| 1 | 1 | | 85R4226 PMO-D |
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| 2 | 2 | | By: Collier H.B. No. 477 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to the provision and use of health coverage information to |
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| 8 | 8 | | educate consumers purchasing individual health benefit coverage. |
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| 9 | 9 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 10 | 10 | | SECTION 1. Subtitle B, Title 5, Insurance Code, is amended |
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| 11 | 11 | | by adding Chapter 526 to read as follows: |
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| 12 | 12 | | CHAPTER 526. CONSUMER HEALTH COVERAGE EDUCATION |
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| 13 | 13 | | Sec. 526.001. DEFINITIONS. In this chapter: |
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| 14 | 14 | | (1) "Agent" means a person who may act as an agent for |
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| 15 | 15 | | the sale of a health benefit plan under a license issued under Title |
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| 16 | 16 | | 13. |
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| 17 | 17 | | (2) "Individual health benefit plan" means: |
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| 18 | 18 | | (A) an individual accident and health insurance |
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| 19 | 19 | | policy to which Chapter 1201 applies; or |
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| 20 | 20 | | (B) individual health maintenance organization |
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| 21 | 21 | | coverage. |
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| 22 | 22 | | Sec. 526.002. PROVISION OF REQUIRED INFORMATION. (a) A |
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| 23 | 23 | | health benefit plan issuer that offers an individual health benefit |
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| 24 | 24 | | plan shall provide health coverage information adopted by the |
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| 25 | 25 | | commissioner under Section 526.003 to each agent who acts on behalf |
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| 26 | 26 | | of the health benefit plan issuer with respect to the sale of the |
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| 27 | 27 | | individual health benefit plan. |
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| 28 | 28 | | (b) An agent who receives health coverage information |
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| 29 | 29 | | described by Subsection (a) may not sell or receive an application |
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| 30 | 30 | | for an individual health benefit plan issued by the health benefit |
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| 31 | 31 | | plan issuer that provided the information until the agent provides |
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| 32 | 32 | | the health coverage information to the prospective purchaser of the |
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| 33 | 33 | | individual health benefit plan. |
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| 34 | 34 | | Sec. 526.003. RULES. (a) The commissioner by rule shall |
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| 35 | 35 | | adopt the form and content of the health coverage information |
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| 36 | 36 | | required under Section 526.002. |
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| 37 | 37 | | (b) The health coverage information adopted under |
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| 38 | 38 | | Subsection (a) must be designed to educate a prospective purchaser |
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| 39 | 39 | | of an individual health benefit plan about policy and coverage |
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| 40 | 40 | | provisions, including copayments, deductibles, and coinsurance, |
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| 41 | 41 | | provider networks, and financial responsibilities for in-network |
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| 42 | 42 | | and out-of-network services. |
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| 43 | 43 | | SECTION 2. This Act takes effect January 1, 2018. |
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