TX
Texas House Bill HB573

Texas 2021 - 87th Regular

Texas House Bill HB573 Compare Versions

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1-87R19880 SCL-F
2- By: Oliverson, Sanford, Jetton H.B. No. 573
3- Substitute the following for H.B. No. 573:
4- By: Oliverson C.S.H.B. No. 573
1+87R209 SCL-F
2+ By: Oliverson H.B. No. 573
53
64
75 A BILL TO BE ENTITLED
86 AN ACT
97 relating to the operation of health care sharing ministries;
10- authorizing a fee; providing a civil penalty.
8+ authorizing a fee; providing an administrative penalty.
119 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12- SECTION 1. Chapter 1681, Insurance Code, is transferred to
13- Subtitle C, Title 5, Business & Commerce Code, redesignated as
14- Chapter 113, Business & Commerce Code, and amended to read as
10+ SECTION 1. Chapter 1681, Insurance Code, is amended by
11+ designating Section 1681.003 as Subchapter A and adding a
12+ subchapter heading to read as follows:
13+ SUBCHAPTER A. GENERAL PROVISIONS
14+ SECTION 2. Subchapter A, Chapter 1681, Insurance Code, as
15+ added by this Act, is amended by adding Section 1681.0011 to read as
1516 follows:
16- CHAPTER 113 [1681]. HEALTH CARE SHARING MINISTRIES
17- SUBCHAPTER A. GENERAL PROVISIONS
18- Sec. 113.001. DEFINITIONS. In this chapter:
17+ Sec. 1681.0011. DEFINITIONS. In this chapter:
1918 (1) "Administrative fee" means an amount collected
2019 from members and used for a purpose other than reimbursing members
2120 for their medical expenses, including amounts used to pay for
2221 health care sharing ministry administrative expenses and the
2322 compensation of third-party vendors for services.
24- (2) "Commissioner" means the commissioner of
25- insurance.
26- (3) "Department" means the Texas Department of
27- Insurance.
28- (4) "Health care sharing ministry" means a [Sec.
29- 1681.001. TREATMENT AS HEALTH CARE SHARING MINISTRY. A]
30- faith-based, nonprofit organization described by 26 U.S.C. Section
31- 501(c)(3) and exempt from taxation under 26 U.S.C. Section 501(a)
32- that [is tax-exempt under the Internal Revenue Code of 1986
33- qualifies for treatment as a health care sharing ministry under
34- this chapter if it]:
35- (A) [(1)] limits its participants to individuals
36- of a similar faith;
37- (B) [(2)] acts as a facilitator among
38- participants who have medical bills and matches those participants
39- with other participants with the present ability to assist those
40- with medical bills in accordance with criteria established by the
41- health care sharing ministry;
42- (C) [(3)] provides for the medical bills of a
43- participant through contributions from one participant to another;
44- (D) [(4)] provides amounts that participants may
45- contribute with no assumption of risk or promise to pay among the
46- participants and no assumption of risk or promise to pay by the
47- health care sharing ministry to the participants; and
48- (E) [(5) provides a written monthly statement to
49- all participants that lists the total dollar amount of qualified
50- needs submitted to the health care sharing ministry, as well as the
51- amount actually published or assigned to participants for their
52- contribution;
53- [(6) discloses administrative fees and costs to
54- participants;
55- [(7) provides that any card issued to a participant
56- for the purpose of presentation to a health care provider clearly
57- indicates that the participant is part of a health care sharing
58- ministry that is not engaging in the business of insurance;
59- [(8) provides a written disclaimer on or accompanying
60- all applications and guideline materials distributed by or on
61- behalf of the ministry that complies with Section 1681.002; and
62- [(9)] does not operate a discount health care program
63- as defined by Section 7001.001, Insurance Code.
64- (5) "Member" means an individual enrolled in a health
23+ (2) "Health care sharing ministry" means an
24+ organization:
25+ (A) described by 26 U.S.C. Section 501(c)(3) and
26+ exempt from taxation under 26 U.S.C. Section 501(a);
27+ (B) in which members:
28+ (i) share a common set of ethical or
29+ religious beliefs and share medical expenses among members in
30+ accordance with those beliefs and without regard to the state in
31+ which a member resides or is employed; and
32+ (ii) retain membership even after the
33+ member develops a medical condition;
34+ (C) that has been in existence or that has a
35+ predecessor that has been in existence at all times since December
36+ 31, 1999, and in which medical expenses of its members have been
37+ shared continuously and without interruption since December 31,
38+ 1999; and
39+ (D) that does not assume risk or promise to pay
40+ any medical expenses for or on behalf of a member or the health care
41+ sharing ministry.
