Texas 2021 - 87th Regular

Texas House Bill HB508 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	By: Beckley H.B. No. 508
2	2
3	3
4	4	A BILL TO BE ENTITLED
5	5	AN ACT
6	6	relating to health benefit plan coverage of preexisting conditions.
7	7	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
8	8	SECTION 1. Subtitle G, Title 8, Insurance Code, is amended
9	9	by adding Chapter 1509 to read as follows:
10	10	CHAPTER 1509. COVERAGE OF PREEXISTING CONDITIONS
11	11	Sec. 1509.001. DEFINITION. In this chapter, "preexisting
12	12	condition" means a condition present before the effective date of
13	13	an individual's coverage under a health benefit plan.
14	14	Sec. 1509.002. APPLICABILITY OF CHAPTER. (a) This chapter
15	15	applies only to a health benefit plan that provides benefits for
16	16	medical or surgical expenses incurred as a result of a health
17	17	condition, accident, or sickness, including an individual, group,
18	18	blanket, or franchise insurance policy or insurance agreement, a
19	19	group hospital service contract, or an individual or group evidence
20	20	of coverage or similar coverage document that is offered by:
21	21	(1) an insurance company;
22	22	(2) a group hospital service corporation operating
23	23	under Chapter 842;
24	24	(3) a health maintenance organization operating under
25	25	Chapter 843;
26	26	(4) an approved nonprofit health corporation that
27	27	holds a certificate of authority under Chapter 844;
28	28	(5) a multiple employer welfare arrangement that holds
29	29	a certificate of authority under Chapter 846;
30	30	(6) a stipulated premium company operating under
31	31	Chapter 884;
32	32	(7) a fraternal benefit society operating under
33	33	Chapter 885;
34	34	(8) a Lloyd's plan operating under Chapter 941; or
35	35	(9) an exchange operating under Chapter 942.
36	36	(b) Notwithstanding any other law, this chapter applies to:
37	37	(1) a small employer health benefit plan subject to
38	38	Chapter 1501, including coverage provided through a health group
39	39	cooperative under Subchapter B of that chapter;
40	40	(2) a standard health benefit plan issued under
41	41	Chapter 1507;
42	42	(3) a basic coverage plan under Chapter 1551;
43	43	(4) a basic plan under Chapter 1575;
44	44	(5) a primary care coverage plan under Chapter 1579;
45	45	(6) a plan providing basic coverage under Chapter
46	46	1601;
47	47	(7) health benefits provided by or through a church
48	48	benefits board under Subchapter I, Chapter 22, Business
49	49	Organizations Code;
50	50	(8) group health coverage made available by a school
51	51	district in accordance with Section 22.004, Education Code;
52	52	(9) the state Medicaid program, including the Medicaid
53	53	managed care program operated under Chapter 533, Government Code;
54	54	(10) the child health plan program under Chapter 62,
55	55	Health and Safety Code;
56	56	(11) a regional or local health care program operated
57	57	under Section 75.104, Health and Safety Code;
58	58	(12) a self-funded health benefit plan sponsored by a
59	59	professional employer organization under Chapter 91, Labor Code;
60	60	(13) county employee group health benefits provided
61	61	under Chapter 157, Local Government Code; and
62	62	(14) health and accident coverage provided by a risk
63	63	pool created under Chapter 172, Local Government Code.
64	64	(c) This chapter applies to coverage under a group health
65	65	benefit plan provided to a resident of this state regardless of
66	66	whether the group policy, agreement, or contract is delivered,
67	67	issued for delivery, or renewed in this state.
68	68	Sec. 1509.003. EXCEPTIONS. (a) This chapter does not apply
69	69	to:
70	70	(1) a plan that provides coverage:
71	71	(A) for wages or payments in lieu of wages for a
72	72	period during which an employee is absent from work because of
73	73	sickness or injury;
74	74	(B) as a supplement to a liability insurance
75	75	policy;
76	76	(C) for credit insurance;
77	77	(D) only for dental or vision care;
78	78	(E) only for hospital expenses; or
79	79	(F) only for indemnity for hospital confinement;
80	80	(2) a workers' compensation insurance policy; or
81	81	(3) medical payment insurance coverage provided under
82	82	a motor vehicle insurance policy.
83	83	(b) This chapter does not apply to an individual health
84	84	benefit plan issued on or before March 23, 2010, that has not had
85	85	any significant changes since that date that reduce benefits or
86	86	increase costs to the individual.
87	87	Sec. 1509.004. PREEXISTING CONDITION RESTRICTIONS
88	88	PROHIBITED. Notwithstanding any other law, a health benefit plan
89	89	issuer may not:
90	90	(1) deny coverage to or refuse to enroll an individual
91	91	in a health benefit plan on the basis of a preexisting condition;
92	92	(2) limit or exclude coverage under the health benefit
93	93	plan for treatment of the individual's preexisting condition
94	94	otherwise covered under the plan; or
95	95	(3) charge the individual more for coverage than the
96	96	health benefit plan issuer charges an individual who does not have a
97	97	preexisting condition.
98	98	SECTION 2. If before implementing any provision of this Act
99	99	a state agency determines that a waiver or authorization from a
100	100	federal agency is necessary for implementation of that provision,
101	101	the agency affected by the provision shall request the waiver or
102	102	authorization and may delay implementing that provision until the
103	103	waiver or authorization is granted.
104	104	SECTION 3. The change in law made by this Act applies only
105	105	to a health benefit plan that is delivered, issued for delivery, or
106	106	renewed on or after January 1, 2022. A health benefit plan that is
107	107	delivered, issued for delivery, or renewed before January 1, 2022,
108	108	is governed by the law as it existed immediately before the
109	109	effective date of this Act, and that law is continued in effect for
110	110	that purpose.
111	111	SECTION 4. This Act takes effect September 1, 2021.