Texas 2011 - 82nd Regular

Texas House Bill HB3419 Latest Draft

Bill / Introduced Version

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                            82R12077 JJT-D
 By: Darby H.B. No. 3419


 A BILL TO BE ENTITLED
 AN ACT
 relating to state fiscal matters related to certain regulatory
 agencies.
 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 ARTICLE 1.  REDUCTION OF EXPENDITURES AND IMPOSITION OF CHARGES
 GENERALLY
 SECTION 1.01.  This article applies to any state agency that
 receives an appropriation under Article VIII of the General
 Appropriations Act.
 SECTION 1.02.  Notwithstanding any other statute of this
 state, each state agency to which this article applies is
 authorized to reduce or recover expenditures by:
 (1)  consolidating any reports or publications the
 agency is required to make and filing or delivering any of those
 reports or publications exclusively by electronic means;
 (2)  extending the effective period of any license,
 permit, or registration the agency grants or administers;
 (3)  entering into a contract with another governmental
 entity or with a private vendor to carry out any of the agency's
 duties;
 (4)  adopting additional eligibility requirements for
 persons who receive benefits under any law the agency administers
 to ensure that those benefits are received by the most deserving
 persons consistent with the purposes for which the benefits are
 provided;
 (5)  providing that any communication between the
 agency and another person and any document required to be delivered
 to or by the agency, including any application, notice, billing
 statement, receipt, or certificate, may be made or delivered by
 e-mail or through the Internet; and
 (6)  adopting and collecting fees or charges to cover
 any costs the agency incurs in performing its lawful functions.
 ARTICLE 2.  FISCAL MATTERS REGARDING REGULATION OF INSURERS
 SECTION 2.01.  Section 463.160, Insurance Code, is amended
 to read as follows:
 Sec. 463.160.  PREMIUM TAX CREDIT FOR CLASS A ASSESSMENT.
 The amount of a Class A assessment paid by a member insurer in each
 taxable year shall be allowed as a credit on the amount of premium
 taxes due [in the same manner as a credit is allowed under Section
 401.151(e)].
 SECTION 2.02.  Sections 221.006, 222.007, 223.009,
 401.151(e), and 401.154, Insurance Code, are repealed.
 SECTION 2.03.  This article takes effect immediately if this
 Act 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 article takes effect September 1, 2011.
 ARTICLE 3.  FISCAL MATTERS REGARDING HEALTH CARE DELIVERY
 SECTION 3.01.  Subtitle A, Title 2, Insurance Code, is
 amended by adding Chapter 41 to read as follows:
 CHAPTER 41. HEALTH CARE PAYMENT AND DELIVERY SYSTEM REFORM
 SUBCHAPTER A. HEALTH CARE PAYMENT AND DELIVERY SYSTEM REFORM
 COMMITTEE
 Sec. 41.001.  DEFINITION. In this chapter, "committee" means
 the Health Care Payment and Delivery System Reform Committee.
 Sec. 41.002.  ESTABLISHMENT; PURPOSE; ADMINISTRATIVE
 SUPPORT.  (a) The Health Care Payment and Delivery System Reform
 Committee is established to identify priority outcomes for cost
 containment and quality improvement in health benefit coverage and
 health care services in this state.
 (b)  The committee is administratively attached to the
 department.  The department shall provide administrative support
 and resources to the committee as necessary for the committee to
 perform its duties.
 Sec. 41.003.  COMPOSITION OF COMMITTEE.  The committee is
 composed of:
 (1)  the following voting members:
 (A)  a representative of the Health and Human
 Services Commission, appointed by the executive commissioner of the
 Health and Human Services Commission;
 (B)  a representative of the Employees Retirement
 System of Texas, appointed by the executive director of the system;
 (C)  two representatives of the Teacher
 Retirement System of Texas, appointed by the executive director of
 the system:
 (i)  one of whom has specialized knowledge
 of basic plans under Chapter 1575; and
 (ii)  one of whom has specialized knowledge
 of the catastrophic care coverage plan and the primary care
 coverage plan under Chapter 1579;
 (D)  a representative of The Texas A&M University
 System, appointed by the governing board of the system; and
 (E)  a representative of The University of Texas
 System, appointed by the governing board of the system; and
 (2)  the following nonvoting members:
 (A)  a representative of the speaker of the house
 of representatives, appointed by the speaker;
 (B)  a representative of the office of the
 lieutenant governor, appointed by the lieutenant governor;
 (C)  a representative of the House Public Health
 Committee or its successor, appointed by the chair of the
 committee; and
 (D)  a representative of the Senate Health and
 Human Services Committee or its successor, appointed by the chair
 of the committee.
