By: Oliverson, et al. (Senate Sponsor - Springer) H.B. No. 3924
(In the Senate - Received from the House May 5, 2021;
May 10, 2021, read first time and referred to Committee on Business &
Commerce; May 13, 2021, reported favorably by the following vote:
Yeas 5, Nays 3; May 13, 2021, sent to printer.)
Click here to see the committee vote
A BILL TO BE ENTITLED
AN ACT
relating to health benefits offered by certain nonprofit
agricultural organizations.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. The heading to Subtitle K, Title 8, Insurance
Code, is amended to read as follows:
SUBTITLE K. CERTAIN BENEFITS AND ARRANGEMENTS THAT ARE NOT
INSURANCE [HEALTH CARE SHARING MINISTRIES]
SECTION 2. Subtitle K, Title 8, Insurance Code, is amended
by adding Chapter 1682 to read as follows:
CHAPTER 1682. HEALTH BENEFITS PROVIDED BY CERTAIN NONPROFIT
AGRICULTURAL ORGANIZATIONS
Sec. 1682.001. DEFINITIONS. In this chapter:
(1) "Nonprofit agricultural organization" means an
organization that:
(A) is exempt from taxation under Section 501(a),
Internal Revenue Code of 1986, as an organization described by
Section 501(c)(5) of that code;
(B) is domiciled in this state;
(C) was in existence prior to 1940;
(D) is composed of members who are residents of
at least 98 percent of the counties in this state;
(E) collects annual dues from its members; and
(F) was created to promote and develop the most
profitable and desirable system of agriculture and the most
wholesome and satisfactory conditions of rural life in accordance
with its articles of organization and bylaws.
(2) "Nonprofit agricultural organization health
benefits" means health benefits:
(A) sponsored by a nonprofit agricultural
organization or an affiliate of the organization;
(B) offered only to:
(i) members of the nonprofit agricultural
organization; and
(ii) family members of members of the
nonprofit agricultural organization;
(C) that are not provided through an insurance
policy or other product the offering or issuance of which
constitutes the business of insurance in this state; and
(D) that are deemed by the nonprofit agricultural
organization to be important in assisting its members to live long
and productive lives.
(3) "Preexisting condition" means a condition present
before the effective date of an individual's enrollment in
nonprofit agricultural organization health benefits.
Sec. 1682.002. NONPROFIT AGRICULTURAL ORGANIZATION HEALTH
BENEFITS AUTHORIZED. A nonprofit agricultural organization or an
affiliate of the organization may offer in this state nonprofit
agricultural organization health benefits.
Sec. 1682.003. WAITING PERIOD FOR PREEXISTING CONDITION.
Notwithstanding any other provision of this chapter, a nonprofit
agricultural organization that offers nonprofit agricultural
organization health benefits may not require a waiting period of
more than six months for treatment of a preexisting condition
otherwise included in nonprofit agricultural organization health
benefits.
Sec. 1682.004. REQUIRED DISCLOSURE BY NONPROFIT
AGRICULTURAL ORGANIZATION. (a) A nonprofit agricultural
organization that offers nonprofit agricultural organization
health benefits must provide to an individual applying for
nonprofit agricultural organization health benefits written notice
that the benefits are not provided through an insurance policy or
other product the offering or issuance of which is regulated as the
business of insurance in this state.
(b) An individual must sign and return to the nonprofit
agricultural organization the notice described by Subsection (a)
before the individual may enroll in nonprofit agricultural
organization health benefits. The nonprofit agricultural
organization must:
(1) maintain a copy of the signed written notice for
the duration of the term during which the nonprofit agricultural
organization health benefits are provided to the individual; and
(2) at the request of the individual, provide a copy of
the written notice to the individual.
Sec. 1682.005. NONPROFIT AGRICULTURAL ORGANIZATION NOT
ENGAGED IN BUSINESS OF INSURANCE. Notwithstanding any other
provision of this code, for the purposes of offering nonprofit
agricultural organization health benefits, a nonprofit
agricultural organization that acts in accordance with this chapter
is not an insurer and is not engaging in the business of insurance
in this state.
Sec. 1682.006. RISK TRANSFER OR COVERAGE. A nonprofit
agricultural organization that offers nonprofit agricultural
organization health benefits under this chapter may contract with a
company authorized to engage in the business of insurance in this
state that is not under common control with the nonprofit
agricultural organization to:
(1) transfer to that company all or a portion of the
organization's risks arising from nonprofit agricultural
organization health benefits offered under this chapter; or
(2) obtain insurance coverage from the company
guarantying the nonprofit agricultural organization's obligations
arising from nonprofit agricultural organization health benefits
offered under this chapter.
Sec. 1682.007. APPLICABILITY OF CERTAIN LAWS TO NONPROFIT
AGRICULTURAL ORGANIZATION HEALTH BENEFITS. Notwithstanding
Section 1682.004, a nonprofit agricultural organization that
offers nonprofit agricultural organization health benefits that
are determined by the commissioner to be structured in the manner of
a preferred provider benefit plan or an exclusive provider benefit
plan, as those terms are defined by Section 1301.001, is subject to
the following laws and rules as if the nonprofit agricultural
organization were an insurer, individuals entitled to nonprofit
agricultural organization health benefits were insureds, and the
nonprofit agricultural organization health benefits were provided
through an insurance policy subject to Chapter 1301:
(1) Section 1301.005;
(2) Section 1301.0053;
(3) Section 1301.0055;
(4) Section 1301.006;
(5) Section 1301.010;
(6) Section 1301.155;
(7) Section 1301.164;
(8) Section 1301.165;
(9) Chapter 1467; and
(10) 28 T.A.C. Chapter 3, Subchapter X.
SECTION 3. This Act takes effect September 1, 2021.
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