42+ (3) "Member" means an individual enrolled in a health
6543 care sharing ministry to share medical expenses with other enrolled
6644 individuals.
67- (6) "Sharing request" means a request for
45+ (4) "Sharing request" means a request for
6846 reimbursement of medical expenses submitted by a member to the
6947 health care sharing ministry.
70- [Sec. 1681.002. NOTICE. To qualify as a health care sharing
71- ministry under this chapter, the notice described by Section
72- 1681.001(8) must read substantially as follows:
73- ["Notice: This health care sharing ministry facilitates the
74- sharing of medical expenses and is not an insurance company, and
75- neither its guidelines nor its plan of operation is an insurance
76- policy. Whether anyone chooses to assist you with your medical
77- bills will be totally voluntary because no other participant will
78- be compelled by law to contribute toward your medical bills. As
79- such, participation in the ministry or a subscription to any of its
80- documents should never be considered to be insurance. Regardless
81- of whether you receive any payment for medical expenses or whether
82- this ministry continues to operate, you are always personally
83- responsible for the payment of your own medical bills. Complaints
84- concerning this health care sharing ministry may be reported to the
85- office of the Texas attorney general."]
86- Sec. 113.002 [1681.003]. EXEMPTION. Notwithstanding any
87- [other] provision of the Insurance Code [this code], a health care
88- sharing ministry that acts in accordance with this chapter is not
89- considered to be engaging in the business of insurance.
90- Sec. 113.003. EXEMPTION FROM HEALTH COVERAGE REQUIREMENT BY
91- INSTITUTION OF HIGHER EDUCATION. A student at an institution of
92- higher education who is a member of a health care sharing ministry
93- may use the membership to comply with a requirement by the
94- institution that the student maintain health benefit coverage.
95- SUBCHAPTER B. FILING REQUIREMENTS
96- Sec. 113.051. INITIAL FILING REQUIREMENT. (a) A person
97- must file information described by Subsection (b) with the
98- department in the form and manner prescribed by the commissioner to
48+ SECTION 3. Chapter 1681, Insurance Code, is amended by
49+ adding Subchapters B, C, and D to read as follows:
50+ SUBCHAPTER B. CERTIFICATE OF REGISTRATION
51+ Sec. 1681.051. CERTIFICATE OF REGISTRATION REQUIRED. (a)
52+ Except as provided by Subsection (b), a person must obtain and
53+ maintain a certificate of registration from the commissioner to
9954 operate as a health care sharing ministry in this state.
100- (b) A person intending to operate a health care sharing
101- ministry must include in the filing described by Subsection (a) all
102- information required by the commissioner, including:
55+ (b) A health care sharing ministry with an expired
56+ certificate of registration may continue to operate without a
57+ certificate until the later of the 90th day after the date of the
58+ certificate's expiration or the date on which a late application
59+ for renewal made under Section 1681.057 is approved or denied.
60+ Sec. 1681.052. APPLICATION FOR CERTIFICATE OF
61+ REGISTRATION. (a) An applicant must apply for a health care
62+ sharing ministry certificate of registration on an application form
63+ prescribed by the commissioner and in the manner prescribed by the
64+ commissioner.