 Sec. 41.004.  TERMS; REMOVAL. (a) Voting members of the
 committee serve staggered two-year terms, with the terms of three
 members expiring on February 1 of each year. The members shall draw
 lots at the first committee meeting to determine the length of each
 member's initial term and which members' terms expire each year.
 (b)  The terms of the nonvoting members of the committee
 expire February 1 of each even-numbered year.
 (c)  A member of the committee may be removed by the
 commissioner with cause stated in writing.  The appropriate person
 or entity shall appoint in the manner provided by Section 41.003 a
 replacement for a member who leaves or is removed from the
 committee.
 Sec. 41.005.  DUTIES. The committee shall:
 (1)  develop a plan to identify priority outcomes for
 cost containment and quality improvement in health insurance and
 health care services in this state;
 (2)  coordinate initiatives for reform of health care
 payment and delivery systems among state health payors;
 (3)  review pilot program proposals submitted to the
 committee under Section 41.051(a) and recommend to the commissioner
 for approval pilot programs the committee determines to be
 consistent with purposes described by Section 41.002;
 (4)  review funding proposals submitted to the
 committee under Section 41.051(b) and recommend to the commissioner
 pilot programs the committee determines to be eligible for funding
 under the rules adopted by the commissioner under Section 41.053;
 and
 (5)  determine outcomes to be measured in evaluating
 the effectiveness of each program approved by the commissioner
 under Section 41.052.
 Sec. 41.006.  SUBMISSION AND POSTING OF PRIORITY OUTCOME
 PLAN. Not later than September 1 of each even-numbered year, the
 committee shall:
 (1)  update the priority outcome plan developed under
 Section 41.005(1) as necessary;
 (2)  submit the priority outcome plan to:
 (A)  the governor; and
 (B)  the Legislative Budget Board; and
 (3)  make the priority outcome plan available to the
 public on the Internet website maintained by the department.
 Sec. 41.007.  EXPIRATION OF CHAPTER. This chapter expires
 September 1, 2021.
 [Sections 41.008-41.050 reserved for expansion]
 SUBCHAPTER B. HEALTH CARE PAYMENT AND DELIVERY SYSTEM REFORM PILOT
 PROGRAMS
 Sec. 41.051.  PROPOSAL OF PILOT PROGRAMS BY PROVIDERS OF
 HEALTH CARE SERVICES. (a)  An individual or entity that provides
 health care services in this state may submit to the committee a
 proposal for a pilot program to design and implement a new health
 care payment or delivery system.
 (b)  An individual or entity that submits a pilot program
 proposal under Subsection (a) may submit to the committee an
 application for funding for the pilot program.  An application may
 be submitted under this subsection:
 (1)  in conjunction with a pilot program proposal; or
 (2)  after a pilot program proposal is approved by the
 commissioner under Section 41.052.
 Sec. 41.052.  APPROVAL BY COMMISSIONER; PILOT PROGRAM
 PROPOSAL AND FUNDING. (a)  On recommendation of the committee, the
 commissioner may approve:
 (1)  a pilot program proposal submitted to the
 committee under Section 41.051(a), if the commissioner finds that
 the pilot program:
 (A)  adequately protects the interests of
 patients and consumers; and
 (B)  may demonstrate improved economy and
 efficiency for health care payment or delivery; or
 (2)  an application for funding for a pilot program
 submitted to the committee under Section 41.051(b).
 (b)  The commissioner may approve an application under
 Subsection (a)(2) only to the extent that sufficient appropriations
 have been received by the department to fund the proposed pilot
 program.
 Sec. 41.053.  RULES. The commissioner shall adopt rules
 necessary to implement this subchapter, including rules that
 establish a procedure through which a pilot program proposal or an
 application for funding for a pilot program may be submitted to, and
 approved by, the commissioner.
