87R5461 MWC-D
By: Lucio III H.B. No. 2118
A BILL TO BE ENTITLED
AN ACT
relating to deceptive marketing of certain health plans, programs,
and arrangements; authorizing an administrative penalty.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle C, Title 5, Insurance Code, is amended
by adding Chapter 564 to read as follows:
CHAPTER 564. PROHIBITED PRACTICES RELATING TO MARKETING OF CERTAIN
HEALTH PLANS, PROGRAMS, AND ARRANGEMENTS
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 564.0001. APPLICABILITY. This chapter applies to a
health benefit plan, health care program, or health expense
arrangement that provides health benefit coverage or otherwise pays
for, reimburses, or discounts health care expenses and that
excludes or limits coverage for preexisting conditions,
discriminates based on health-status related factors, or does not
provide essential health benefits required under 42 U.S.C. Section
18022, including:
(1) an individual accident and health insurance policy
governed by Chapter 1201;
(2) a group accident and health insurance policy
governed by Chapter 1251;
(3) a short-tem limited-duration insurance policy
governed by Chapter 1509;
(4) a health care sharing ministry operated under
Chapter 1681;
(5) a discount health care program governed by Chapter
7001; or
(6) a direct primary care arrangement governed by
Subchapter F, Chapter 162, Occupations Code.
Sec. 564.0002. RULES. The commissioner may adopt rules
necessary to implement this chapter.
SUBCHAPTER B. DECEPTIVE MARKETING PROHIBITED
Sec. 564.0101. PROHIBITED MARKETING TECHNIQUES. A person
who issues or operates a plan, program, or arrangement to which this
chapter applies or an agent or third party marketing the plan,
program, or arrangement on behalf of the issuer or operator may not:
(1) represent that a plan, program, or arrangement
provides benefits that it does not provide;
(2) sell or offer multiple plans, programs, or
arrangements to an individual as part of a single transaction in a
manner that is false, misleading, or deceptive;
(3) use terms associated with health coverage
regulated under the Patient Protection and Affordable Care Act
(Pub. L. No. 111-148) in a manner that is false, misleading, or
deceptive;
(4) use terms associated with major medical coverage
in a manner that is false, misleading, or deceptive;
(5) represent that the federal open enrollment period
applies to an excepted benefit plan or discount health care
program;
(6) misrepresent that a health insurance rate will
change if the consumer does not make an immediate purchase;
(7) fail to explain the difference in an excepted
benefit plan and major medical coverage to a consumer;
(8) solicit the sale of an insurance product to which
this chapter applies through an Internet website, e-mail, printed
advertisement, text message, phone call, or other means without
identifying the agent's name and national producer number in a
visible manner;
(9) contact a prospective purchaser or participant
without disclosing the employee's, agent's, or third party's name
and national producer number, if applicable, at the start of the
contact;
(10) try to contact a prospective purchaser or
participant by phone and fail to leave a voice mail message if it is
possible to leave a voice mail message; or
(11) use marketing media that has not been filed with
the department.
Sec. 564.0102. DUTY TO RECORD MARKETING CALLS. (a) An agent
shall make an audio recording of each phone call marketing an
insurance product to which this chapter applies.
(b) An issuer of an insurance product to which this chapter
applies shall retain the recording made under Subsection (a) for a
time period determined by the department.
Sec. 564.0103. REQUIREMENT TO PROVIDE CERTAIN INFORMATION.
An issuer of an insurance product to which this chapter applies
shall provide to the department on request:
(1) a recording or a transcript of a recording made
under Section 564.0102; or
(2) a copy of a written communication soliciting the
sale of a product to which this chapter applies sent by e-mail,
text, Internet website, or other means.
Sec. 564.0104. ADVERTISING FILING REQUIREMENTS. An issuer
of an insurance product to which this chapter applies shall file for
informational purposes with the department a copy of any sales or
marketing materials for the product that the issuer intends to use
in this state.
Sec. 564.0105. VIOLATION. (a) If an issuer or operator
holding a certificate of authority or license under this code or an
agent or third party acting on behalf of the issuer or operator
violates this chapter or a rule adopted under this chapter, the
issuer or operator and the agent or third party commit an unfair
practice in violation of Chapter 541 and the issuer or operator is
subject to administrative penalties and other sanctions under
Chapter 82.
(b) If an issuer or operator that does not hold a
certificate of authority or license under this code or an agent or
third party acting on behalf of the issuer or operator violates this
chapter or a rule adopted under this chapter, the issuer or operator
and the agent or third party commit a false, misleading, or
deceptive act or practice under Section 17.46, Business & Commerce
Code.
SECTION 2. This Act takes effect September 1, 2021.