65+ (b) A health care sharing ministry application must include
66+ the application form along with all information required by the
67+ commissioner, including:
10368 (1) the responsible director or manager of the
104- ministry;
105- (2) the ministry's physical, mailing, and electronic
69+ applicant;
70+ (2) the applicant's physical, mailing, and electronic
10671 mail addresses;
10772 (3) the contact phone number for the responsible
108- director or manager of the ministry;
109- (4) information demonstrating that the ministry meets
110- the definition of a health care sharing ministry under Section
111- 113.001;
112- (5) a copy of the most recent annual audit created by
113- an independent certified public accounting firm in accordance with
114- generally accepted accounting principles and which is made
115- available to the public on request;
73+ director or manager of the applicant;
74+ (4) information demonstrating that the applicant:
75+ (A) meets the definition of a health care sharing
76+ ministry under Section 1681.0011; and
77+ (B) complies with Section 1681.108;
78+ (5) a copy of the most recent annual audit required
79+ under 26 U.S.C. Section 5000A(d)(2)(B);
11680 (6) a list of any third-party vendors acting on behalf
117- of the ministry in this state for the purposes of:
81+ of the applicant in this state for the purposes of:
11882 (A) enrolling members;
11983 (B) negotiating with health care providers after
12084 services are rendered; or
12185 (C) the financial sharing of member medical
12286 needs;
123- (7) a copy of any application forms and organization
124- guidelines used by the ministry;
125- (8) a report of the ministry's members in this state as
126- of the date of the filing that includes the:
87+ (7) a copy of any application forms and ministry
88+ guidelines used by the applicant;
89+ (8) a report of the applicant's members in this state
90+ as of the date of application that includes the:
12791 (A) total number of enrolled members;
12892 (B) distribution of members by age; and
129- (C) distribution of members by sex; and
130- (9) a certification that the ministry does not
93+ (C) distribution of members by sex;
94+ (9) a certification that the applicant does not
13195 compensate anyone to solicit or enroll members in this state based
13296 on the number of members solicited or enrolled or the amount of
13397 contributions received from enrolled members, including by
134- commission, at a rate of more than five percent of the membership
135- fee received in the first year of membership.
136- (c) Subsection (b)(9) does not apply to:
137- (1) a salaried individual employed by the health care
138- sharing ministry who does not receive any form of commission,
139- compensation, or other valuable consideration based on enrolling
140- new members; or
141- (2) a new member referral program providing credit for
142- membership for existing members of a health care sharing ministry
143- who have referred new members only if the program is limited to
144- credit for no more than 12 months of membership for the existing
145- members annually.
146- Sec. 113.052. ANNUAL FILING REQUIREMENT. (a) A health care
147- sharing ministry shall submit an annual filing of information
148- described by Subsection (b) to the department in the form and manner
149- prescribed by the commissioner.
150- (b) The annual filing must include all information required
151- by the commissioner, including:
98+ commission; and
99+ (10) other information as prescribed by the
100+ commissioner.
101+ Sec. 1681.053. ISSUANCE OF CERTIFICATE OF REGISTRATION.
102+ (a) The commissioner shall issue a certificate of registration to
103+ each applicant that meets the requirements of this chapter and
104+ rules adopted under this chapter.
105+ (b) The commissioner may deny an application that does not
106+ meet the requirements of this chapter and rules adopted under this
107+ chapter.
108+ (c) On the applicant's request, the commissioner shall hold
109+ a hearing on a denial of an application for a certificate of
110+ registration. The hearing is a contested case under Chapter 2001,
111+ Government Code.
112+ Sec. 1681.054. TERM OF CERTIFICATE OF REGISTRATION. A
113+ certificate of registration issued under this chapter expires one
114+ year after the date of issuance unless it is renewed as provided by
115+ Section 1681.055.
116+ Sec. 1681.055. APPLICATION FOR RENEWAL OF CERTIFICATE OF
117+ REGISTRATION. (a) Before a certificate of registration expires, a
118+ health care sharing ministry may renew it for an additional
119+ one-year term if the ministry applies for the renewal in the form
120+ and manner prescribed by the commissioner.