 SECTION 3.02.  Chapter 162, Occupations Code, is amended by
 adding Subchapter F to read as follows:
 SUBCHAPTER F. PARTICIPATION IN PILOT PROGRAM TO PROMOTE HEALTH
 CARE PAYMENT AND DELIVERY SYSTEM REFORM
 Sec. 162.301.  EMPLOYMENT OF PHYSICIANS.  (a)  A person,
 including a partnership, trust, association, or corporation,
 operating a pilot program approved by the Health Care Payment and
 Delivery System Reform Committee under Chapter 41, Insurance Code,
 may employ a physician:
 (1)  for the purposes of the pilot program; and
 (2)  for the duration of the pilot program, as
 approved.
 (b)  A person that employs a physician under this section
 does not violate Section 164.052(a)(13) or (17) or 165.156, or any
 other law that prohibits the practice of medicine by a person other
 than a physician, to the extent that the physician is performing
 services for the purpose of the pilot program.
 (c)  This section does not authorize a person to supervise or
 control the practice of medicine or permit the unauthorized
 practice of medicine as prohibited by this subtitle.
 Sec. 162.302.  EXPIRATION OF SUBCHAPTER.  This subchapter
 expires September 1, 2021.
 SECTION 3.03.  Notwithstanding Section 41.006, Insurance
 Code, as added by this article, not later than February 1, 2012, the
 Health Care Payment and Delivery System Reform Committee shall
 develop the first plan required by Section 41.005(1), Insurance
 Code, as added by this article, submit the plan to the governor and
 Legislative Budget Board, and make the plan available to the public
 on the Texas Department of Insurance's Internet website.
 SECTION 3.04.  This article takes effect September 1, 2011.
 ARTICLE 4.  TEXAS HEALTH INSURANCE CONNECTOR
 SECTION 4.01.  Subtitle G, Title 8, Insurance Code, is
 amended by adding Chapter 1509 to read as follows:
 CHAPTER 1509. TEXAS HEALTH INSURANCE CONNECTOR
 SUBCHAPTER A. GENERAL PROVISIONS
 Sec. 1509.001.  DEFINITIONS. In this chapter:
 (1)  "Board" means the board of directors of the
 connector.
 (2)  "Connector" means the Texas Health Insurance
 Connector.
 (3)  "Enrollee" means an individual who is enrolled in
 a qualified health plan.
 (4)  "Executive commissioner" means the executive
 commissioner of the Health and Human Services Commission.
 (5)  "Qualified health plan" means a health benefit
 plan that the board has certified under Section 1509.108.
 (6)  "Qualified individual" means an individual who is
 eligible to become an enrollee in accordance with the criteria
 adopted by the board under Section 1509.109.
 (7)  "Secretary" means the secretary of the United
 States Department of Health and Human Services.
 (8)  "Small employer" has the meaning assigned by
 Section 1501.002, except that the term does not include
 governmental entities described by that section.
 Sec. 1509.002.  DEFINITION OF HEALTH BENEFIT PLAN. (a)  In
 this chapter, "health benefit plan" means an insurance policy,
 insurance agreement, evidence of coverage, or other similar
 coverage document that provides coverage for medical or surgical
 expenses incurred as a result of a health condition, accident, or
 sickness that is issued by:
 (1)  an insurance company;
 (2)  a group hospital service corporation operating
 under Chapter 842;
 (3)  a fraternal benefit society operating under
 Chapter 885;
 (4)  a stipulated premium company operating under
 Chapter 884;
 (5)  an exchange operating under Chapter 942;
 (6)  a health maintenance organization operating under
 Chapter 843;
 (7)  a multiple employer welfare arrangement that holds
 a certificate of authority under Chapter 846; or
 (8)  an approved nonprofit health corporation that
 holds a certificate of authority under Chapter 844.
 (b)  In this chapter, "health benefit plan" does not include:
 (1)  a plan that provides coverage:
 (A)  for wages or payments in lieu of wages for a
 period during which an employee is absent from work because of
 sickness or injury;
 (B)  as a supplement to a liability insurance
 policy;
 (C)  for credit insurance;
 (D)  only for vision care;
 (E)  only for hospital expenses; or
 (F)  only for indemnity for hospital confinement;
 (2)  a Medicare supplemental policy as defined by
 Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);
 (3)  a workers' compensation insurance policy; or
 (4)  medical payment insurance coverage provided under
 a motor vehicle insurance policy.
