87R9199 SMT-D
By: Shaheen H.B. No. 3074
A BILL TO BE ENTITLED
AN ACT
relating to the eligibility of certain individuals to purchase
Medicare supplement benefit plans at the lowest standard premium
rate.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter A, Chapter 1652, Insurance Code, is
amended by adding Section 1652.006 to read as follows:
Sec. 1652.006. RATE REQUIREMENTS FOR POLICIES OFFERED AT
CERTAIN PERIODS. (a) In this section:
(1) "Entity" means an entity that delivers or issues
for delivery a Medicare supplement benefit plan in this state.
(2) "Substantially comparable plan" means a Medicare
supplement benefit plan that is of the same tier as another Medicare
supplement benefit plan as provided by Subsection (b).
(b) For purposes of this section:
(1) a Medicare supplement benefit plan is considered a
"tier one plan" if the plan is identified by the department as Plan
C, D, E, F except for high-deductible F, G except for
high-deductible G, I, J, M, or N;
(2) a Medicare supplement benefit plan is considered a
"tier two plan" if the plan is identified by the department as Plan
A or B; and
(3) a Medicare supplement benefit plan is considered a
"tier three plan" if the plan is identified by the department as
high-deductible Plan F or G or Plan K or L.
(c) Except as provided by Subsection (f), an entity shall
offer a plan at the lowest standard premium rate charged for that
plan if:
(1) on the date an applicant applies for the plan, the
applicant is covered by a substantially comparable plan; and
(2) the applicant applies for the plan during the
applicant's eligibility period described by Subsection (d).
(d) An applicant is eligible under Subsection (c) for a
period occurring once every five years, beginning the year in which
the applicant's 70th birthday occurs. The eligibility period:
(1) begins on the first day of the applicant's birth
month; and
(2) ends on the last day of the second month that
follows the applicant's birth month.
(e) An entity may not deny coverage or offer a plan to which
this section applies at a higher premium rate based on the
applicant's:
(1) height;
(2) weight; or
(3) medical history except for age and tobacco use.
(f) Notwithstanding Subsection (c), an entity may charge a
higher standard rate for tobacco users than non-tobacco users.
SECTION 2. The changes in law made by this Act apply only to
a Medicare supplement benefit plan delivered, issued for delivery,
or renewed on or after January 1, 2022.
SECTION 3. This Act takes effect September 1, 2021.