121+ (b) A renewal form must include all information required by
122+ the commissioner, including:
152123 (1) an update of any changes made to documents
153124 previously filed with the department;
154125 (2) a copy of the most recent annual audit required
155126 under 26 U.S.C. Section 5000A(d)(2)(B);
156- (3) an organization financial report detailing the
127+ (3) a ministry financial report detailing the
157128 following for the prior registration period:
158- (A) the total amount of money collected from
159- members in this state, including contributions, administrative
160- fees, or other funds;
161- (B) the total number of sharing requests made by
129+ (A) the total amount collected from members in
130+ this state, including contributions, administrative fees, or other
131+ funds;
132+ (B) the total amount of sharing requests made by
162133 members in this state;
163- (C) the total amount of money paid for health
164- care services for members in this state;
165- (D) the total number of sharing requests that
166- were denied;
134+ (C) the total amount paid for health care
135+ services for members in this state;
136+ (D) the total amount of sharing requests that
137+ were denied; and
167138 (E) the total amount of administrative fees
168139 collected from members in this state, including amounts paid to
169140 each third-party vendor for services provided to members in this
170- state; and
171- (F) the total equivalent monetary amount of
172- membership contributions waived for participants rewarded by
173- referring others to a new member enrollment program;
141+ state;
174142 (4) a report of the health care sharing ministry's
175- members in this state as of the date of the filing that includes
176- the:
143+ members in this state as of the date of application for renewal that
144+ includes the:
177145 (A) total number of enrolled members;
178146 (B) distribution of members by age; and
179147 (C) distribution of members by sex;
180148 (5) a report detailing the following:
181- (A) the number of sharing requests made by
149+ (A) the total number of sharing requests made by
150+ members in this state;
151+ (B) the number of sharing requests made by
182152 members in this state that were approved for sharing;
183- (B) the number of sharing requests made by
153+ (C) the number of sharing requests made by
184154 members in this state that were denied for sharing; and
185- (C) the number of complaints made by members in
186- this state; and
155+ (D) the number of complaints made by members in
156+ this state;
187157 (6) a certification that the health care sharing
188158 ministry does not compensate anyone to solicit or enroll members in
189159 this state based on the number of members solicited or enrolled or
190160 the amount of contributions received from enrolled members,
191- including by commission, at a rate of more than five percent of the
192- membership fee received in the first year of membership.
193- (c) Subsection (b)(6) does not apply to:
194- (1) a salaried individual employed by the health care
195- sharing ministry who does not receive any form of commission,
196- compensation, or other valuable consideration based on enrolling
197- new members; or
198- (2) a new member referral program providing credit for
199- membership for existing members of a health care sharing ministry
200- who have referred new members only if the program is limited to
201- credit for no more than 12 months of membership for the existing
202- members annually.
203- Sec. 113.053. LATE FILING. (a) A health care sharing
204- ministry that fails to timely submit a filing required by this
205- subchapter must pay the following fee to the department:
206- (1) $250 for a filing submitted 1 to 30 days late;
207- (2) $500 for a filing submitted 31 to 60 days late; or
208- (3) $1,000 for a filing submitted 61 to 90 days late.
209- (b) If a health care sharing ministry fails to submit a
210- filing required by this subchapter within 90 days after the
211- filing's deadline, the ministry may not operate as a health care
212- sharing ministry for two years.
213- Sec. 113.054. FEES. Except as provided by Section 113.053,
214- the commissioner by rule shall set a fee for a filing required under
215- this subchapter in an amount not to exceed $100. A fee collected
216- under this section shall be deposited to the credit of the Texas
217- Department of Insurance operating account.
161+ including by commission; and
162+ (7) other information as prescribed by the
163+ commissioner.
164+ (c) The commissioner shall send written notice of an
165+ impending expiration of a certificate of registration to a health
166+ care sharing ministry not later than 30 days before the expiration
167+ of the certificate of registration.
168+ Sec. 1681.056. ISSUANCE OF RENEWAL OF CERTIFICATE OF
169+ REGISTRATION. (a) The commissioner shall renew a certificate of
170+ registration for each health care sharing ministry that meets the
171+ requirements of this chapter and rules adopted under this chapter.
172+ (b) The commissioner may deny a renewal application that
173+ does not meet the requirements of this chapter and rules adopted
174+ under this chapter.
175+ (c) On the applicant's request, the commissioner shall hold
176+ a hearing on a denial of a renewal application. Not later than the
177+ 30th day after the date of the applicant's request for a hearing,
178+ the commissioner shall request a hearing date. The hearing is a
179+ contested case under Chapter 2001, Government Code.
180+ Sec. 1681.057. LATE RENEWAL OF CERTIFICATE OF REGISTRATION.
181+ (a) The commissioner shall renew a certificate of registration in
182+ accordance with Section 1681.056 if a request is made by the health
183+ care sharing ministry within 90 days after the expiration of the
184+ certificate.
185+ (b) A health care sharing ministry that fails to timely
186+ renew a certificate of registration must pay the following fee:
187+ (1) $250 for an application for renewal filed 1 to 30
188+ days late;
189+ (2) $500 for an application for renewal filed 31 to 60
190+ days late; or
191+ (3) $1,000 for an application for renewal filed 61 to
192+ 90 days late.