 Sec. 1509.003.  RULES.  (a)  The board may adopt rules
 necessary and proper to implement this chapter.
 (b)  The board may adopt rules necessary to implement state
 responsibility in compliance with a federal law or regulation or
 action of a federal court relating to a person or activity under
 the purview of the connector if:
 (1)  the federal law, regulation, or action of the
 federal court requires:
 (A)  a state to adopt the rules; or
 (B)  action by a state to ensure protection of the
 citizens of the state;
 (2)  the rules will avoid federal preemption of state
 insurance regulation; or
 (3)  the rules will prevent the loss of federal funds to
 this state.
 (c)  The board may adopt a rule under Subsection (b) only if
 the federal action requiring the adoption of a rule occurs or takes
 effect between sessions of the legislature or at such a time during
 a session of a legislature that sufficient time does not remain to
 permit the preparation of a recommendation for legislative action
 or permit the legislature to act. A rule adopted under this section
 remains in effect until the 30th day after the end of the first
 regular session of the legislature that follows the adoption of the
 rule unless a law is enacted that authorizes the subject matter of
 the rule. If a law is enacted that authorizes the subject matter of
 the rule, the rule continues in effect.
 Sec. 1509.004.  AGENCY COOPERATION.  (a)  The connector, the
 department, and the Health and Human Services Commission shall
 cooperate fully in performing their respective duties under this
 code or another law of this state relating to the operation of the
 connector.
 (b)  The connector and the department shall cooperate to
 promote a stable health benefit plan market in this state.
 Sec. 1509.005.  SUNSET PROVISION. The connector is subject
 to review under Chapter 325, Government Code (Texas Sunset Act).
 Unless continued in existence as provided by that chapter, the
 connector is abolished and this chapter expires September 1, 2019.
 Sec. 1509.006.  CONNECTOR NOT INSURER. The connector is not
 an insurer or health maintenance organization and is not subject to
 regulation by the department.
 Sec. 1509.007.  EXEMPTION FROM STATE TAXES AND FEES.  The
 connector is not subject to any state tax, regulatory fee, or
 surcharge, including a premium or maintenance tax or fee.
 Sec. 1509.008.  COMPLIANCE WITH FEDERAL LAW. The connector
 shall comply with all applicable federal law and regulations.
 [Sections 1509.009-1509.050 reserved for expansion]
 SUBCHAPTER B. ESTABLISHMENT AND GOVERNANCE
 Sec. 1509.051.  ESTABLISHMENT. The Texas Health Insurance
 Connector is established as the American Health Benefit Exchange
 and the Small Business Health Options Program (SHOP) Exchange
 required by Section 1311, Patient Protection and Affordable Care
 Act (Pub. L. No. 111-148).
 Sec. 1509.052.  GOVERNANCE OF CONNECTOR; BOARD MEMBERSHIP.
 (a)  The connector is governed by a board of directors.
 (b)  The board consists of seven members composed as follows:
 (1)  five members appointed by the governor:
 (A)  two of whom must be chosen from a list
 submitted to the governor by the lieutenant governor; and
 (B)  two of whom must be chosen from a list
 submitted to the governor by the speaker of the house of
 representatives;
 (2)  the commissioner, as a nonvoting ex officio
 member; and
 (3)  the executive commissioner, as a nonvoting ex
 officio member.
 (c)  At least three of the five board members appointed by
 the governor must have experience in health care administration,
 health care economics, or health insurance or be knowledgeable
 concerning general business or actuarial principles.  One of the
 board members appointed by the governor must represent the
 interests of health benefit plan consumers in this state, one must
 represent the interests of small employers in this state, and one
 must be an enrollee or be reasonably expected to qualify for
 coverage under a qualified health plan in this state.
 (d)  A person may not serve as a member of the board if the
 person is required to register as a lobbyist under Chapter 305,
 Government Code, because of the person's activities for
 compensation related to the operation of the connector or the
 business of insurance in this state.
