| 1 | 1 | | 87R9199 SMT-D |
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| 2 | 2 | | By: Shaheen H.B. No. 3074 |
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| 3 | 3 | | |
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| 4 | 4 | | |
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| 5 | 5 | | A BILL TO BE ENTITLED |
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| 6 | 6 | | AN ACT |
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| 7 | 7 | | relating to the eligibility of certain individuals to purchase |
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| 8 | 8 | | Medicare supplement benefit plans at the lowest standard premium |
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| 9 | 9 | | rate. |
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| 10 | 10 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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| 11 | 11 | | SECTION 1. Subchapter A, Chapter 1652, Insurance Code, is |
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| 12 | 12 | | amended by adding Section 1652.006 to read as follows: |
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| 13 | 13 | | Sec. 1652.006. RATE REQUIREMENTS FOR POLICIES OFFERED AT |
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| 14 | 14 | | CERTAIN PERIODS. (a) In this section: |
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| 15 | 15 | | (1) "Entity" means an entity that delivers or issues |
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| 16 | 16 | | for delivery a Medicare supplement benefit plan in this state. |
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| 17 | 17 | | (2) "Substantially comparable plan" means a Medicare |
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| 18 | 18 | | supplement benefit plan that is of the same tier as another Medicare |
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| 19 | 19 | | supplement benefit plan as provided by Subsection (b). |
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| 20 | 20 | | (b) For purposes of this section: |
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| 21 | 21 | | (1) a Medicare supplement benefit plan is considered a |
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| 22 | 22 | | "tier one plan" if the plan is identified by the department as Plan |
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| 23 | 23 | | C, D, E, F except for high-deductible F, G except for |
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| 24 | 24 | | high-deductible G, I, J, M, or N; |
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| 25 | 25 | | (2) a Medicare supplement benefit plan is considered a |
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| 26 | 26 | | "tier two plan" if the plan is identified by the department as Plan |
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| 27 | 27 | | A or B; and |
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| 28 | 28 | | (3) a Medicare supplement benefit plan is considered a |
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| 29 | 29 | | "tier three plan" if the plan is identified by the department as |
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| 30 | 30 | | high-deductible Plan F or G or Plan K or L. |
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| 31 | 31 | | (c) Except as provided by Subsection (f), an entity shall |
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| 32 | 32 | | offer a plan at the lowest standard premium rate charged for that |
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| 33 | 33 | | plan if: |
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| 34 | 34 | | (1) on the date an applicant applies for the plan, the |
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| 35 | 35 | | applicant is covered by a substantially comparable plan; and |
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| 36 | 36 | | (2) the applicant applies for the plan during the |
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| 37 | 37 | | applicant's eligibility period described by Subsection (d). |
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| 38 | 38 | | (d) An applicant is eligible under Subsection (c) for a |
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| 39 | 39 | | period occurring once every five years, beginning the year in which |
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| 40 | 40 | | the applicant's 70th birthday occurs. The eligibility period: |
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| 41 | 41 | | (1) begins on the first day of the applicant's birth |
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| 42 | 42 | | month; and |
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| 43 | 43 | | (2) ends on the last day of the second month that |
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| 44 | 44 | | follows the applicant's birth month. |
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| 45 | 45 | | (e) An entity may not deny coverage or offer a plan to which |
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| 46 | 46 | | this section applies at a higher premium rate based on the |
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| 47 | 47 | | applicant's: |
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| 48 | 48 | | (1) height; |
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| 49 | 49 | | (2) weight; or |
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| 50 | 50 | | (3) medical history except for age and tobacco use. |
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| 51 | 51 | | (f) Notwithstanding Subsection (c), an entity may charge a |
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| 52 | 52 | | higher standard rate for tobacco users than non-tobacco users. |
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| 53 | 53 | | SECTION 2. The changes in law made by this Act apply only to |
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| 54 | 54 | | a Medicare supplement benefit plan delivered, issued for delivery, |
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| 55 | 55 | | or renewed on or after January 1, 2022. |
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| 56 | 56 | | SECTION 3. This Act takes effect September 1, 2021. |
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