193+ (c) If a health care sharing ministry fails to apply to
194+ renew a certificate of registration within 90 days after the
195+ expiration of the certificate, the ministry may not reapply for a
196+ certificate of registration for two years.
197+ Sec. 1681.058. FEES. Except as provided by Section
198+ 1681.057, the commissioner by rule shall set a fee for an
199+ application for the issuance or renewal of a certificate of
200+ registration under this chapter in an amount not to exceed $100.
218201 SUBCHAPTER C. REGULATION OF HEALTH CARE SHARING MINISTRIES
219- Sec. 113.101. NAME. A health care sharing ministry may not
220- operate under any name other than the name under which the ministry
221- has submitted a filing under Subchapter B.
222- Sec. 113.102. MARKETING AND COMMUNICATION. (a) In all
223- communications with the public, a health care sharing ministry may
224- not:
225- (1) make a direct or indirect representation that:
226- (A) the ministry provides insurance; or
227- (B) a health care service is free or included
228- with membership; or
229- (2) include "premium," "copay," "deductible,"
230- "coverage," "network," "benefit plan," or a similar term in
231- marketing except to explain the differences between a health care
232- sharing ministry and insurance.
233- (b) A violation of this section is a false, misleading, or
234- deceptive act or practice in violation of Section 17.46.
235- Sec. 113.103. PROHIBITED COMPENSATION. (a) A health care
236- sharing ministry may not compensate anyone to solicit or enroll
202+ Sec. 1681.101. NAME. A health care sharing ministry may not
203+ operate under any name other than the name for which the ministry's
204+ certificate of registration has been issued.
205+ Sec. 1681.102. MARKETING AND COMMUNICATION. (a) Except
206+ for a health care sharing ministry making its annual audit
207+ available to the public, the ministry may not make a direct or
208+ indirect representation that it:
209+ (1) is operating in a financially sound manner; or
210+ (2) has a successful history of meeting members'
211+ medical costs.
212+ (b) In all communications with members or the public, a
213+ health care sharing ministry may not:
214+ (1) use insurance terms that may mislead or confuse a
215+ member or prospective member, including terms such as premium,
216+ copay, deductible, coverage, network, and benefit plan; or
217+ (2) make a direct or indirect representation that a
218+ health care service is free or included with membership.
219+ Sec. 1681.103. COMPENSATION FOR SERVICES. A health care
220+ sharing ministry may not compensate anyone for services provided to
237221 members in this state based on the number of members solicited or
238222 enrolled or the amount of contributions received from enrolled
239- members, including by commission, at a rate of more than five
240- percent of the membership fee received in the first year of
241- membership.
242- (b) This section does not apply to:
243- (1) a salaried individual employed by the health care
244- sharing ministry who does not receive any form of commission,
245- compensation, or other valuable consideration based on enrolling
246- new members; or
247- (2) a new member referral program providing credit for
248- membership for existing members of a health care sharing ministry
249- who have referred new members only if the program is limited to
250- credit for no more than 12 months of membership for the existing
251- members annually.
252- Sec. 113.104. ENROLLMENT DISCLOSURES. A health care
223+ members, including by commission.
224+ Sec. 1681.104. ENROLLMENT DISCLOSURES. A health care
253225 sharing ministry shall disclose the following information in
254226 writing for each calendar year from the previous five calendar
255227 years in a prominent and conspicuous manner before and at the time
256228 an individual is enrolled as a member:
257229 (1) total member contributions;
258230 (2) total amounts paid for sharing requests;
259231 (3) total administrative fees paid by members; and
260232 (4) the percentage of money paid by members that was
261233 paid toward the following:
262234 (A) sharing requests; and
263235 (B) administrative fees.