 Sec. 1509.053.  PRESIDING OFFICER. The governor shall
 designate one member of the board to serve as presiding officer at
 the pleasure of the governor.
 Sec. 1509.054.  TERMS; VACANCY. (a) Appointed members of
 the board serve staggered six-year terms.
 (b)  The governor shall fill a vacancy on the board by
 appointing, for the unexpired term, an individual who has the
 appropriate qualifications to fill that position.
 Sec. 1509.055.  CONFLICT OF INTEREST. (a) A board member,
 or a member of a committee formed by the board, with a direct
 interest in a matter before the board, personally or through an
 employer, shall abstain from deliberations and actions on the
 matter in which the conflict of interest arises, shall abstain from
 any vote on the matter, and may not in any manner participate in a
 decision on the matter.
 (b)  Each board member shall file a conflict of interest
 statement and a statement of ownership interests with the board to
 ensure disclosure of all existing and potential personal interests
 related to board business.
 Sec. 1509.056.  REIMBURSEMENT. A member of the board is not
 entitled to compensation but is entitled to reimbursement for
 travel or other expenses incurred while performing duties as a
 board member in the amount provided by the General Appropriations
 Act for state officials.
 Sec. 1509.057.  MEMBER'S IMMUNITY. (a) A member of the
 board is not liable for an act or omission made in good faith in the
 performance of powers and duties under this chapter.
 (b)  A cause of action does not arise against a member of the
 board for an act or omission described by Subsection (a).
 Sec. 1509.058.  OPEN RECORDS AND OPEN MEETINGS. (a) The
 board is subject to Chapter 551, Government Code. The board may
 meet in executive session in accordance with Chapter 551,
 Government Code, to discuss confidential or proprietary
 information, including contract decisions and qualified health
 plan rates.
 (b)  The board is subject to Chapter 552, Government Code,
 except that, notwithstanding any other law, documents that contain
 proprietary information, relate to deliberative processes or
 communications, relate to contracting decisions, or reveal work
 product, plans, or strategy that would influence decisions in the
 health benefit plan marketplace are not public information.
 Sec. 1509.059.  RECORDS. The board shall keep records of the
 board's proceedings for at least seven years.
 Sec. 1509.060.  BIENNIAL REPORT. Not later than January 1 of
 each odd-numbered year, the board shall provide a report to the
 governor, the legislature, the commissioner, and the executive
 commissioner. The report must include information regarding the
 development and implementation of the connector, specifically
 detailing progress made by the connector in implementing the
 requirements of this chapter.
 Sec. 1509.061.  ADDITIONAL REPORT. (a) The board shall
 issue a report that meets the requirements of Section 1509.060 to
 the entities described by that section not later than January 1,
 2014.
 (b)  This section expires January 31, 2014.
 [Sections 1509.062-1509.100 reserved for expansion]
 SUBCHAPTER C. POWERS AND DUTIES OF CONNECTOR
 Sec. 1509.101.  EMPLOYEES; COMMITTEES. (a)  The board may
 employ, and determine the compensation of, an executive director, a
 chief fiscal officer, a general counsel, a technology officer, and
 any other agent or employee the board considers necessary to assist
 the connector in carrying out the connector's responsibilities and
 functions.
 (b)  The connector may appoint appropriate legal, actuarial,
 and other committees necessary to provide technical assistance in
 operating the connector and performing any of the functions of the
 connector.
 Sec. 1509.102.  CONTRACTS. The connector may enter into any
 contract that the connector considers necessary to implement or
 administer this chapter, including a contract with the department
 or the Health and Human Services Commission for the department or
 commission, in exchange for payment, to perform functions or
 provide services in connection with the operation of the connector.
 Sec. 1509.103.  INFORMATION SHARING AND CONFIDENTIALITY.
 The connector may enter into information-sharing agreements with
 federal and state agencies to carry out the connector's
 responsibilities under this chapter. An agreement entered into
 under this section must include adequate protection with respect to
 the confidentiality of any information shared and comply with all
 applicable state and federal law.
 Sec. 1509.104.  MEMORANDUM OF UNDERSTANDING. The connector
 shall enter into a memorandum of understanding with the department
 and the Health and Human Services Commission regarding the exchange
 of information and the division of regulatory functions among the
 connector, the department, and the commission.
