H.B. No. 3752
AN ACT
relating to the offering of health benefit coverage 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) A subsidiary of the company may not offer or issue an
occupational policy for an employer or an employer's employees
covering an occupational bodily injury, disease, or death that
explicitly provides liability coverage to an employer that elects
not to maintain workers' compensation insurance coverage under
Chapter 406, Labor Code.
(d) A subsidiary of the company may not offer or issue any
policy, plan, or benefit coverage under this section before
September 1, 2023. This subsection expires September 1, 2023.
Sec. 2054.603. CONSIDERATIONS AND GUIDING PRINCIPLES FOR
DEVELOPING HEALTH BENEFIT COVERAGE OFFERINGS. (a) In developing
health benefit coverage 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 adequacy of benefits and access to care
for individuals in this state with preexisting conditions;
(4) issuing coverage in a manner that does not
discriminate against individuals with preexisting conditions;
(5) leveraging federal tax credits that may be
available for private health benefit plans to the greatest extent
possible to increase the affordability of health benefit plans;
(6) ensuring transparency and coherence of costs and
coverage to inform individuals shopping for health benefits;
(7) reducing incidences of medical debt faced by
individuals in this state and uncompensated care faced by providers
in this state; and
(8) ensuring equitable costs regardless of gender or
prospects of pregnancy or childbirth.
(b) Not later than September 1, 2022, the company shall
submit to the legislature a report explaining how any anticipated
health benefit coverage offerings would comply with all
considerations and guiding principles for developing health
benefit coverage offerings under Subsection (a). This subsection
expires January 1, 2023.
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.
Sec. 2054.606. SUBSIDIARY NOT ENGAGED IN BUSINESS OF
INSURANCE. Notwithstanding any other provision of this code, for
the purposes of offering alternative health benefit coverage as
described by Section 2054.601, a subsidiary of the company that
acts in accordance with this subchapter is not an insurer and is not
engaging in the business of insurance in this state.
Sec. 2054.607. RISK TRANSFER OR COVERAGE. A subsidiary of
the company that offers health benefit coverage under this
subchapter may contract with an outside company authorized to
engage in the business of insurance in this state that is not under
common control with the company or the subsidiary to:
(1) transfer to the outside company all or a portion of
the subsidiary's risks arising from health benefit coverage offered
under this subchapter; or
(2) obtain insurance coverage from the outside company
guarantying the subsidiary's obligations arising from health
benefit coverage offered under this subchapter.
SECTION 3. This Act takes effect September 1, 2021.
______________________________ ______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 3752 was passed by the House on May 5,
2021, by the following vote: Yeas 100, Nays 46, 1 present, not
voting; that the House refused to concur in Senate amendments to
H.B. No. 3752 on May 28, 2021, and requested the appointment of a
conference committee to consider the differences between the two
houses; and that the House adopted the conference committee report
on H.B. No. 3752 on May 30, 2021, by the following vote: Yeas 89,
Nays 53, 2 present, not voting.
______________________________
Chief Clerk of the House
I certify that H.B. No. 3752 was passed by the Senate, with
amendments, on May 25, 2021, by the following vote: Yeas 31, Nays
0; at the request of the House, the Senate appointed a conference
committee to consider the differences between the two houses; and
that the Senate adopted the conference committee report on H.B. No.
3752 on May 30, 2021, by the following vote: Yeas 31, Nays 0.
______________________________
Secretary of the Senate
APPROVED: __________________
Date
__________________
Governor