264- Sec. 113.105. QUARTERLY STATEMENTS. A health care sharing
265- ministry must provide a prominent and conspicuous written quarterly
236+ Sec. 1681.105. MONTHLY STATEMENTS. A health care sharing
237+ ministry must provide a prominent and conspicuous written monthly
266238 and annual statement to all members that includes the following:
267- (1) the number of members participating that quarter
268- and for that calendar year;
239+ (1) the number of members participating that month and
240+ for that calendar year;
269241 (2) the amount of money contributed by members that
270- quarter and for that calendar year;
242+ month and for that calendar year;
271243 (3) the number of and monetary amount of all sharing
272- requests submitted that quarter and for that calendar year;
244+ requests submitted that month and for that calendar year;
273245 (4) the number of and monetary amount of sharing
274- requests paid that quarter and for that calendar year;
246+ requests paid that month and for that calendar year;
275247 (5) the amount of member contributions remaining for
276- future sharing requests for that quarter and for that calendar
277- year;
278- (6) the amount of administrative fees for services to
279- members for that quarter and for that calendar year, including:
248+ future sharing requests for that month and for that calendar year;
249+ (6) the amount of administrative fees for that month
250+ and for that calendar year, including:
280251 (A) the purpose of the administrative fee;
281252 (B) the amount paid for each type of
282253 administrative fee; and
283254 (C) any third-party vendor to which the fee is
284- paid;
255+ paid; and
285256 (7) the percentage of money paid by members that was
286- paid toward the following for that quarter and for that calendar
287- year:
257+ paid toward the following for that month and for that calendar year:
288258 (A) sharing requests;
289259 (B) administrative fees; and
290260 (C) any amount remaining that is designated for
291- the payment of future sharing requests; and
292- (8) the total amount of membership contributions
293- waived for that quarter and for that calendar year for participants
294- in a new member enrollment program.
295- Sec. 113.106. NOTICE; DISCLOSURE. (a) A health care
261+ the payment of future sharing requests.
262+ Sec. 1681.107. ANNUAL AUDIT. A health care sharing
263+ ministry shall conduct an annual audit that is:
264+ (1) performed by an independent certified public
265+ accounting firm in accordance with generally accepted accounting
266+ principles; and
267+ (2) made available to the public on request.
268+ Sec. 1681.108. COMPLIANCE WITH CERTAIN FEDERAL LAW
269+ REQUIRED. A health care sharing ministry shall operate in
270+ accordance with 26 U.S.C. Section 5000A(d)(2)(B).
271+ SUBCHAPTER D. ENFORCEMENT
272+ Sec. 1681.151. ENFORCEMENT ACTIONS. If a health care
273+ sharing ministry is violating or has violated this chapter or other
274+ law, the commissioner may:
275+ (1) suspend or revoke a certificate of registration
276+ issued to the ministry under this chapter;
277+ (2) impose a sanction under Chapter 82;
278+ (3) issue a cease and desist order under Chapter 83;
279+ (4) impose an administrative penalty under Chapter 84;
280+ or
281+ (5) any combination of Subdivisions (1) through (4).
282+ Sec. 1681.152. INJUNCTION. If the commissioner believes
283+ that a health care sharing ministry or another person is violating
284+ or has violated this chapter, the attorney general at the request of
285+ the commissioner may bring an action in a Travis County district
286+ court to enjoin the violation, order restitution, and obtain other
287+ relief the court considers appropriate.
288+ Sec. 1681.153. REMEDIES CUMULATIVE. A remedy or action
289+ authorized by this subchapter is in addition to any other civil,
290+ administrative, or criminal action provided by law.
291+ SECTION 4. Section 1681.002, Insurance Code, is transferred
292+ to Subchapter C, Chapter 1681, Insurance Code, as added by this Act,
293+ redesignated as Section 1681.106, Insurance Code, and amended to
294+ read as follows:
295+ Sec. 1681.106 [1681.002]. NOTICE. (a) A health care
296296 sharing ministry shall provide written notice on or accompanying
297297 all applications, guideline materials, and written advertisements,
298298 including print and digital advertisements, distributed by or on
299299 behalf of the ministry.
300300 (b) The notice described by Subsection (a) must be in at
301- least 10-point font, in a prominent and conspicuous place, and read
301+ least 10-point font, in a prominent and conspicuous place, and [To
302+ qualify as a health care sharing ministry under this chapter, the
303+ notice described by Section 1681.001(8) must] read [substantially]
302304 as follows:
303305 "Notice: Payment of your medical expenses is not guaranteed.
304306 This health care sharing ministry facilitates the sharing of
305307 medical expenses and is not an insurance company, and neither its
306308 guidelines nor its plan of operation is an insurance policy.
