Texas 2019 - 86th Regular

Texas Senate Bill SB2407 Compare Versions

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

Old	New	Differences
1	1	86R6572 SMT-F
2	2	By: Menéndez S.B. No. 2407
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the regulation of short-term limited-duration health
8	8	insurance policies.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Section 1201.104(a), Insurance Code, is amended
11	11	to read as follows:
12	12	(a) For individual accident and health insurance policies,
13	13	the commissioner shall adopt rules establishing minimum standards
14	14	for benefits under each of the following categories of coverage:
15	15	(1) basic hospital expense;
16	16	(2) basic medical-surgical expense;
17	17	(3) hospital indemnity or other fixed indemnity;
18	18	(4) major medical expense;
19	19	(5) disability income protection;
20	20	(6) accident only;
21	21	(7) specified disease;
22	22	(8) specified accident; [and]
23	23	(9) limited benefit; and
24	24	(10) short-term limited-duration health.
25	25	SECTION 2. Chapter 1201, Insurance Code, is amended by
26	26	adding Subchapter G to read as follows:
27	27	SUBCHAPTER G. SHORT-TERM LIMITED-DURATION HEALTH INSURANCE
28	28	Sec. 1201.301. DEFINITIONS. In this subchapter:
29	29	(1) "Health benefit exchange" has the meaning assigned
30	30	by Section 1369.201.
31	31	(2) "Short-term limited-duration health insurance
32	32	policy" means a health insurance policy under which coverage is
33	33	limited to fewer than 365 days in duration.
34	34	Sec. 1201.302. ADVERTISING DISCLOSURES REQUIRED. (a) An
35	35	insurer issuing a short-term limited-duration health insurance
36	36	policy shall display, on all sales and marketing materials,
37	37	including any Internet websites advertising or selling the policy,
38	38	the following statement in bold type at least 14-point in size:
39	39	"NOTICE: THIS SHORT-TERM LIMITED-DURATION INSURANCE POLICY
40	40	DOES NOT INCLUDE ALL ESSENTIAL HEALTH BENEFITS AS REQUIRED BY THE
41	41	AFFORDABLE CARE ACT. PREEXISTING CONDITIONS (ARE/ARE NOT) COVERED.
42	42	BE SURE TO CHECK YOUR POLICY CAREFULLY TO MAKE SURE YOU UNDERSTAND
43	43	WHAT THE POLICY DOES AND DOES NOT COVER. THIS POLICY CANNOT BE
44	44	RENEWED. WHEN THIS COVERAGE ENDS, YOU MIGHT HAVE TO WAIT UP TO A
45	45	YEAR UNTIL THE NEXT OPEN ENROLLMENT PERIOD TO GET OTHER HEALTH
46	46	COVERAGE. YOU MAY BE ABLE TO GET LONGER TERM INSURANCE WITH
47	47	ESSENTIAL HEALTH BENEFITS AND HELP TO PAY FOR IT AT (health benefit
48	48	exchange Internet website address)."
49	49	(b) An agent selling a short-term limited-duration health
50	50	insurance policy in person or through the telephone shall read out
51	51	loud the disclosure prescribed by Subsection (a) to a prospective
52	52	purchaser.
53	53	Sec. 1201.303. POLICY DISCLOSURE FORM. (a) The
54	54	commissioner by rule shall prescribe a disclosure form to be
55	55	provided with the short-term limited-duration health insurance
56	56	policy and the application.
57	57	(b) The disclosure form must be in an easily readable font
58	58	at least 14-point in size and include:
59	59	(1) the duration of coverage;
60	60	(2) a statement that:
61	61	(A) the policy may not be renewed;
62	62	(B) the expiration of short-term coverage does
63	63	not make a person eligible for a special enrollment period; and
64	64	(C) when the policy ends, the insured may have to
65	65	wait up to a year until the next open enrollment period;
66	66	(3) whether the policy covers preexisting conditions;
67	67	(4) the maximum dollar amount payable under the
68	68	policy;
69	69	(5) the deductibles under the policy and the health
70	70	care services to which the deductibles apply;
71	71	(6) whether common health care services are covered,
72	72	including:
73	73	(A) prescription drug coverage;
