87R1471 MEW-D
By: Leach H.B. No. 1342
A BILL TO BE ENTITLED
AN ACT
relating to the provision of certain historical claims data and
other information to school districts and other participating
entities in the Texas school employees uniform group health
coverage program.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter A, Chapter 1579, Insurance Code, is
amended by adding Section 1579.010 to read as follows:
Sec. 1579.010. PARTICIPATING ENTITY REQUEST FOR CERTAIN
INFORMATION. (a) Subject to Subsection (b), the trustee shall
provide to a participating entity any historical claims data,
enrollment information, or other relevant information available to
the trustee as requested by the entity in connection with a search
for alternative health benefit plan coverage for the entity's
employees and the employees' dependents. The information provided
must include, for each tier of group coverage and for the five-year
period preceding the date of the request:
(1) the monthly claims experience history;
(2) information concerning the type of illness or
injury and the ongoing status of the illness or injury for:
(A) each medical claim that exceeds $50,000; and
(B) each related series of medical claims for the
same covered individual and for the same diagnosis that exceeds
$50,000;
(3) any other information requested by the
participating entity concerning covered individuals who are
responsible for a claim or claims that total a large amount, as
specified by the requesting participating entity;
(4) information concerning prescription drug claims
and costs; and
(5) plan enrollment.
(b) The information provided by the trustee under this
section may not include any personally identifying information of a
covered individual, including any information that would identify a
named covered individual as having a particular medical condition.
(c) The trustee shall provide the information requested
under this section at no cost to the requesting participating
entity.
SECTION 2. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2021.