 Sec. 1509.105.  LEGAL ACTION. (a) The connector may sue or
 be sued.
 (b)  The connector may take any legal action necessary to
 recover or collect amounts due the connector, including:
 (1)  assessments due the connector;
 (2)  amounts erroneously or improperly paid by the
 connector; and
 (3)  amounts paid by the connector as a mistake of fact
 or law.
 Sec. 1509.106.  FUNCTIONS. The connector shall:
 (1)  by rule establish procedures consistent with
 federal law and regulations for the certification,
 recertification, and decertification of health benefit plans as
 qualified health plans;
 (2)  provide for the operation of a toll-free telephone
 hotline to respond to requests for assistance;
 (3)  maintain an Internet website through which an
 enrollee or prospective enrollee may:
 (A)  obtain standardized, comparative information
 concerning qualified health plans issued in this state; and
 (B)  locate comparative coverage information
 concerning qualified health plans through a searchable database of
 diseases, disabilities, or other medical conditions;
 (4)  assign a rating to each qualified health plan
 certified by the connector based on criteria developed by the
 secretary;
 (5)  use a standard format for presenting information
 concerning qualified health plan options;
 (6)  inform individuals of the eligibility
 requirements for Medicaid, the state child health plan program, or
 any other similar federal, state, or local public health benefit
 program;
 (7)  if the connector determines that an individual is
 eligible for Medicaid, the state child health plan program, or any
 other similar federal, state, or local public health benefit
 program, coordinate with the Health and Human Services Commission
 to enroll the individual in the program for which the individual is
 eligible;
 (8)  establish, and make available electronically, a
 calculator to determine the actual cost of coverage after the
 application of any premium tax credit or cost-sharing subsidy
 available under federal law;
 (9)  as applicable, certify that an individual is
 exempt from the individual responsibility penalty under Section
 5000A, Internal Revenue Code of 1986, and notify the secretary of
 the exemption;
 (10)  establish a navigator program as described by
 Section 1311(i), Patient Protection and Affordable Care Act (Pub.
 L. No. 111-148);
 (11)  provide for the processing of applications for
 coverage under a qualified health plan, the enrollment of persons
 in qualified health plans, and the disenrollment of enrollees from
 qualified health plans;
 (12)  establish billing and payment policies for
 issuers of qualified health plans;
 (13)  engage in marketing and outreach activities; and
 (14)  collect and maintain information concerning
 qualified health plans, including data concerning enrollment,
 disenrollment, claims, and claims denials.
 Sec. 1509.107.  TYPES OF PLANS. The connector shall, in a
 manner consistent with federal law, establish certification
 requirements for at least six different types of qualified health
 plans, at least two of which must include a health savings account
 described by Section 223, Internal Revenue Code of 1986, at least
 one of which must offer benchmark coverage or benchmark equivalent
 coverage described by Section 1937(b), Social Security Act (42
 U.S.C. Section 1396u-7), and at least one of which must offer
 limited scope dental benefits either separately or in conjunction
 with another type of plan.
 Sec. 1509.108.  CERTIFICATION OF PLAN. The board shall
 certify a health benefit plan as a qualified health plan if the
 health benefit plan meets the requirements for certification set
 forth by the secretary. The connector may not, as a condition of
 certification, require a health benefit plan issuer to:
 (1)  participate in both the individual and small
 employer markets; or
 (2)  offer benefit levels that exceed benefit levels
 required under federal law.
 Sec. 1509.109.  QUALIFICATION OF INDIVIDUALS. The board by
 rule shall establish criteria for eligibility for a potential
 enrollee to be considered a qualified individual. At a minimum, the
 criteria must require that the individual:
 (1)  seek to enroll in a qualified health plan in the
 individual health benefit plan market offered through the
 connector;
 (2)  reside in and be a citizen or lawful resident of
 this state, except as provided by Section 1312, Patient Protection
 and Affordable Care Act (Pub. L. No. 111-148); and
 (3)  at the time of enrollment, not be incarcerated,
 other than being incarcerated pending the disposition of any
 criminal charges.
