Texas 2021 - 87th Regular

Texas House Bill HB3923 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	By: Oliverson, et al. (Senate Sponsor - Hancock) H.B. No. 3923
2		-	(In the Senate - Received from the House May 5, 2021;
3		-	May 10, 2021, read first time and referred to Committee on Business &
4		-	Commerce; May 20, 2021, reported favorably by the following vote:
5		-	Yeas 9, Nays 0; May 20, 2021, sent to printer.)
6		-	Click here to see the committee vote
	1	+	87R19313 RDS-F
	2	+	By: Oliverson, Shaheen, Rogers, et al. H.B. No. 3923
7	3
8	4
9	5		A BILL TO BE ENTITLED
10	6		AN ACT
11	7		relating to multiple employer welfare arrangements.
12	8		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
13	9		SECTION 1. Subchapter A, Chapter 846, Insurance Code, is
14	10		amended by adding Section 846.0035 to read as follows:
15	11		Sec. 846.0035. APPLICABILITY OF CERTAIN LAWS TO ASSOCIATION
16	12		PROVIDING HEALTH BENEFITS. (a) This section applies only to a
17	13		multiple employer welfare arrangement:
18	14		(1) that was issued an initial certificate of
19	15		authority under Section 846.054 on or after January 1, 2022; or
20	16		(2) that elects to be bound by this section in the
21	17		manner prescribed by the commissioner.
22	18		(b) A multiple employer welfare arrangement that provides a
23	19		comprehensive health benefit plan, as determined by the
24	20		commissioner, is subject to the following laws as if the
25	21		arrangement were an insurer, individuals entitled to coverage under
26	22		the plan were insureds, and the health benefits were provided
27	23		through an insurance policy:
28	24		(1) Chapter 421;
29	25		(2) Chapter 422;
30	26		(3) Subchapters C, F, and K, Chapter 1451; and
31	27		(4) Chapter 4201.
32	28		(c) A multiple employer welfare arrangement that provides a
33	29		comprehensive health benefit plan, as determined by the
34	30		commissioner, that is determined by the commissioner to be
35	31		structured in the manner of a preferred provider benefit plan or an
36	32		exclusive provider benefit plan as defined in Section 1301.001 is
37	33		subject to the following laws as if the arrangement were an insurer,
38	34		individuals entitled to coverage under the plan were insureds, and
39	35		the health benefits were provided through an insurance policy:
40	36		(1) Chapter 1301; and
41	37		(2) Chapter 1467.
42	38		SECTION 2. Section 846.052(b), Insurance Code, is amended
43	39		to read as follows:
44	40		(b) The application form must be completed and submitted
45	41		along with all information required by the commissioner, including:
46	42		(1) a copy of each organizational document;
47	43		(2) current financial statements of the arrangement;
48	44		(3) a fully detailed statement indicating the plan
49	45		under which the arrangement proposes to transact business;
50	46		(4) an initial actuarial opinion in compliance with
51	47		the requirements of Section 846.153(a)(2) and subject to Section
52	48		846.157(b); and
53	49		(5) demonstration [a statement] by the applicant
54	50		[certifying] that the arrangement is in compliance with all
55	51		applicable federal and state laws [provisions of the Employee
56	52		Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et
57	53		seq.)].
58	54		SECTION 3. Section 846.053, Insurance Code, is amended by
59	55		amending Subsections (b) and (c) and adding Subsection (d-1) to
60	56		read as follows:
61	57		(b) The employers in the multiple employer welfare
62	58		arrangement must:
63	59		(1) be members of an association or group of five or
64	60		more businesses that are in the same trade or industry, including
65	61		closely related businesses that provide support, services, or
66	62		supplies primarily to that trade or industry; or
67	63		(2) for a multiple employer welfare arrangement to
68	64		which Section 846.0035 applies, each have a principal place of
69	65		business in the same region that does not exceed the boundaries of
70	66		this state or the boundaries of a metropolitan statistical area
71	67		designated by the United States Office of Management and Budget.
72	68		(c) If the employers in the multiple employer welfare
73	69		arrangement are members of an association, the association must:
74	70		(1) be engaged in substantial activity for its
75	71		members other than sponsorship of an employee welfare benefit plan;
76	72		and
77	73		(2) if Section 846.0035 does not apply to the multiple
78	74		employer welfare arrangement, have been in existence for at least
79	75		two years before engaging in any activities relating to providing
80	76		employee health benefits to its members.
81	77		(d-1) For purposes of a multiple employer welfare
82	78		arrangement to which Section 846.0035 applies, a working owner of a
83	79		trade or business without employees may qualify as both an employer
84	80		and as an employee of the trade or industry for the purposes of this
85	81		section. In this subsection, "working owner" means an individual
86	82		who:
87	83		(1) has an ownership right of any nature in a trade or
88	84		business, whether incorporated or unincorporated, including a
89	85		partner and other self-employed individual;
90	86		(2) earns wages or self-employment income from the
91	87		trade or business for providing personal services to the trade or
92	88		business; and
93	89		(3) either:
94	90		(A) works on average at least 20 hours per week or
95	91		at least 80 hours per month providing personal services to the
96	92		working owner's trade or business; or
97	93		(B) has wages or self-employment income from the
98	94		individual's trade or business that at least equals the
99	95		individual's cost of coverage for participation by the individual
100	96		and any covered beneficiaries in the group health plan sponsored by
101	97		the group or association in which the individual is participating.
102	98		SECTION 4. This Act takes effect September 1, 2021.
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