307309 Whether anyone chooses to assist you with your medical bills will be
308310 totally voluntary because no other participant will be compelled by
309- law to contribute toward your medical bills. As such,
310- participation in the ministry or a subscription to any of its
311- documents should never be considered to be insurance. Regardless
312- of whether you receive any payment for medical expenses or whether
313- this ministry continues to operate, you are always personally
314- responsible for the payment of your own medical bills. Complaints
315- concerning this health care sharing ministry may be reported to the
316- office of the Texas attorney general."
311+ law to contribute toward your medical bills. As such, participation
312+ in the ministry or a subscription to any of its documents should
313+ never be considered to be insurance. Regardless of whether you
314+ receive any payment for medical expenses or whether this ministry
315+ continues to operate, you are always personally responsible for the
316+ payment of your own medical bills. Complaints concerning this
317+ health care sharing ministry may be reported to the Texas
318+ Department of Insurance [office of the Texas attorney general]."
317319 (c) A health care sharing ministry shall provide the
318320 following notice in any audio or visual advertisement clearly,
319321 conspicuously, and in a manner that a listener would hear and
320322 understand:
321323 "Payment of your medical expenses is not guaranteed. This
322324 health care sharing ministry facilitates the sharing of medical
323325 expenses, is not an insurance company, and is not offering an
324326 insurance policy. Regardless of whether you receive any payment for
325327 medical expenses or whether this ministry continues to operate, you
326328 are always personally responsible for the payment of your own
327329 medical bills."
328- (d) A health care sharing ministry shall provide a written
329- disclosure to a member at enrollment that states:
330- (1) the member may not be exempt from Section
331- 5000A(d)(2)(B) of the Internal Revenue Code; and
332- (2) the member may be subject to a tax if Congress
333- reinstates the tax.
334- Sec. 113.107. ANNUAL AUDIT. A health care sharing ministry
335- shall conduct an annual audit that is:
336- (1) performed by an independent certified public
337- accounting firm in accordance with generally accepted accounting
338- principles; and
339- (2) made available to the public on request.
340- Sec. 113.108. EXCESS BENEFIT TRANSACTIONS PROHIBITED. A
341- health care sharing ministry may not conduct an excess benefit
342- transaction as defined by 26 U.S.C. Section 4958.
343- SUBCHAPTER D. ENFORCEMENT
344- Sec. 113.151. CEASE AND DESIST ORDER. (a) The attorney
345- general ex parte may issue an emergency cease and desist order if
346- the attorney general believes that:
347- (1) a person is operating a health care sharing
348- ministry in violation of this chapter; and
349- (2) the alleged conduct:
350- (A) is fraudulent;
351- (B) is hazardous or creates an immediate danger
352- to public safety; or
353- (C) is causing or can be reasonably expected to
354- cause public injury that:
355- (i) is likely to occur at any moment;
356- (ii) is incapable of being repaired or
357- rectified; and
358- (iii) has or is likely to have influence or
359- effect.
360- (b) The cease and desist order must:
361- (1) be served on the person by registered or certified
362- mail, return receipt requested, at the person's last known address;
363- (2) contain a statement of the charges; and
364- (3) require the person to immediately cease and desist
365- from the acts, methods, or practices stated in the order.
366- (c) A person affected by the cease and desist order is
367- entitled to request a hearing to contest the order. The hearing is
368- a contested case under Chapter 2001, Government Code.
369- (d) An order is final on the 31st day after the date it is
370- received unless the affected person requests a hearing under
371- Subsection (c). Pending a hearing under this section, the order
372- continues in effect unless the order is stayed by the attorney
373- general.
374- (e) The attorney general shall provide to the affected
375- person with the order written notice of the opportunity to request a
376- contested case hearing under Chapter 2001, Government Code.
377- (f) If the affected person requests a hearing under
378- Subsection (c), the attorney general shall set a contested case
379- hearing under Chapter 2001, Government Code, and notify the person
380- of the hearing.
381- (g) The administrative law judge shall make findings of fact
382- and conclusions of law and promptly issue to the attorney general a
383- proposal for a decision regarding the order.
384- Sec. 113.152. CIVIL PENALTY. (a) A person who violates
385- this chapter, including a cease and desist order issued under
386- Section 113.151, is liable to this state for a civil penalty in an
387- amount not to exceed $25,000 for each violation.