74	74	(B) mental health services;
75	75	(C) substance abuse treatment;
76	76	(D) maternity care;
77	77	(E) hospitalization;
78	78	(F) surgery;
79	79	(G) emergency health care; and
80	80	(H) preventive health care; and
81	81	(7) a statement that, before enrolling, an individual
82	82	should determine whether the individual is able to purchase
83	83	long-term health coverage through the health benefit exchange and
84	84	that the individual may be eligible for financial assistance to pay
85	85	for it.
86	86	(c) An insurer issuing a short-term limited-duration health
87	87	insurance policy shall adopt procedures in accordance with
88	88	commissioner rule to obtain a signed form from the insured
89	89	acknowledging receipt of the disclosure form described by this
90	90	section. The insurer shall retain the acknowledgment form until
91	91	the fifth anniversary of the date the insurer receives the form, and
92	92	the insurer shall make the form available to the department on
93	93	request.
94	94	Sec. 1201.304. DURATION. A short-term limited-duration
95	95	health insurance policy must expire not later than the 91st day
96	96	after the date the policy takes effect.
97	97	Sec. 1201.305. RENEWAL PROHIBITED; NEW POLICY LIMITATION.
98	98	(a) An insurer may not renew a short-term limited-duration health
99	99	insurance policy.
100	100	(b) An insurer may not issue a short-term limited-duration
101	101	health insurance policy to an individual covered by a short-term
102	102	limited-duration health insurance policy during the preceding 275
103	103	days.
104	104	Sec. 1201.306. TERMINATION. (a) Except as provided by
105	105	Subsection (b), an insurer issuing a short-term limited-duration
106	106	health insurance policy may not terminate the policy before the
107	107	policy's expiration date except for nonpayment of premiums or
108	108	fraud.
109	109	(b) An insurer issuing a short-term limited-duration health
110	110	insurance policy shall provide an option under the policy for the
111	111	insured to cancel the policy effective after each 30-day interval
112	112	after the effective date of coverage.
113	113	Sec. 1201.307. ADVERTISING FILING REQUIREMENTS. An insurer
114	114	that advertises or issues a short-term limited-duration health
115	115	insurance policy shall file for informational purposes with the
116	116	department a copy of any sales or marketing materials for the policy
117	117	that the insurer intends to use in this state.
118	118	SECTION 3. Subchapter B, Chapter 1701, Insurance Code, is
119	119	amended by adding Section 1701.0525 to read as follows:
120	120	Sec. 1701.0525. APPROVAL REQUIRED FOR CERTAIN DOCUMENTS.
121	121	Notwithstanding Section 1701.052, an insurer may not use a document
122	122	described by Section 1701.002 until the document has been approved
123	123	by the commissioner if the document relates to a short-term
124	124	limited-duration health insurance policy as defined by Section
125	125	1201.301.
126	126	SECTION 4. Not later than January 1, 2020, the commissioner
127	127	of insurance shall adopt rules necessary to implement Section
128	128	1201.104, Insurance Code, as amended by this Act, and Subchapter G,
129	129	Chapter 1201, Insurance Code, as added by this Act.
130	130	SECTION 5. Subchapter G, Chapter 1201, and Section
131	131	1701.0525, Insurance Code, as added by this Act, apply only to an
132	132	insurance policy delivered, issued for delivery, or renewed on or
133	133	after January 1, 2020. An insurance policy delivered, issued for
134	134	delivery, or renewed before January 1, 2020, is governed by the law
135	135	as it existed immediately before the effective date of this Act, and
136	136	that law is continued in effect for that purpose.
137	137	SECTION 6. This Act takes effect September 1, 2019.