Texas 2015 - 84th Regular

Texas House Bill HB3024 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	By: Guerra (Senate Sponsor - Hinojosa) H.B. No. 3024
2		-	(In the Senate - Received from the House May 13, 2015;
3		-	May 13, 2015, read first time and referred to Committee on Business
4		-	and Commerce; May 20, 2015, reported favorably by the following
5		-	vote: Yeas 8, Nays 1; May 20, 2015, sent to printer.)
6		-	Click here to see the committee vote
	1	+	H.B. No. 3024
7	2
8	3
9		-	COMMITTEE VOTE
10		-	YeaNayAbsentPNV
11		-	EltifeX
12		-	CreightonX
13		-	EllisX
14		-	HuffinesX
15		-	SchwertnerX
16		-	SeligerX
17		-	TaylorofGalvestonX
18		-	WatsonX
19		-	WhitmireX
20		-	A BILL TO BE ENTITLED
21	4		AN ACT
22	5		relating to coordination of dental benefits under certain insurance
23	6		policies.
24	7		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
25	8		SECTION 1. Chapter 1203, Insurance Code, is amended by
26	9		adding Subchapter B to read as follows:
27	10		SUBCHAPTER B. DENTAL INSURANCE
28	11		Sec. 1203.051. APPLICABILITY OF SUBCHAPTER; EXCEPTION. (a)
29	12		This subchapter applies only to an insurance policy that provides
30	13		benefits for dental expenses, including, except as provided by
31	14		Subsection (b), an individual, group, blanket, or franchise
32	15		insurance policy or insurance agreement, or a group hospital
33	16		service contract, that is offered by:
34	17		(1) an insurance company;
35	18		(2) a group hospital service corporation operating
36	19		under Chapter 842;
37	20		(3) a fraternal benefit society operating under
38	21		Chapter 885;
39	22		(4) a stipulated premium company operating under
40	23		Chapter 884;
41	24		(5) a reciprocal exchange operating under Chapter 942;
42	25		or
43	26		(6) a Lloyd's plan operating under Chapter 941.
44	27		(b) This subchapter does not apply to a separate dental
45	28		policy that exclusively provides a non-coordinated, fixed
46	29		indemnity benefit, regardless of expenses incurred paid directly to
47	30		the policyholder or to the provider under an assignment of benefits
48	31		provision.
49	32		Sec. 1203.052. COORDINATION OF BENEFITS BETWEEN PRIMARY AND
50	33		SECONDARY INSURERS. (a) This section applies if:
51	34		(1) an insured is covered by at least two different
52	35		insurance policies; and
53	36		(2) each policy provides the insured dental benefits.
54	37		(b) The primary insurer, as determined under a coordination
55	38		of benefits provision applicable to the policies, is responsible
56	39		for dental expenses covered under the insurance policy issued by
57	40		the primary insurer up to the full amount of any policy limit
58	41		applicable to the covered dental expenses.
59	42		(c) Before the policy limit described by Subsection (b) is
60	43		reached, the secondary insurer, as determined under a coordination
61	44		of benefits provision applicable to the policies, is responsible
62	45		only for dental expenses covered under the insurance policy issued
63	46		by the secondary insurer that are not covered under the policy
64	47		issued by the primary insurer.
65	48		(d) After the policy limit described by Subsection (b) has
66	49		been reached, the secondary insurer, in addition to the
67	50		responsibility described by Subsection (c), is responsible for any
68	51		dental expenses covered by both policies that exceed the policy
69	52		limit described by Subsection (b), not to exceed the policy limit of
70	53		the secondary policy.
71	54		Sec. 1203.053. CERTAIN COORDINATION OF BENEFITS PROVISIONS
72	55		PROHIBITED. An insurance policy subject to this subchapter may not
73	56		be delivered, issued for delivery, or renewed in this state if:
74	57		(1) a provision of the policy excludes or reduces the
75	58		payment of benefits for dental expenses to or on behalf of an
76	59		insured;
77	60		(2) the reason for the exclusion or reduction is that
78	61		dental benefits are payable or have been paid to or on behalf of the
79	62		insured under another insurance policy; and
80	63		(3) the exclusion or reduction would apply before the
81	64		full amount of the dental expenses incurred by the insured and
82	65		covered by both policies have been paid or reimbursed or the full
83	66		amount of the applicable policy limit of the policy containing the
84	67		exclusion or reduction is reached.
85	68		Sec. 1203.054. CERTAIN COORDINATION OF BENEFITS PROVISIONS
86	69		VOID. A provision of an insurance policy that violates Section
87	70		1203.053 is void.
88	71		SECTION 2. Chapter 1203, Insurance Code, is amended by
89	72		designating Sections 1203.001 through 1203.003 as Subchapter A and
90	73		adding a subchapter heading to read as follows:
91	74		SUBCHAPTER A. SUPPLEMENTAL INSURANCE POLICIES
92	75		SECTION 3. Section 1203.001, Insurance Code, is amended to
93	76		read as follows:
94	77		Sec. 1203.001. APPLICABILITY OF SUBCHAPTER [CHAPTER]. (a)
95	78		This subchapter [chapter] applies only to:
96	79		(1) a policy of group accident and health insurance as
97	80		described by Chapter 1251;
98	81		(2) a policy of blanket accident and health insurance
99	82		as described by Chapter 1251;
100	83		(3) a policy of individual accident and health
101	84		insurance as defined by Section 1201.001; or
102	85		(4) an evidence of coverage as defined by Section
103	86		843.002.
104	87		(b) This subchapter [chapter] does not apply to an
105	88		individual accident and health insurance policy that is designed to
106	89		fully integrate with other policies through a variable deductible.
107	90		SECTION 4. The change in law made by this Act applies only
108	91		to an insurance policy that is delivered, issued for delivery, or
109	92		renewed on or after January 1, 2016. A policy delivered, issued for
110	93		delivery, or renewed before January 1, 2016, is governed by the law
111	94		as it existed immediately before the effective date of this Act, and
112	95		that law is continued in effect for that purpose.
113	96		SECTION 5. This Act takes effect September 1, 2015.
114		-	* * * * *
	97	+	______________________________ ______________________________
	98	+	President of the Senate Speaker of the House
	99	+	I certify that H.B. No. 3024 was passed by the House on May
	100	+	12, 2015, by the following vote: Yeas 115, Nays 26, 3 present, not
	101	+	voting.
	102	+	______________________________
	103	+	Chief Clerk of the House
	104	+	I certify that H.B. No. 3024 was passed by the Senate on May
	105	+	22, 2015, by the following vote: Yeas 26, Nays 5.
	106	+	______________________________
	107	+	Secretary of the Senate
	108	+	APPROVED: _____________________
	109	+	Date
	110	+	_____________________
	111	+	Governor