Texas 2019 - 86th Regular

Texas House Bill HB1645 Compare Versions

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

Old	New	Differences
1	1	86R6927 MEW-D
2	2	By: Beckley H.B. No. 1645
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to health benefit plan coverage of preexisting conditions.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. Subtitle G, Title 8, Insurance Code, is amended
10	10	by adding Chapter 1509 to read as follows:
11	11	CHAPTER 1509. COVERAGE OF PREEXISTING CONDITIONS
12	12	Sec. 1509.001. DEFINITION. In this chapter, "preexisting
13	13	condition" means a condition present before the effective date of
14	14	an individual's coverage under a health benefit plan.
15	15	Sec. 1509.002. APPLICABILITY OF CHAPTER. (a) This chapter
16	16	applies only to a health benefit plan that provides benefits for
17	17	medical or surgical expenses incurred as a result of a health
18	18	condition, accident, or sickness, including an individual, group,
19	19	blanket, or franchise insurance policy or insurance agreement, a
20	20	group hospital service contract, or an individual or group evidence
21	21	of coverage or similar coverage document that is offered by:
22	22	(1) an insurance company;
23	23	(2) a group hospital service corporation operating
24	24	under Chapter 842;
25	25	(3) a health maintenance organization operating under
26	26	Chapter 843;
27	27	(4) an approved nonprofit health corporation that
28	28	holds a certificate of authority under Chapter 844;
29	29	(5) a multiple employer welfare arrangement that holds
30	30	a certificate of authority under Chapter 846;
31	31	(6) a stipulated premium company operating under
32	32	Chapter 884;
33	33	(7) a fraternal benefit society operating under
34	34	Chapter 885;
35	35	(8) a Lloyd's plan operating under Chapter 941; or
36	36	(9) an exchange operating under Chapter 942.
37	37	(b) Notwithstanding any other law, this chapter applies to:
38	38	(1) a small employer health benefit plan subject to
39	39	Chapter 1501, including coverage provided through a health group
40	40	cooperative under Subchapter B of that chapter;
41	41	(2) a standard health benefit plan issued under
42	42	Chapter 1507;
43	43	(3) a basic coverage plan under Chapter 1551;
44	44	(4) a basic plan under Chapter 1575;
45	45	(5) a primary care coverage plan under Chapter 1579;
46	46	(6) a plan providing basic coverage under Chapter
47	47	1601;
48	48	(7) health benefits provided by or through a church
49	49	benefits board under Subchapter I, Chapter 22, Business
50	50	Organizations Code;
51	51	(8) group health coverage made available by a school
52	52	district in accordance with Section 22.004, Education Code;
53	53	(9) the state Medicaid program, including the Medicaid
54	54	managed care program operated under Chapter 533, Government Code;
55	55	(10) the child health plan program under Chapter 62,
56	56	Health and Safety Code;
57	57	(11) a regional or local health care program operated
58	58	under Section 75.104, Health and Safety Code;
59	59	(12) a self-funded health benefit plan sponsored by a
60	60	professional employer organization under Chapter 91, Labor Code;
61	61	(13) county employee group health benefits provided
62	62	under Chapter 157, Local Government Code; and
63	63	(14) health and accident coverage provided by a risk
64	64	pool created under Chapter 172, Local Government Code.
65	65	(c) This chapter applies to coverage under a group health
66	66	benefit plan provided to a resident of this state regardless of
67	67	whether the group policy, agreement, or contract is delivered,
68	68	issued for delivery, or renewed in this state.
69	69	Sec. 1509.003. EXCEPTIONS. (a) This chapter does not apply
70	70	to:
71	71	(1) a plan that provides coverage:
72	72	(A) for wages or payments in lieu of wages for a
73	73	period during which an employee is absent from work because of
74	74	sickness or injury;
75	75	(B) as a supplement to a liability insurance
76	76	policy;
77	77	(C) for credit insurance;
78	78	(D) only for dental or vision care;
79	79	(E) only for hospital expenses; or
80	80	(F) only for indemnity for hospital confinement;
81	81	(2) a workers' compensation insurance policy; or
82	82	(3) medical payment insurance coverage provided under
83	83	a motor vehicle insurance policy.
84	84	(b) This chapter does not apply to an individual health
85	85	benefit plan issued on or before March 23, 2010, that has not had
86	86	any significant changes since that date that reduce benefits or
87	87	increase costs to the individual.
88	88	Sec. 1509.004. PREEXISTING CONDITION RESTRICTIONS
89	89	PROHIBITED. Notwithstanding any other law, a health benefit plan
90	90	issuer may not:
91	91	(1) deny coverage to or refuse to enroll an individual
92	92	in a health benefit plan on the basis of a preexisting condition;
93	93	(2) limit or exclude coverage under the health benefit
94	94	plan for treatment of the individual's preexisting condition
95	95	otherwise covered under the plan; or
96	96	(3) charge the individual more for coverage than the
97	97	health benefit plan issuer charges an individual who does not have a
98	98	preexisting condition.
99	99	SECTION 2. If before implementing any provision of this Act
100	100	a state agency determines that a waiver or authorization from a
101	101	federal agency is necessary for implementation of that provision,
102	102	the agency affected by the provision shall request the waiver or
103	103	authorization and may delay implementing that provision until the
104	104	waiver or authorization is granted.
105	105	SECTION 3. The change in law made by this Act applies only
106	106	to a health benefit plan that is delivered, issued for delivery, or
107	107	renewed on or after January 1, 2020. A health benefit plan that is
108	108	delivered, issued for delivery, or renewed before January 1, 2020,
109	109	is governed by the law as it existed immediately before the
110	110	effective date of this Act, and that law is continued in effect for
111	111	that purpose.
112	112	SECTION 4. This Act takes effect September 1, 2019.