86R7094 PMO-D
By: Collier H.B. No. 1156
A BILL TO BE ENTITLED
AN ACT
relating to the provision and use of health coverage information to
educate consumers purchasing individual health benefit coverage.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle B, Title 5, Insurance Code, is amended
by adding Chapter 526 to read as follows:
CHAPTER 526. CONSUMER HEALTH COVERAGE EDUCATION
Sec. 526.001. DEFINITIONS. In this chapter:
(1) "Agent" means a person who may act as an agent for
the sale of a health benefit plan under a license issued under Title
13.
(2) "Individual health benefit plan" means:
(A) an individual accident and health insurance
policy to which Chapter 1201 applies; or
(B) individual health maintenance organization
coverage.
Sec. 526.002. PROVISION OF REQUIRED INFORMATION. (a) A
health benefit plan issuer that offers an individual health benefit
plan shall provide health coverage information adopted by the
commissioner under Section 526.003 to each agent who acts on behalf
of the health benefit plan issuer with respect to the sale of the
individual health benefit plan.
(b) An agent who receives health coverage information
described by Subsection (a) from a health benefit plan issuer may
not sell or receive an application for an individual health benefit
plan issued by the health benefit plan issuer until the agent
provides the health coverage information to the prospective
purchaser of the individual health benefit plan.
Sec. 526.003. RULES. (a) The commissioner by rule shall
adopt the form and content of the health coverage information
required under Section 526.002.
(b) The health coverage information adopted under
Subsection (a) must be designed to educate a prospective purchaser
of an individual health benefit plan about policy and coverage
provisions, including copayments, deductibles, and coinsurance,
provider networks, and financial responsibilities for in-network
and out-of-network services.
SECTION 2. This Act takes effect January 1, 2020.