Texas 2015 - 84th Regular

Texas House Bill HB2219 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New	Differences
1	1	84R1526 PMO-D
2	2	By: Coleman, Morrison H.B. No. 2219
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to health benefit plan coverage for injuries related to
8	8	certain conduct of a covered individual.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subtitle E, Title 8, Insurance Code, is amended
11	11	by adding Chapter 1380 to read as follows:
12	12	CHAPTER 1380. COVERAGE RELATING TO INJURIES RELATED TO CERTAIN
13	13	CONDUCT
14	14	Sec. 1380.001. APPLICABILITY OF CHAPTER. (a) This chapter
15	15	applies only to a health benefit plan that provides benefits for
16	16	medical or surgical expenses incurred as a result of a health
17	17	condition, accident, or sickness, including an individual, group,
18	18	blanket, or franchise insurance policy or insurance agreement, a
19	19	group hospital service contract, or an individual or group evidence
20	20	of coverage or similar coverage document that is offered by:
21	21	(1) an insurance company;
22	22	(2) a group hospital service corporation operating
23	23	under Chapter 842;
24	24	(3) a health maintenance organization operating under
25	25	Chapter 843;
26	26	(4) an approved nonprofit health corporation that
27	27	holds a certificate of authority under Chapter 844;
28	28	(5) a multiple employer welfare arrangement that holds
29	29	a certificate of authority under Chapter 846;
30	30	(6) a stipulated premium company operating under
31	31	Chapter 884;
32	32	(7) a fraternal benefit society operating under
33	33	Chapter 885; or
34	34	(8) an exchange operating under Chapter 942.
35	35	(b) Notwithstanding Section 1501.251 or any other law, this
36	36	chapter applies to coverage under a small employer health benefit
37	37	plan subject to Chapter 1501.
38	38	(c) This chapter applies to a consumer choice of benefits
39	39	plan issued under Chapter 1507.
40	40	Sec. 1380.002. CONDITIONAL EXCEPTION. This chapter does
41	41	not apply to a qualified health plan if a determination is made
42	42	under 45 C.F.R. Section 155.170 that:
43	43	(1) this chapter requires the plan to offer benefits
44	44	in addition to the essential health benefits required under 42
45	45	U.S.C. Section 18022(b); and
46	46	(2) this state is required to defray the cost of the
47	47	benefits mandated under this chapter.
48	48	Sec. 1380.003. EXCLUSION OF COVERAGE PROHIBITED. (a) A
49	49	health benefit plan may not exclude coverage for any emergency or
50	50	other medical, hospital, or surgical expenses incurred by a covered
51	51	individual as a result of and related to an injury that is
52	52	self-inflicted or caused in an attempt to commit suicide,
53	53	regardless of:
54	54	(1) the individual's state of mental health; or
55	55	(2) whether the injury results in the individual's
56	56	death.
57	57	(b) Coverage required under this chapter may be subject to
58	58	deductibles, copayments, coinsurance, or annual or maximum payment
59	59	limits that are consistent with deductibles, copayments,
60	60	coinsurance, or annual or maximum payment limits applicable to
61	61	other similar coverage under the health benefit plan.
62	62	Sec. 1380.004. RULES. The commissioner shall adopt rules
63	63	necessary to implement this chapter.
64	64	SECTION 2. The change in law made by this Act applies only
65	65	to a health benefit plan that is delivered, issued for delivery, or
66	66	renewed on or after January 1, 2016. A health benefit plan that is
67	67	delivered, issued for delivery, or renewed before January 1, 2016,
68	68	is governed by the law as it existed immediately before the
69	69	effective date of this Act, and that law is continued in effect for
70	70	that purpose.
71	71	SECTION 3. This Act takes effect September 1, 2015.