84R2570 LED-D
By: Márquez H.B. No. 1797
A BILL TO BE ENTITLED
AN ACT
relating to coverage for certain individuals under certain health
benefit plans offered to governmental employees.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter A, Chapter 1551, Insurance Code, is
amended by adding Section 1551.0041 to read as follows:
Sec. 1551.0041. DEFINITION OF QUALIFIED INDIVIDUAL. In
this chapter, "qualified individual" means an individual who is at
least 18 years old and unmarried in this state and who is, with
respect to an individual eligible to participate in the group
benefits program under Section 1551.101, 1551.102, 1551.1021, or
1551.1022:
(1) not related to the eligible individual within the
third degree of consanguinity;
(2) financially interdependent with the eligible
individual; and
(3) cohabitating with the eligible individual.
SECTION 2. Section 1551.151, Insurance Code, is amended to
read as follows:
Sec. 1551.151. ENTITLEMENT TO COVERAGE. An individual who
is eligible to participate in the group benefits program under
Section 1551.101, 1551.102, 1551.1021, or 1551.1022 is entitled to
secure for a dependent of the individual or for a qualified
individual any group coverages provided under this chapter, as
determined by the board of trustees and subject to the exceptions
provided by this subchapter.
SECTION 3. Subchapter D, Chapter 1551, Insurance Code, is
amended by adding Section 1551.1511 to read as follows:
Sec. 1551.1511. PROOF OF QUALIFIED INDIVIDUAL STATUS. The
board of trustees may require an individual who secures coverage
under this chapter for a qualified individual to provide proof of
any two of the following documents:
(1) joint liability of the individuals for a mortgage,
lease, or loan;
(2) the designation of one of the individuals as the
primary beneficiary under a life insurance policy on the life of the
other individual or under a retirement plan of the other
individual;
(3) the designation of one of the individuals as the
primary beneficiary of the will of the other individual;
(4) a durable power of attorney for health care or
financial management granted by one of the individuals to the other
individual;
(5) joint ownership or lease by the individuals of a
motor vehicle;
(6) a joint checking account, joint investments, or a
joint credit account;
(7) a joint renter's or homeowner's insurance policy;
(8) joint responsibility for child care, such as
guardianship or school documents; or
(9) a relationship or cohabitation contract.
SECTION 4. Section 1551.310, Insurance Code, is amended to
read as follows:
Sec. 1551.310. STATE CONTRIBUTION REQUIRED. (a) The state
shall contribute to the cost of each participant's group coverages,
including dependents' group coverages, the amounts appropriated
for the coverages in the General Appropriations Act.
(b) The state shall pay the same portion of the cost of the
required contributions for a qualified individual as this state
pays for similar dependent coverage for an employee or annuitant
participating in the program.
SECTION 5. Subchapter A, Chapter 1575, Insurance Code, is
amended by adding Section 1575.0031 to read as follows:
Sec. 1575.0031. DEFINITION OF QUALIFIED INDIVIDUAL. In
this chapter, "qualified individual" means an individual who is at
least 18 years old and unmarried in this state and who is, with
respect to a retiree:
(1) not related to the retiree within the third degree
of consanguinity;
(2) financially interdependent with the retiree; and
(3) cohabitating with the retiree.
SECTION 6. Section 1575.155(a), Insurance Code, is amended
to read as follows:
(a) A retiree participating in the group program is entitled
to secure for the retiree's dependents or a qualified individual
group coverage provided for the retiree under this chapter, as
determined by the trustee.
SECTION 7. Subchapter D, Chapter 1575, Insurance Code, is
amended by adding Section 1575.1551 to read as follows:
Sec. 1575.1551. PROOF OF QUALIFIED INDIVIDUAL STATUS. The
trustee may require a retiree who secures coverage under this
chapter for a qualified individual to provide proof of any two of
the following documents:
(1) joint liability of the individuals for a mortgage,
lease, or loan;
(2) the designation of one of the individuals as the
primary beneficiary under a life insurance policy on the life of the
other individual or under a retirement plan of the other
individual;
(3) the designation of one of the individuals as the
primary beneficiary of the will of the other individual;
(4) a durable power of attorney for health care or
financial management granted by one of the individuals to the other
individual;
(5) joint ownership or lease by the individuals of a
motor vehicle;
(6) a joint checking account, joint investments, or a
joint credit account;
(7) a joint renter's or homeowner's insurance policy;
(8) joint responsibility for child care, such as
guardianship or school documents; or
(9) a relationship or cohabitation contract.
SECTION 8. Section 1575.201, Insurance Code, is amended by
adding Subsection (a-1) and amending Subsection (b) to read as
follows:
(a-1) The state shall pay the same portion of the cost of the
required contributions for a qualified individual as this state
pays for similar dependent coverage for a retiree participating in
the group program.
(b) The trustee shall collect the amount of premium required
for basic coverage under the group program that exceeds the amount
contributed by the state for those individuals described by
Subsections [Subsection] (a)(2) and (a-1).
SECTION 9. Subchapter A, Chapter 1579, Insurance Code, is
amended by adding Section 1579.0041 to read as follows:
Sec. 1579.0041. DEFINITION OF QUALIFIED INDIVIDUAL. In
this chapter, "qualified individual" means an individual who is at
least 18 years old and unmarried in this state and who is, with
respect to a participating employee:
(1) not related to the participating employee within
the third degree of consanguinity;
(2) financially interdependent with the participating
employee; and
(3) cohabitating with the participating employee.
