Texas 2017 - 85th Regular

Texas Senate Bill SB789 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	85R7477 BEE-F
2	2	By: Huffman S.B. No. 789
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the administration of and benefits payable under the
8	8	Texas School Employees Uniform Group Health Coverage Act.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 1579.002(4), Insurance Code, is amended
11	11	to read as follows:
12	12	(4) "Health coverage plan" means any [group policy or
13	13	contract, hospital service agreement, health maintenance
14	14	organization agreement, preferred provider arrangement, or any
15	15	similar] group arrangement to provide health care benefits or to
16	16	pay or reimburse [or any combination of those policies, contracts,
17	17	agreements, or arrangements that provides for, pays for, or
18	18	reimburses] expenses for health care services.
19	19	SECTION 2. Subchapter A, Chapter 1579, Insurance Code, is
20	20	amended by adding Section 1579.0025 to read as follows:
21	21	Sec. 1579.0025. REFERENCES TO PRIMARY CARE COVERAGE PLAN.
22	22	A reference in this code to a "primary care coverage plan" under
23	23	this chapter means the health coverage plan provided under Section
24	24	1579.101.
25	25	SECTION 3. The heading to Subchapter C, Chapter 1579,
26	26	Insurance Code, is amended to read as follows:
27	27	SUBCHAPTER C. COVERAGES; HEALTH SAVINGS ACCOUNTS
28	28	SECTION 4. The heading to Section 1579.101, Insurance Code,
29	29	is amended to read as follows:
30	30	Sec. 1579.101. HEALTH COVERAGE PLAN [PLANS OF GROUP
31	31	COVERAGES].
32	32	SECTION 5. Section 1579.101(a), Insurance Code, is amended
33	33	to read as follows:
34	34	(a) The trustee [by rule] shall establish or contract for
35	35	and make available a high deductible health coverage plan to be
36	36	offered to eligible [plans of group coverages for] employees of all
37	37	participating entities [in the program] and their eligible
38	38	dependents and that provides for, pays for, or reimburses expenses
39	39	for health care services that the trustee considers advisable.
40	40	SECTION 6. Subchapter C, Chapter 1579, Insurance Code, is
41	41	amended by adding Section 1579.109 to read as follows:
42	42	Sec. 1579.109. HEALTH SAVINGS ACCOUNT PROGRAM. The trustee
43	43	may establish or contract for and make available a health savings
44	44	account program to be offered to eligible employees and their
45	45	eligible dependents.
46	46	SECTION 7. Subchapter D, Chapter 1579, Insurance Code, is
47	47	amended by adding Sections 1579.1511, 1579.1521, and 1579.1531 to
48	48	read as follows:
49	49	Sec. 1579.1511. PARTICIPATION OF ENTITIES WITH 1,000 OR
50	50	FEWER EMPLOYEES. (a) Except as provided by Section 1579.1521(b), a
51	51	participating entity that had 1,000 or fewer employees on January
52	52	1, 2017, is required to continue to participate in the program on
53	53	and after September 1, 2018, unless the participating entity makes
54	54	a one-time election to discontinue its participation in the program
55	55	effective September 1, 2018.
56	56	(b) An entity eligible to become a participating entity that
57	57	had 1,000 or fewer employees on January 1, 2017, may make a one-time
58	58	election to participate in the program effective September 1, 2018.
59	59	(c) An entity otherwise eligible to become a participating
60	60	entity that is established after January 1, 2017, and has 1,000 or
61	61	fewer employees on the date the entity begins operating may make a
62	62	one-time election to participate in the program effective on:
63	63	(1) the earliest September 1 that occurs after the
64	64	first anniversary of the date the entity begins operating; or
65	65	(2) an earlier date if approved by the trustee.
66	66	(d) An entity otherwise eligible to become a participating
67	67	entity that had more than 1,000 employees on January 1, 2017, that
68	68	subsequently has 1,000 or fewer employees for five consecutive
69	69	years may make a one-time election to participate in the program.
70	70	(e) The trustee shall prescribe the time and manner for
71	71	making an election under this section.
72	72	Sec. 1579.1521. PARTICIPATION OF ENTITIES WITH MORE THAN
73	73	1,000 EMPLOYEES. (a) An entity that has more than 1,000 employees
74	74	on January 1, 2017, may not participate in the program on or after
75	75	September 1, 2018.