 Sec. 1509.110.  PREMIUM COLLECTION AND AGGREGATION. The
 board by rule shall establish a mechanism for the collection and
 aggregation of premium payments directly or indirectly from
 enrollees and the payment of premiums to issuers of qualified
 health plans.  Rules adopted under this section must include rules
 regarding an employer's authority to withhold premium payments from
 an enrollee's paycheck and to submit those premium payments to
 issuers of qualified health plans.
 Sec. 1509.111.  PREMIUM INCREASE JUSTIFICATION. (a)  The
 connector shall require an issuer of a qualified health plan to file
 with the connector an explanation of any premium increase before
 implementation of the increase.
 (b)  A health benefit plan issuer shall prominently display
 the explanation of any premium increase on the health benefit plan
 issuer's Internet website.
 [Sections 1509.112-1509.150 reserved for expansion]
 SUBCHAPTER D.  COVERAGE REQUIREMENTS OR LIMITATIONS
 Sec. 1509.151.  PROHIBITED COVERAGE THROUGH CONNECTOR.  A
 qualified health plan offered through the connector may not provide
 coverage for an abortion, as defined by Section 171.002, Health and
 Safety Code.
 [Sections 1509.152-1509.200 reserved for expansion]
 SUBCHAPTER E. ASSESSMENTS FOR OPERATION OF CONNECTOR
 Sec. 1509.201.  ASSESSMENTS; PENALTY FOR NONPAYMENT. (a)
 The connector may charge the issuers of qualified health plans and
 health benefit plans applying for certification as qualified health
 plans an assessment as reasonable and necessary for the connector's
 organizational and operating expenses.
 (b)  The connector may refuse to recertify or may decertify a
 health benefit plan as a qualified health plan if the issuer of the
 plan fails or refuses to pay an assessment under this section.
 Sec. 1509.202.  GRANTS AND FEDERAL FUNDS. (a) The connector
 may accept a grant from a public or private organization and may
 spend those funds to pay the costs of program administration and
 operations.
 (b)  The connector may accept federal funds and shall use
 those funds in compliance with applicable federal law, regulations,
 and guidelines.
 Sec. 1509.203.  USE OF CONNECTOR ASSETS; ANNUAL REPORT. (a)
 The assets of the connector may be used only to pay the costs of the
 administration and operation of the connector.
 (b)  The connector shall prepare annually a complete and
 detailed written report accounting for all funds received and
 disbursed by the connector during the preceding fiscal year. The
 report must meet any reporting requirements provided in the General
 Appropriations Act, regardless of whether the connector receives
 any funds under that Act.  The connector shall submit the report to
 the governor, the legislature, the commissioner, and the executive
 commissioner not later than January 31 of each year.
 [Sections 1509.204-1509.250 reserved for expansion]
 SUBCHAPTER F. TRUST FUND
 Sec. 1509.251.  TRUST FUND. (a)  The connector fund is
 established as a special trust fund outside of the state treasury in
 the custody of the comptroller separate and apart from all public
 money or funds of this state.
 (b)  The connector may deposit assessments, gifts or
 donations, and any federal funding obtained by the connector into
 the connector fund in accordance with procedures established by the
 comptroller.
 (c)  Interest or other income from the investment of the fund
 shall be deposited to the credit of the fund.
 SECTION 4.02.  (a) As soon as possible after the effective
 date of this article, but not later than October 31, 2011, the
 governor shall appoint the initial members of the board of
 directors of the Texas Health Insurance Connector. In making the
 appointments, the governor shall designate two persons to terms
 expiring February 1, 2013, two persons to terms expiring February
 1, 2015, and one person to a term expiring February 1, 2017.
 (b)  As soon as possible after the appointments required by
 Subsection (a) of this section are made, but not later than November
 30, 2011, the board of directors of the Texas Health Insurance
 Connector shall hold a special meeting to discuss the adoption of
 rules and procedures necessary to implement Chapter 1509, Insurance
 Code, as added by this Act.
 (c)  As soon as possible after the effective date of this
 article, but not later than January 31, 2012, the board of directors
 of the Texas Health Insurance Connector shall adopt rules and
 procedures necessary to implement Chapter 1509, Insurance Code, as
 added by this article.
 SECTION 4.03.  This article takes effect immediately if this
 Act 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 article takes effect September 1, 2011.