Texas 2011 - 82nd Regular

Texas House Bill HB2723 Compare Versions

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Old	New	Differences
1	1	82R20428 PMO-F
2	2	By: Walle H.B. No. 2723
3	3	Substitute the following for H.B. No. 2723:
4	4	By: Walle C.S.H.B. No. 2723
5	5
6	6
7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to notice of premium increase for certain health benefit
10	10	plans.
11	11	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	12	SECTION 1. Subchapter F, Chapter 843, Insurance Code, is
13	13	amended by adding Section 843.2071 to read as follows:
14	14	Sec. 843.2071. NOTICE OF INCREASE IN CHARGE FOR COVERAGE.
15	15	(a) Not less than 60 days before the date on which an increase in a
16	16	charge for coverage under this chapter takes effect, a health
17	17	maintenance organization shall:
18	18	(1) give to each enrollee under an individual evidence
19	19	of coverage written notice of the effective date of the increase;
20	20	and
21	21	(2) provide the enrollee a table that clearly lists:
22	22	(A) the actual dollar amount of the charge for
23	23	coverage on the date of the notice;
24	24	(B) the actual dollar amount of the charge for
25	25	coverage after the charge increase; and
26	26	(C) the percentage change between the amounts
27	27	described by Paragraphs (A) and (B).
28	28	(b) The notice required by this section must be based on
29	29	coverage in effect on the date of the notice.
30	30	(c) This section may not be construed to prevent a health
31	31	maintenance organization, at the request of an enrollee, from
32	32	negotiating a change in benefits or rates after delivery of the
33	33	notice required by this section.
34	34	(d) A health maintenance organization may not require an
35	35	enrollee entitled to notice under this section to respond to the
36	36	health maintenance organization to renew the coverage or take other
37	37	action relating to the renewal or extension of the coverage before
38	38	the 45th day after the date the notice described by Subsection (a)
39	39	is given.
40	40	(e) The notice required by this section must include:
41	41	(1) contact information for the department, including
42	42	information concerning how to file a complaint with the department;
43	43	(2) contact information for the Texas Consumer Health
44	44	Assistance Program, including information concerning how to
45	45	request from the program consumer protection information or
46	46	assistance with filing a complaint; and
47	47	(3) the addresses of Internet websites that provide
48	48	consumer information related to rate increase justifications,
49	49	including the websites of the department and the United States
50	50	Department of Health and Human Services.
51	51	SECTION 2. Subchapter C, Chapter 1201, Insurance Code, is
52	52	amended by adding Section 1201.109 to read as follows:
53	53	Sec. 1201.109. NOTICE OF RATE INCREASE. (a) Not less than
54	54	60 days before the date on which a premium rate increase takes
55	55	effect on an individual accident and health insurance policy
56	56	delivered or issued for delivery in this state by an insurer, the
57	57	insurer shall:
58	58	(1) give written notice to the insured of the
59	59	effective date of the increase; and
60	60	(2) provide the insured a table that clearly lists:
61	61	(A) the actual dollar amount of the premium on
62	62	the date of the notice;
63	63	(B) the actual dollar amount of the premium after
64	64	the premium rate increase; and
65	65	(C) the percentage change between the amounts
66	66	described by Paragraphs (A) and (B).
67	67	(b) The notice required by this section must be based on
68	68	coverage in effect on the date of the notice.
69	69	(c) This section may not be construed to prevent an insurer,
70	70	at the request of an insured, from negotiating a change in benefits
71	71	or rates after delivery of the notice required by this section.
72	72	(d) An insurer may not require an insured entitled to notice
73	73	under this section to respond to the insurer to renew the policy or
74	74	take other action relating to the renewal or extension of the policy
75	75	before the 45th day after the date the notice described by
76	76	Subsection (a) is given.
77	77	(e) The notice required by this section must include:
78	78	(1) contact information for the department, including
79	79	information concerning how to file a complaint with the department;
80	80	(2) contact information for the Texas Consumer Health
81	81	Assistance Program, including information concerning how to
82	82	request from the program consumer protection information or
83	83	assistance with filing a complaint; and
84	84	(3) the addresses of Internet websites that provide
85	85	consumer information related to rate increase justifications,
86	86	including the websites of the department and the United States
87	87	Department of Health and Human Services.
88	88	SECTION 3. Subchapter E, Chapter 1501, Insurance Code, is
89	89	amended by adding Section 1501.216 to read as follows:
90	90	Sec. 1501.216. PREMIUM RATES: NOTICE OF INCREASE. (a) Not
91	91	less than 60 days before the date on which a premium rate increase
92	92	takes effect on a small employer health benefit plan delivered or
93	93	issued for delivery in this state by an insurer, the insurer shall:
94	94	(1) give written notice to the small employer of the
95	95	effective date of the increase; and
96	96	(2) provide the small employer a table that clearly
97	97	lists:
98	98	(A) the actual dollar amount of the premium on
99	99	the date of the notice;
100	100	(B) the actual dollar amount of the premium after
101	101	the premium rate increase; and
102	102	(C) the percentage change between the amounts
103	103	described by Paragraphs (A) and (B).
104	104	(b) The notice required by this section must be based on
105	105	coverage in effect on the date of the notice.
106	106	(c) This section may not be construed to prevent an insurer,
107	107	at the request of a small employer, from negotiating a change in
108	108	benefits or rates after delivery of the notice required by this
109	109	section.
110	110	(d) An insurer may not require a small employer entitled to
111	111	notice under this section to respond to the insurer to renew the
112	112	policy or take other action relating to the renewal or extension of
113	113	the policy before the 45th day after the date the notice described
114	114	by Subsection (a) is given.
115	115	(e) The notice required by this section must include:
116	116	(1) contact information for the department, including
117	117	information concerning how to file a complaint with the department;
118	118	(2) contact information for the Texas Consumer Health
119	119	Assistance Program, including information concerning how to
120	120	request from the program consumer protection information or
121	121	assistance with filing a complaint; and
122	122	(3) the addresses of Internet websites that provide
123	123	consumer information related to rate increase justifications,
124	124	including the websites of the department and the United States
125	125	Department of Health and Human Services.
126	126	SECTION 4. This Act applies to a health maintenance
127	127	organization individual evidence of coverage, an individual
128	128	accident and health insurance policy, or a small employer health
129	129	benefit plan that is delivered, issued for delivery, or renewed on
130	130	or after the effective date of this Act. An evidence of coverage,
131	131	policy, or plan delivered, issued for delivery, or renewed before
132	132	the effective date of this Act is governed by the law as it existed
133	133	immediately before the effective date of this Act, and that law is
134	134	continued in effect for that purpose.
135	135	SECTION 5. This Act takes effect September 1, 2011.