76	76	(b) An entity that continued to participate in or elected to
77	77	participate in the program under Section 1579.1511 that
78	78	subsequently has more than 1,000 employees for five consecutive
79	79	years may not continue to participate in the program. The trustee
80	80	shall prescribe the time and manner of a participating entity's
81	81	exit from the program under this subsection.
82	82	Sec. 1579.1531. PARTICIPATION BY ENTITIES IN RISK POOLS.
83	83	(a) For purposes of determining the number of employees of an
84	84	entity for purposes of Sections 1579.1511 and 1579.1521, members of
85	85	a risk pool established under Chapter 172, Local Government Code,
86	86	as provided by Section 22.004, Education Code, may elect to be
87	87	treated as a single unit by notifying the trustee in the time and
88	88	manner prescribed by the trustee.
89	89	(b) Entities that make an election under this section,
90	90	acting as a risk pool, have the same rights and are subject to the
91	91	same restrictions under Sections 1579.1511 and 1579.1521 as an
92	92	entity that does not make an election under this section.
93	93	SECTION 8. Section 1579.202(b), Insurance Code, is amended
94	94	to read as follows:
95	95	(b) An employee described by Subsection (a) who applies for
96	96	coverage during an open enrollment period prescribed by the trustee
97	97	is automatically covered by the health [catastrophic care] coverage
98	98	plan provided under Section 1579.101 unless the employee[:
99	99	[(1) specifically waives coverage under this chapter;
100	100	[(2) selects a higher tier coverage plan; or
101	101	[(3)] is expelled from the program.
102	102	SECTION 9. Sections 1579.203(a) and (c), Insurance Code,
103	103	are amended to read as follows:
104	104	(a) A participating employee may select coverage in the
105	105	health [any] coverage plan offered by the trustee.
106	106	(c) If the combined contributions received from the state
107	107	and the employing participating entity under Subchapter F exceed
108	108	the cost of the [a] coverage for [plan selected by] the employee,
109	109	the employee may use the excess amount of contributions to [obtain
110	110	coverage under a higher tier coverage plan or to] pay all or part of
111	111	the cost of coverage for the employee's dependents.
112	112	SECTION 10. Section 1579.204, Insurance Code, is amended to
113	113	read as follows:
114	114	Sec. 1579.204. CERTAIN PART-TIME EMPLOYEES. A part-time
115	115	employee of a participating entity who is not a participating
116	116	member in the Teacher Retirement System of Texas is eligible to
117	117	participate in the program only if the employee pays all of the
118	118	premiums and other costs associated with the [health] coverage for
119	119	[plan selected by] the employee under the program.
120	120	SECTION 11. Section 1579.205, Insurance Code, is amended to
121	121	read as follows:
122	122	Sec. 1579.205. PAYMENT BY PARTICIPATING ENTITY.
123	123	Notwithstanding Section 1579.204, a participating entity may pay
124	124	any portion of what otherwise would be the employee share of
125	125	premiums and other costs associated with the coverage for [selected
126	126	by] the employee under the program.
127	127	SECTION 12. Section 1579.253, Insurance Code, is amended to
128	128	read as follows:
129	129	Sec. 1579.253. CONTRIBUTION BY EMPLOYEE. (a) An employee
130	130	covered by the program shall pay that portion of the cost of
131	131	coverage for [selected by] the employee and the employee's enrolled
132	132	dependents that exceeds the amount of the state contribution under
133	133	Section 1579.251 and the participating entity contribution under
134	134	Section 1579.252.
135	135	(b) The employee may pay the employee's contribution under
136	136	this section [subsection] from the amount distributed to the
137	137	employee under Subchapter D, Chapter 22, Education Code.
138	138	(c) Notwithstanding Subsection (a), a participating entity
139	139	may pay any portion of what otherwise would be the employee share of
140	140	premiums and other costs associated with the coverage for [selected
141	141	by] the employee.
142	142	SECTION 13. The following provisions of the Insurance Code
143	143	are repealed:
144	144	(1) Sections 1579.101(b), (c), and (d);
145	145	(2) Sections 1579.102, 1579.151, 1579.152, and
146	146	1579.153;
147	147	(3) Section 1579.154(b); and
148	148	(4) Section 1579.203(b).
149	149	SECTION 14. The changes in law made by this Act apply only
150	150	to health coverage provided under Chapter 1579, Insurance Code,
151	151	beginning with the 2018 plan year. A plan year before the 2018 plan
152	152	year is governed by the law as it existed immediately before the
153	153	effective date of this Act, and that law is continued in effect for
154	154	that purpose.
155	155	SECTION 15. This Act takes effect September 1, 2017.