83R10349 SCL-F
By: Smithee H.B. No. 2783
A BILL TO BE ENTITLED
AN ACT
relating to who is an employee for large and small employers for
health benefit plans.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Sections 1501.002(8), (13), and (14), Insurance
Code, are amended to read as follows:
(8) "Large employer" means a person who employed an
average of at least 51 [eligible] employees on business days during
the preceding calendar year and who employs at least two employees
on the first day of the plan year. The term includes a governmental
entity subject to Article 3.51-1, 3.51-4, or 3.51-5, to Subchapter
C, Chapter 1364, to Chapter 1578, or to Chapter 177, Local
Government Code, that otherwise meets the requirements of this
subdivision. For purposes of this definition, a partnership is the
employer of a partner.
(13) "Premium" means all amounts paid by a small or
large employer and [eligible] employees as a condition of receiving
coverage from a small or large employer health benefit plan issuer,
including any fees or other contributions associated with a health
benefit plan.
(14) "Small employer" means a person who employed an
average of at least two employees but not more than 50 [eligible]
employees on business days during the preceding calendar year and
who employs at least two employees on the first day of the plan
year. The term includes a governmental entity subject to Article
3.51-1, 3.51-4, or 3.51-5, to Subchapter C, Chapter 1364, to
Chapter 1578, or to Chapter 177, Local Government Code, that
otherwise meets the requirements of this subdivision. For
purposes of this definition, a partnership is the employer of a
partner.
SECTION 2. Section 1501.003, Insurance Code, is amended to
read as follows:
Sec. 1501.003. APPLICABILITY: SMALL EMPLOYER HEALTH
BENEFIT PLANS. An individual or group health benefit plan is a
small employer health benefit plan subject to Subchapters C-H if it
provides health care benefits covering two or more [eligible]
employees of a small employer and:
(1) the employer pays a portion of the premium or
benefits;
(2) the employer or a covered individual treats the
health benefit plan as part of a plan or program for purposes of
Section 106 or 162, Internal Revenue Code of 1986 (26 U.S.C. Section
106 or 162); or
(3) the health benefit plan is an employee welfare
benefit plan under 29 C.F.R. Section 2510.3-1(j).
SECTION 3. Section 1501.004, Insurance Code, is amended to
read as follows:
Sec. 1501.004. APPLICABILITY: LARGE EMPLOYER HEALTH
BENEFIT PLANS. An individual or group health benefit plan is a
large employer health benefit plan subject to Subchapters C and M if
the plan provides health care benefits to [eligible] employees of a
large employer and:
(1) the employer pays a portion of the premium or
benefits;
(2) the employer or a covered individual treats the
health benefit plan as part of a plan or program for purposes of
Section 106 or 162, Internal Revenue Code of 1986 (26 U.S.C. Section
106 or 162); or
(3) the health benefit plan is an employee welfare
benefit plan under 29 C.F.R. Section 2510.3-1(j).
SECTION 4. Section 1501.009(a), Insurance Code, is amended
to read as follows:
(a) An independent school district may elect to participate
as a small employer without regard to the number of [eligible]
employees in the district. An independent school district that
makes the election is treated as a small employer under this chapter
for all purposes.
SECTION 5. Sections 1501.011(a) and (b), Insurance Code,
are amended to read as follows:
(a) For an employer that did not exist throughout the
calendar year preceding the year in which the determination of
whether the employer is a small employer is made, the determination
is based on the average number of employees [and eligible
employees] the employer reasonably expects to employ on business
days in the calendar year in which the determination is made.
(b) For an employer that did not exist throughout the
calendar year preceding the year in which the determination of
whether the employer is a large employer is made, the determination
is based on the average number of [eligible] employees the employer
reasonably expects to employ on business days in the calendar year
in which the determination is made.
SECTION 6. The change in law made by this Act applies only
to a health benefit plan delivered, issued for delivery, or renewed
on or after January 1, 2014. A plan that is delivered, issued for
delivery, or renewed before January 1, 2014, is governed by the law
in effect immediately before the effective date of this Act, and
that law continues in effect for that purpose.
SECTION 7. This Act takes effect September 1, 2013.