By: Frank, Oliverson, Raymond, White, et al. H.B. No. 3752
A BILL TO BE ENTITLED
AN ACT
relating to the offering of health benefits by subsidiaries of the
Texas Mutual Insurance Company.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 2054.107, Insurance Code, is amended to
read as follows:
Sec. 2054.107. CERTAIN RELATIONSHIPS WITH OTHER INSURERS
PROHIBITED. Except as provided by Section 2054.602, the [The]
company may not have:
(1) an affiliate, spin-off, or subsidiary that writes
a line of insurance other than workers' compensation insurance; or
(2) interlocking boards of directors with an insurer
that writes a line of insurance other than workers' compensation
insurance.
SECTION 2. Chapter 2054, Insurance Code, is amended by
adding Subchapter M to read as follows:
SUBCHAPTER M. SUBSIDIARIES AUTHORIZED TO PROVIDE HEALTH BENEFIT
COVERAGE
Sec. 2054.601. DEFINITION. In this subchapter,
"alternative health benefit coverage" means health benefit
coverage:
(1) provided by a subsidiary of the company that is not
authorized to engage in the business of insurance in this state;
(2) offered only to:
(A) individuals;
(B) small businesses with not more than 250
full-time equivalent employees; or
(C) the company's policyholders or their
employees; and
(3) that is not:
(A) provided through an insurance policy or other
product the offering or issuance of which constitutes the business
of insurance in this state; or
(B) benefit coverage subject to the laws
governing workers' compensation in this state.
Sec. 2054.602. HEALTH BENEFIT COVERAGE OFFERED BY
SUBSIDIARY AUTHORIZED. (a) The company may create, acquire, or
otherwise own or operate one or more subsidiaries that offer
accident or health insurance or another type of health benefit
coverage or health benefit plan as provided by this subchapter.
(b) A subsidiary of the company may offer in this state:
(1) accident or health insurance or another type of
health benefit plan authorized under this code, in accordance with
a certificate of authority issued to the subsidiary under this
code; or
(2) alternative health benefit coverage as described
by Section 2054.601.
(c) The company may not be held liable for an act or
obligation of a subsidiary of the company operating under this
section.
(d) A subsidiary of the company may not offer or issue any
policy, plan, or benefit coverage under this section before January
1, 2023. This subsection expires September 1, 2023.
Sec. 2054.603. CONSIDERATIONS AND GUIDING PRINCIPLES FOR
DEVELOPING HEALTH BENEFITS OFFERINGS. In developing health
benefits or health benefit plan options to be offered through a
subsidiary of the company, the company shall fully explore all
health coverage options that may be offered under this subchapter
and place emphasis on:
(1) increasing competition in the health insurance
market;
(2) utilizing innovations that improve the quality of
health care while lowering health care costs;
(3) ensuring coverage and access to care for
individuals in this state with preexisting conditions;
(4) leveraging federal tax credits that may be
available for private health benefit coverage to the greatest
extent possible to increase the affordability of health benefit
coverage;
(5) ensuring transparency and coherence of costs and
coverage to inform individuals shopping for health benefits;
(6) reducing incidences of medical debt faced by
individuals in this state and uncompensated care faced by providers
in this state; and
(7) ensuring equitable costs regardless of gender or
prospects of pregnancy or childbirth.
Sec. 2054.604. RULES. Except with respect to alternative
health benefit coverage as described by Section 2054.601 or a
subsidiary of the company offering alternative health benefit
coverage, the commissioner may adopt rules as necessary to
implement this subchapter.
Sec. 2054.605. EXEMPTION FROM OTHER INSURANCE LAWS. A
provision of this code, other than this chapter, does not apply to
alternative health benefit coverage as described by Section
2054.601 unless alternative health benefit coverage is expressly
mentioned in the other law.
SECTION 3. This Act takes effect September 1, 2021.