119	119	(2) allocated by the board to an enrollee's health
120	120	savings account in the manner described by Section 1551.458(c).
121	121	(d) A covered dependent of a plan enrollee:
122	122	(1) is subject to Subchapter H in the same manner as a
123	123	dependent who is covered by the basic coverage offered under the
124	124	group benefits program; and
125	125	(2) must be a dependent for purposes of this chapter.
126	126	Sec. 1551.457. IDENTIFICATION CARDS FOR PLAN ENROLLEES.
127	127	(a) The board of trustees or the account administrator, as
128	128	applicable, shall issue to each plan enrollee an identification
129	129	card.
130	130	(b) The board of trustees or the account administrator, as
131	131	applicable, shall issue a duplicate identification card to each
132	132	plan enrollee's dependent for whom qualified medical expenses may
133	133	be paid out of a health savings account established under this
134	134	subchapter.
135	135	Sec. 1551.458. STATE CONTRIBUTION. (a) For each plan
136	136	enrollee, from the state contribution that would otherwise be made
137	137	for basic coverage for the enrollee, the state shall annually
138	138	contribute to a high deductible health plan provided under this
139	139	subchapter the amount that is necessary to pay the cost of coverage
140	140	under the high deductible health plan and does not exceed the amount
141	141	the state annually contributes for a full-time or part-time
142	142	employee, as applicable, who is covered by the basic coverage.
143	143	(b) For each plan enrollee's dependent covered under this
144	144	subchapter from the state contribution that would otherwise be made
145	145	for basic coverage for the dependent, the state shall annually
146	146	contribute to a high deductible health plan provided under this
147	147	subchapter the same percentage of the cost of coverage under the
148	148	high deductible health plan as the state annually contributes for
149	149	dependent coverage in the basic coverage.
150	150	(c) Before each plan year, the board may determine how to
151	151	allocate to an enrollee's health savings account the portion, if
152	152	any, of the state contribution that would otherwise be made for
153	153	basic coverage for the enrollee and that remains after payment for
154	154	coverage under Subsection (a) or (b).
155	155	(d) For a calendar year, the amount of any allocations made
156	156	under Subsection (c) and Section 1551.456(c)(2), in the aggregate,
157	157	may not exceed the sum of the monthly limitations imposed by federal
158	158	law for health savings accounts.
159	159	Sec. 1551.459. PLAN ENROLLEE CONTRIBUTIONS. (a) Each plan
160	160	enrollee, in accordance with Section 1551.305, shall contribute any
161	161	amount required to cover the selected participation in the state
162	162	consumer-directed health plan that exceeds the state contribution
163	163	amount under Section 1551.458.
164	164	(b) A plan enrollee may contribute any amount allowed under
165	165	federal law to the enrollee's health savings account in addition to
166	166	receiving an allocation of the state contribution under Section
167	167	1551.458.
168	168	(c) A plan enrollee shall make contributions under this
169	169	section in the manner prescribed by the board of trustees.
170	170	Sec. 1551.460. COORDINATION WITH CAFETERIA PLAN. (a) The
171	171	board of trustees has exclusive authority to determine the
172	172	eligibility of a plan enrollee to participate in any medical
173	173	flexible savings account that is part of a cafeteria plan offered
174	174	under this chapter.
175	175	(b) The board of trustees shall adopt rules regarding:
176	176	(1) the eligibility of a plan enrollee to participate
177	177	in any medical flexible savings account that is part of a cafeteria
178	178	plan offered under this chapter; and
179	179	(2) the coordination of benefits provided under this
180	180	subchapter and any medical flexible savings account that is part of
181	181	a cafeteria plan offered under this chapter.
182	182	(c) The rules adopted by the board of trustees under
183	183	Subsection (b) must prohibit a plan enrollee from participating in
184	184	any medical flexible savings account that would disqualify the
185	185	enrollee's health savings account from favorable tax treatment
186	186	under federal law.
187	187	Sec. 1551.461. CONFIDENTIALITY OF RECORDS. To the extent
188	188	allowed under federal law and subject to Section 1551.063, the
189	189	board of trustees or the account administrator, as applicable, may
190	190	disclose to a carrier information in an individual's records that
191	191	the board of trustees or administrator determines is necessary to
192	192	administer the state consumer-directed health plan.
193	193	Sec. 1551.462. EXEMPTION FROM EXECUTION; UNASSIGNABILITY.
194	194	A state contribution to a health savings account or a high
195	195	deductible health plan is exempt from execution and is unassignable
196	196	in the same manner and to the same extent as is an amount described
197	197	by Section 1551.011.
198	198	Sec. 1551.463. ASSISTANCE. Any state agency that the board
199	199	of trustees considers appropriate shall assist the board in
200	200	implementing and administering this subchapter.
201	201	SECTION 2. The Employees Retirement System of Texas shall
202	202	develop the state consumer-directed health plan to be implemented
203	203	under Chapter 1551, Insurance Code, as amended by this Act,
204	204	including enrollment requirements, during the state fiscal
205	205	biennium beginning September 1, 2011, with coverage beginning
206	206	September 1, 2012.
207	207	SECTION 3. Not later than July 31, 2012, the Employees
208	208	Retirement System of Texas shall provide written information to
209	209	individuals eligible to participate in the state consumer-directed
210	210	health plan under Chapter 1551, Insurance Code, as amended by this
211	211	Act, that provides a general description of the requirements for
212	212	the plan as adopted under Chapter 1551, Insurance Code, as amended
213	213	by this Act.
214	214	SECTION 4. The Employees Retirement System of Texas shall
215	215	develop and implement the health savings account program under
216	216	Chapter 1551, Insurance Code, as amended by this Act, in a manner
217	217	that is as revenue neutral as is possible.
218	218	SECTION 5. (a) Not later than January 1, 2017, the board of
219	219	trustees of the Employees Retirement System of Texas shall submit a
220	220	report to the governor, lieutenant governor, speaker of the house
221	221	of representatives, and Legislative Budget Board concerning:
222	222	(1) the manner in which, and the level at which, plan
223	223	enrollees use the coverage provided under the state
224	224	consumer-directed health plan established under Subchapter J,
225	225	Chapter 1551, Insurance Code, as added by this Act;
226	226	(2) whether the coverage provided under the state
227	227	consumer-directed health plan established under Subchapter J,
228	228	Chapter 1551, Insurance Code, as added by this Act, is more or less
229	229	cost-effective for plan enrollees and the state than the coverage
230	230	provided under the basic coverage plan under Chapter 1551,
231	231	Insurance Code; and
232	232	(3) whether continuation of the state
233	233	consumer-directed health plan established under Subchapter J,
234	234	Chapter 1551, Insurance Code, as added by this Act, is feasible or
235	235	desirable.
236	236	(b) The report required by this section may be submitted
237	237	separately from, or included in, the annual report that is required
238	238	under Section 1551.061, Insurance Code, and is submitted closest to
239	239	January 1, 2017.
240	240	SECTION 6. Except as otherwise provided by this Act, this
241	241	Act takes effect September 1, 2011.