388- (b) In determining the amount of the civil penalty, the
389- court shall consider:
390- (1) the seriousness of the violation, including:
391- (A) the nature, circumstances, extent, and
392- gravity of the violation; and
393- (B) the hazard or potential hazard created to the
394- health, safety, or economic welfare of the public;
395- (2) the economic harm to the public interest or public
396- confidence caused by the violation;
397- (3) the history of previous violations;
398- (4) the amount necessary to deter future violations;
399- (5) efforts to correct the violation;
400- (6) whether the violation was intentional; and
401- (7) any other matter that justice may require.
402- Sec. 113.153. ENFORCEMENT ACTION. If the attorney general
403- believes that a health care sharing ministry or another person is
404- violating or has violated this chapter, the attorney general may
405- bring an action in a Travis County district court to enjoin the
406- violation, recover a civil penalty under Section 113.152, order
407- restitution, and obtain other relief the court considers
408- appropriate.
409- Sec. 113.154. REMEDIES CUMULATIVE. A remedy or action
410- authorized by this subchapter is in addition to any other civil,
411- administrative, or criminal action provided by law.
412- SECTION 2. Section 562.0041, Insurance Code, is amended to
413- read as follows:
414- Sec. 562.0041. EXEMPTION. This chapter does not apply to a
415- health care sharing ministry operated under Chapter 113, Business &
416- Commerce Code [1681].
417- SECTION 3. Section 651.002(c), Insurance Code, is amended
418- to read as follows:
419- (c) This chapter does not apply to a health care sharing
420- ministry operated under Chapter 113, Business & Commerce Code
421- [1681].
422- SECTION 4. Section 4151.0022, Insurance Code, is amended to
423- read as follows:
424- Sec. 4151.0022. NONAPPLICABILITY. This chapter does not
425- apply to a health care sharing ministry operated under Chapter 113,
426- Business & Commerce Code [1681].
427- SECTION 5. Section 7001.002, Insurance Code, is amended to
428- read as follows:
429- Sec. 7001.002. EXEMPTION. This chapter does not apply to a
430- program operator who is an insurer and who holds a certificate of
431- authority under Title 6, or a health care sharing ministry operated
432- under Chapter 113, Business & Commerce Code [1681].
433- SECTION 6. Section 7002.004, Insurance Code, is amended to
434- read as follows:
435- Sec. 7002.004. EXEMPTION. This chapter does not apply to a
436- health care sharing ministry operated under Chapter 113, Business &
437- Commerce Code [1681].
438- SECTION 7. (a) Notwithstanding Section 113.051, Business &
439- Commerce Code, as added by this Act, a health care sharing ministry
440- operating in this state immediately before the effective date of
441- this Act is not required to submit a filing under Subchapter B,
442- Chapter 113, Business & Commerce Code, as added by this Act, before
443- March 1, 2022. The ministry may continue operating without a filing
444- until April 1, 2022.
330+ SECTION 5. Section 1681.001, Insurance Code, is repealed.
331+ SECTION 6. (a) Notwithstanding Section 1681.051, Insurance
332+ Code, as added by this Act, a health care sharing ministry operating
333+ in this state immediately before the effective date of this Act is
334+ not required to apply for a certificate of registration under
335+ Chapter 1681, Insurance Code, as amended by this Act, before March
336+ 1, 2022. The ministry may continue operating without a certificate
337+ of registration until the application is approved or denied.
445338 (b) A health care sharing ministry described by Subsection
446- (a) of this section that fails to submit a filing under Subchapter
447- B, Chapter 113, Business & Commerce Code, as added by this Act,
448- before March 1, 2022, may not operate as a health care sharing
449- ministry until the ministry submits a filing on or after March 1,
450- 2024.
451- SECTION 8. This Act takes effect September 1, 2021.
339+ (a) of this section that fails to apply for a certificate of
340+ registration under Chapter 1681, Insurance Code, as amended by this
341+ Act, before March 1, 2022, or whose application for registration
342+ made before that date is denied, may not apply for a certificate of
343+ registration under Section 1681.052, Insurance Code, as added by
344+ this Act, before March 1, 2024.
345+ SECTION 7. This Act takes effect September 1, 2021.