SECTION 10. Section 1579.101(a), Insurance Code, is amended
to read as follows:
(a) The trustee by rule shall establish plans of group
coverages for employees participating in the program, [and] their
dependents, and qualified individuals.
SECTION 11. Subchapter C, Chapter 1579, Insurance Code, is
amended by adding Section 1579.1011 to read as follows:
Sec. 1579.1011. PROOF OF QUALIFIED INDIVIDUAL STATUS. The
trustee may require an employee who secures coverage under this
chapter for a qualified individual to provide proof of any two of
the following documents:
(1) joint liability of the individuals for a mortgage,
lease, or loan;
(2) the designation of one of the individuals as the
primary beneficiary under a life insurance policy on the life of the
other individual or under a retirement plan of the other
individual;
(3) the designation of one of the individuals as the
primary beneficiary of the will of the other individual;
(4) a durable power of attorney for health care or
financial management granted by one of the individuals to the other
individual;
(5) joint ownership or lease by the individuals of a
motor vehicle;
(6) a joint checking account, joint investments, or a
joint credit account;
(7) a joint renter's or homeowner's insurance policy;
(8) joint responsibility for child care, such as
guardianship or school documents; or
(9) a relationship or cohabitation contract.
SECTION 12. Section 1579.203(c), Insurance Code, is amended
to read as follows:
(c) If the combined contributions received from the state
and the employing participating entity under Subchapter F exceed
the cost of a coverage plan selected by the employee, the employee
may use the excess amount of contributions to obtain coverage under
a higher tier coverage plan or to pay all or part of the cost of
coverage for the employee's dependents or a qualified individual.
SECTION 13. Subchapter A, Chapter 1601, Insurance Code, is
amended by adding Section 1601.0041 to read as follows:
Sec. 1601.0041. DEFINITION OF QUALIFIED INDIVIDUAL. In
this chapter, "qualified individual" means an individual who is at
least 18 years old and unmarried in this state and who is, with
respect to an individual eligible to participate in the group
benefits program under Section 1601.101, 1601.102, or 1601.1021:
(1) not related to the eligible individual within the
third degree of consanguinity;
(2) financially interdependent with the eligible
individual; and
(3) cohabitating with the eligible individual.
SECTION 14. Section 1601.107, Insurance Code, is amended to
read as follows:
Sec. 1601.107. COVERAGE FOR DEPENDENTS AND QUALIFIED
INDIVIDUALS. An individual who is eligible to participate in the
uniform program under Section 1601.101, 1601.102, or 1601.1021 is
entitled to secure for a dependent of the individual or for a
qualified individual any group coverages provided under this
chapter for dependents under rules adopted by the applicable
system.
SECTION 15. Subchapter C, Chapter 1601, Insurance Code, is
amended by adding Section 1601.1071 to read as follows:
Sec. 1601.1071. PROOF OF QUALIFIED INDIVIDUAL STATUS. A
system may require an individual who secures coverage under this
chapter for a qualified individual to provide proof of any two of
the following documents:
(1) joint liability of the individuals for a mortgage,
lease, or loan;
(2) the designation of one of the individuals as the
primary beneficiary under a life insurance policy on the life of the
other individual or under a retirement plan of the other
individual;
(3) the designation of one of the individuals as the
primary beneficiary of the will of the other individual;
(4) a durable power of attorney for health care or
financial management granted by one of the individuals to the other
individual;
(5) joint ownership or lease by the individuals of a
motor vehicle;
(6) a joint checking account, joint investments, or a
joint credit account;
(7) a joint renter's or homeowner's insurance policy;
(8) joint responsibility for child care, such as
guardianship or school documents; or
(9) a relationship or cohabitation contract.
SECTION 16. Section 1601.201, Insurance Code, is amended by
amending Subsections (b) and (c) and adding Subsection (e) to read
as follows:
(b) For an employee designated by the system as working 40
or more hours a week, the system may contribute:
(1) the full cost of basic coverage for the employee;
and
(2) not more than 50 percent of the cost of dependent
coverage, including the cost of coverage of a qualified individual.
(c) For an employee designated by the system as working less
than 40 hours a week, including an individual employed by the system
in a position that as a condition of employment requires the
individual to be enrolled as a student in the system in
graduate-level courses, the system, from money appropriated from
the general revenue fund, may contribute:
(1) not more than 50 percent of the cost of basic
coverage for the employee; and
(2) not more than 25 percent of the cost of dependent
coverage, including the cost of coverage of a qualified individual.
(e) The state shall pay the same portion of the cost of the
required contributions for a qualified individual as this state
pays for similar dependent coverage for an employee participating
in the program.
SECTION 17. As soon as practicable after the effective date
of this Act, but not later than January 1, 2016, The University of
Texas System, The Texas A&M University System, the board of
trustees of the Teacher Retirement System of Texas, and the board of
trustees of the Employees Retirement System of Texas shall adopt
rules necessary to implement the changes in law made by this Act.
SECTION 18. The changes in law made by this Act apply only
to health benefit plans provided under Chapters 1551, 1575, 1579,
and 1601, Insurance Code, beginning with the 2016-2017 plan year. A
plan year before 2016-2017 is governed by the law as it existed
immediately before September 1, 2015, and that law is continued in
effect for that purpose.
SECTION 19. This Act takes effect September 1, 2015.