87R23046 RDS-D
By: Capriglione, Oliverson, Smithee H.B. No. 3742
Substitute the following for H.B. No. 3742:
By: Oliverson C.S.H.B. No. 3742
A BILL TO BE ENTITLED
AN ACT
relating to a prohibition on the use of genetic information
gathered from direct-to-consumer genetic tests by a long-term care
benefit plan issuer or a life insurance company.
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. USE OF GENETIC INFORMATION GATHERED FROM
DIRECT-TO-CONSUMER GENETIC TEST
Sec. 564.001. APPLICABILITY OF CHAPTER. (a) This chapter
applies only to:
(1) an individual long-term care benefit plan that is
delivered or issued for delivery in this state;
(2) a group long-term care benefit plan that is:
(A) delivered or issued for delivery in this
state; and
(B) issued to an eligible group as described by
Subchapter B, Chapter 1251;
(3) an evidence of coverage delivered or issued for
delivery in this state for long-term care; and
(4) a life insurance policy issued or delivered in
this state.
(b) This chapter applies only to a policy, certificate, or
evidence of coverage that is issued by:
(1) a capital stock insurance company, including a
life, health and accident, or general casualty insurance company;
(2) a mutual life insurance company;
(3) a mutual assessment life insurance company,
including a statewide mutual assessment corporation, local mutual
aid association, and burial association;
(4) a mutual or mutual assessment association,
including an association subject to Section 887.101;
(5) a mutual insurance company other than a life
insurance company;
(6) a mutual or natural premium life or casualty
insurance company;
(7) a fraternal benefit society;
(8) a Lloyd's plan insurer;
(9) a reciprocal or interinsurance exchange;
(10) a nonprofit medical, hospital, or dental service
corporation, including a company subject to Chapter 842;
(11) a stipulated premium company;
(12) a health maintenance organization under Chapter
843; or
(13) another insurer required to be licensed by the
department.
Sec. 564.002. EXEMPTIONS. This chapter does not apply to:
(1) a group policy or certificate that is delivered or
issued for delivery in this state under a single employer or labor
union group policy that is delivered or issued for delivery outside
this state; or
(2) a benefit plan, including a health benefit plan,
that is not advertised, marketed, or offered as a long-term care
benefit plan or nursing home benefit plan.
Sec. 564.003. LONG-TERM CARE BENEFIT PLAN DEFINED. (a) In
this chapter, "long-term care benefit plan" means an insurance
policy or group certificate, or rider to the policy or certificate,
or evidence of coverage issued by a health maintenance organization
subject to Chapter 843, that is advertised or marketed as
providing, or offered or designed to provide, coverage for not less
than 12 consecutive months for each covered individual on an
expense-incurred, indemnity, prepaid, or other basis for one or
more necessary or medically necessary diagnostic, preventive,
therapeutic, rehabilitative, maintenance, or personal care
services provided in a setting other than an acute care unit of a
hospital.
(b) The term includes a plan or rider, other than a group or
individual annuity or life insurance policy, that provides for
payment of benefits based on cognitive impairment or the loss of
functional capacity.
(c) The term does not include an insurance policy, group
certificate, or evidence of coverage that is offered primarily to
provide:
(1) basic Medicare supplement coverage, basic
hospital expense coverage, basic medical-surgical expense
coverage, hospital confinement indemnity coverage, major medical
expense coverage, disability income protection coverage,
accident-only coverage, specified disease or specified accident
coverage, or limited benefit health coverage; or
(2) basic or single health care services.
Sec. 564.004. USE OF INFORMATION GATHERED FROM
DIRECT-TO-CONSUMER GENETIC TESTS PROHIBITED. (a) In this section,
"direct-to-consumer genetic test" means a genetic test that is
marketed directly to consumers using television, print
advertisements, or the Internet and that may be purchased directly
by a consumer.
(b) Without written consent from an individual applying for
coverage under a long-term care benefit plan or life insurance
policy, a long-term care benefit plan issuer or life insurance
company may not:
(1) require the individual to furnish genetic
information gathered from a direct-to-consumer genetic test; or
(2) use genetic information gathered from a
direct-to-consumer genetic test to reject, deny, limit, increase
the premiums for, or otherwise adversely affect eligibility for or
coverage under the plan or policy.
(c) Nothing in this section may be construed to prohibit or
limit the ability of an insurer to request and obtain medical
information from an individual applying for insurance.
SECTION 2. Chapter 564, Insurance Code, as added by this
Act, applies only to an insurance policy, contract, or evidence of
coverage that is delivered, issued for delivery, or renewed on or
after January 1, 2022. A policy, contract, or evidence of coverage
delivered, issued for delivery, or renewed before January 1, 2022,
is governed by the law as it existed immediately before the
effective date of this Act, and that law is continued in effect for
that purpose.
SECTION 3. This Act takes effect September 1, 2021.