87R8372 SCL-F
By: Hull H.B. No. 3045
A BILL TO BE ENTITLED
AN ACT
relating to financial regulation of certain life, health, and
accident insurers and health maintenance organizations.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Sections 841.351(c) and (d), Insurance Code, are
amended to read as follows:
(c) A domestic insurance company may, at its option,
withdraw a deposit made under Subsection (a), or any portion of the
deposit[, after substituting a deposit of securities of a like
class and of an amount and value equal to the withdrawn deposit or
portion of deposit].
(d) The commissioner must first approve any securities
deposited or withdrawn [being substituted] under this section.
SECTION 2. Section 843.082, Insurance Code, is amended to
read as follows:
Sec. 843.082. REQUIREMENTS FOR APPROVAL OF APPLICATION.
The commissioner shall issue a certificate of authority on payment
of the application fee prescribed by Section 843.154(c) if the
commissioner is satisfied that:
(1) with respect to health care services to be
provided, the applicant:
(A) has demonstrated the willingness and
potential ability to ensure that the health care services will be
provided in a manner to:
(i) ensure both availability and
accessibility of adequate personnel and facilities; and
(ii) enhance availability, accessibility,
quality of care, and continuity of services;
(B) has arrangements, established in accordance
with rules adopted by the commissioner, for a continuing quality of
health care assurance program concerning health care processes and
outcomes; and
(C) has a procedure, that is in accordance with
rules adopted by the commissioner, to develop, compile, evaluate,
and report statistics relating to the cost of operation, the
pattern of utilization of services, and availability and
accessibility of services;
(2) the person responsible for the conduct of the
affairs of the applicant is competent, is trustworthy, and has a
good reputation;
(3) the health care plan, limited health care service
plan, or single health care service plan is an appropriate
mechanism through which the health maintenance organization will
effectively provide or arrange for the provision of basic health
care services, limited health care services, or a single health
care service on a prepaid basis, through insurance or otherwise,
except to the extent of reasonable requirements for copayments;
(4) the health maintenance organization is fully
responsible and may reasonably be expected to meet its obligations
to enrollees and prospective enrollees, after considering:
(A) the financial soundness of the health care
plan's arrangement for health care services and the schedule of
charges used in connection with the arrangement;
(B) the adequacy of working capital;
(C) any agreement with an insurer, a group
hospital service corporation, a political subdivision of
government, or any other organization for insuring the payment of
the cost of health care services or providing for automatic
applicability of an alternative coverage in the event the plan is
discontinued; and
(D) any agreement that provides for the provision
of health care services; and
[(E) any deposit of cash or securities submitted
in accordance with Section 843.405 as a guarantee that the
obligations will be performed; and]
(5) the proposed plan of operation, as shown by the
information submitted under Section 843.078 and, if applicable,
Section 843.079, or by independent investigation, does not violate
state law.
SECTION 3. Subchapter L, Chapter 843, Insurance Code, is
amended by adding Section 843.4055 to read as follows:
Sec. 843.4055. DEPOSIT WITH OR WITHDRAWAL FROM COMPTROLLER.
(a) A health maintenance organization may, at its option and after
receiving commissioner approval, deposit with the comptroller
cash, securities, or any combination of cash, securities, and other
guarantees.
(b) A health maintenance organization may, at its option and
after receiving commissioner approval, withdraw a deposit made
under Subsection (a) or any portion of the deposit.
SECTION 4. Section 534.153, Health and Safety Code, is
amended to read as follows:
Sec. 534.153. APPLICATION OF LAWS AND RULES. A health
maintenance organization created and operating under this
subchapter is governed as, and is subject to the same laws and rules
of the Texas Department of Insurance as, any other health
maintenance organization of the same type. The commissioner of
insurance may adopt rules as necessary to accept funding sources
other than the sources specified by Section 843.4055 [843.405],
Insurance Code, from a nonprofit health maintenance organization
created and operating under this subchapter, to meet the minimum
surplus requirements of that section.
SECTION 5. The following provisions of the Insurance Code
are repealed:
(1) Section 841.355;
(2) Section 841.357;
(3) Sections 843.105(d), (e), (f), and (g);
(4) Section 843.402; and
(5) Section 843.405.
SECTION 6. On the effective date of this Act, the
comptroller of public accounts of the State of Texas shall release,
transfer, and deliver to the owner any deposits made by a health
maintenance organization under former Sections 843.105(g),
843.402, and 843.405, Insurance Code.
SECTION 7. This Act takes effect September 1, 2021.