S.B. No. 1852
AN ACT
relating to disclosures required in connection with the issuance of
certain health benefit plans.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 1507.006(b), Insurance Code, is amended
to read as follows:
(b) Each applicant for initial coverage [and each
policyholder on renewal of coverage] must sign the disclosure
statement provided by the health carrier under Subsection (a) and
return the statement to the health carrier. Under a group policy or
contract, the term "applicant" means the employer.
SECTION 2. Section 1507.056(b), Insurance Code, is amended
to read as follows:
(b) Each applicant for initial enrollment [and each
contract holder on renewal] must sign the disclosure statement
provided by the health maintenance organization under Subsection
(a) and return the statement to the health maintenance
organization. Under a group evidence of coverage, the term
"applicant" means the employer.
SECTION 3. Subtitle G, Title 8, Insurance Code, is amended
by adding Chapter 1509 to read as follows:
CHAPTER 1509. SHORT-TERM LIMITED-DURATION INSURANCE
Sec. 1509.001. DEFINITION. In this chapter, "short-term
limited-duration insurance" has the meaning assigned by 26 C.F.R.
Section 54.9801-2.
Sec. 1509.002. POLICY DISCLOSURE FORM. (a) The
commissioner by rule shall prescribe a disclosure form to be
provided with a short-term limited-duration insurance policy and
application.
(b) The disclosure form must be in an easily readable font
at least 14-point in size and include:
(1) the duration of coverage;
(2) a statement:
(A) of the number of times the policy may be
renewed or that the policy may not be renewed, as applicable;
(B) that the expiration of short-term coverage is
not a qualifying life event that would make a person eligible for a
special enrollment period; and
(C) that the policy may expire outside of the
open enrollment period;
(3) to the extent the information is available, the
dates of the next three open enrollment periods under the Patient
Protection and Affordable Care Act (Pub. L. No. 111-148) following
the date the policy expires;
(4) whether the policy contains any limitations or
exclusions to preexisting conditions;
(5) the maximum dollar amount payable under the
policy;
(6) the deductibles under the policy and the health
care services to which the deductibles apply;
(7) whether the following health care services are
covered, including:
(A) prescription drug coverage;
(B) mental health services;
(C) substance abuse treatment;
(D) maternity care;
(E) hospitalization;
(F) surgery;
(G) emergency health care; and
(H) preventive health care; and
(8) any other information the commissioner determines
is important for a purchaser of a short-term limited-duration
insurance policy.
(c) An insurer issuing a short-term limited-duration
insurance policy shall adopt procedures in accordance with
commissioner rule to obtain a signed form from the insured
acknowledging receipt of the disclosure form described by this
section. The rule must allow for electronic acknowledgment. The
insurer shall retain an acknowledgment form until the fifth
anniversary of the date the insurer receives the form, and the
insurer shall make the form available to the department on request.
SECTION 4. Chapter 1507, Insurance Code, as amended by this
Act, applies only to a policy or evidence of coverage delivered,
issued for delivery, or renewed on or after the effective date of
this Act. A policy or evidence of coverage delivered, issued for
delivery, or renewed before the effective date of this Act is
governed by the law as it existed immediately before the effective
date of this Act, and that law is continued in effect for that
purpose.
SECTION 5. Not later than January 1, 2020, the commissioner
of insurance shall prescribe the disclosure form required by
Section 1509.002, Insurance Code, as added by this Act.
SECTION 6. Chapter 1509, Insurance Code, as added by this
Act, applies only to an insurance policy delivered, issued for
delivery, or renewed on or after January 1, 2020. An insurance
policy delivered, issued for delivery, or renewed before January 1,
2020, is governed by the law as it existed immediately before the
effective date of this Act, and that law is continued in effect for
that purpose.
SECTION 7. This Act takes effect September 1, 2019.
______________________________ ______________________________
President of the Senate Speaker of the House
I hereby certify that S.B. No. 1852 passed the Senate on
April 17, 2019, by the following vote: Yeas 31, Nays 0; and that
the Senate concurred in House amendment on May 23, 2019, by the
following vote: Yeas 31, Nays 0.
______________________________
Secretary of the Senate
I hereby certify that S.B. No. 1852 passed the House, with
amendment, on May 16, 2019, by the following vote: Yeas 134,
Nays 0, two present not voting.
______________________________
Chief Clerk of the House
Approved:
______________________________
Date
______________________________
Governor