Texas 2023 - 88th Regular

Texas House Bill HB290 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New	Differences
1	1	H.B. No. 290
2	2
3	3
4	4	AN ACT
5	5	relating to multiple employer welfare arrangements.
6	6	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
7	7	SECTION 1. Subchapter A, Chapter 846, Insurance Code, is
8	8	amended by adding Section 846.0035 to read as follows:
9	9	Sec. 846.0035. APPLICABILITY OF CERTAIN LAWS TO ASSOCIATION
10	10	PROVIDING HEALTH BENEFITS. (a) This section applies only to a
11	11	multiple employer welfare arrangement:
12	12	(1) that was issued an initial certificate of
13	13	authority under Section 846.054 on or after January 1, 2024; or
14	14	(2) that elects to be bound by this section in the
15	15	manner prescribed by the commissioner.
16	16	(b) A multiple employer welfare arrangement that provides a
17	17	comprehensive health benefit plan, as determined by the
18	18	commissioner, is subject to the following laws as if the
19	19	arrangement were an insurer, individuals entitled to coverage under
20	20	the plan were insureds, and the health benefits were provided
21	21	through an insurance policy:
22	22	(1) Chapter 421;
23	23	(2) Chapter 422;
24	24	(3) Subchapters C, F, and K, Chapter 1451; and
25	25	(4) Chapter 4201.
26	26	(c) A multiple employer welfare arrangement that provides a
27	27	comprehensive health benefit plan, as determined by the
28	28	commissioner, that is determined by the commissioner to be
29	29	structured in the manner of a preferred provider benefit plan or an
30	30	exclusive provider benefit plan as defined in Section 1301.001 is
31	31	subject to the following laws as if the arrangement were an insurer,
32	32	individuals entitled to coverage under the plan were insureds, and
33	33	the health benefits were provided through an insurance policy:
34	34	(1) Chapter 1301; and
35	35	(2) Chapter 1467.
36	36	SECTION 2. Section 846.052(b), Insurance Code, is amended
37	37	to read as follows:
38	38	(b) The application form must be completed and submitted
39	39	along with all information required by the commissioner, including:
40	40	(1) a copy of each organizational document;
41	41	(2) current financial statements of the arrangement;
42	42	(3) a fully detailed statement indicating the plan
43	43	under which the arrangement proposes to transact business;
44	44	(4) an initial actuarial opinion in compliance with
45	45	the requirements of Section 846.153(a)(2) and subject to Section
46	46	846.157(b); and
47	47	(5) demonstration [a statement] by the applicant
48	48	[certifying] that the arrangement is in compliance with all
49	49	applicable federal and state laws, as determined by the
50	50	commissioner [provisions of the Employee Retirement Income
51	51	Security Act of 1974 (29 U.S.C. Section 1001 et seq.)].
52	52	SECTION 3. Section 846.053, Insurance Code, is amended by
53	53	amending Subsections (b) and (c) and adding Subsection (d-1) to
54	54	read as follows:
55	55	(b) The employers in the multiple employer welfare
56	56	arrangement must:
57	57	(1) be members of an association or group of five or
58	58	more businesses that are in the same trade or industry, including
59	59	closely related businesses that provide support, services, or
60	60	supplies primarily to that trade or industry; or
61	61	(2) for a multiple employer welfare arrangement to
62	62	which Section 846.0035 applies, each have a principal place of
63	63	business in the same region that does not exceed the boundaries of
64	64	this state or the boundaries of a metropolitan statistical area
65	65	designated by the United States Office of Management and Budget.
66	66	(c) If the employers in the multiple employer welfare
67	67	arrangement are members of an association, the association must:
68	68	(1) be engaged in substantial activity for its
69	69	members other than sponsorship of an employee welfare benefit plan;
70	70	and
71	71	(2) if Section 846.0035 does not apply to the multiple
72	72	employer welfare arrangement, have been in existence for at least
73	73	two years before engaging in any activities relating to providing
74	74	employee health benefits to its members.
75	75	(d-1) For purposes of a multiple employer welfare
76	76	arrangement to which Section 846.0035 applies, a working owner of a
77	77	trade or business without employees may qualify as both an employer
78	78	and as an employee of the trade or industry for the purposes of this
79	79	section. In this subsection, "working owner" means an individual
80	80	who:
81	81	(1) has an ownership right of any nature in a trade or
82	82	business, whether incorporated or unincorporated, including a
83	83	partner and other self-employed individual;
84	84	(2) earns wages or self-employment income from the
85	85	trade or business for providing personal services to the trade or
86	86	business; and
87	87	(3) either:
88	88	(A) works on average at least 20 hours per week or
89	89	at least 80 hours per month providing personal services to the
90	90	working owner's trade or business; or
91	91	(B) has wages or self-employment income from the
92	92	individual's trade or business that at least equals the
93	93	individual's cost of coverage for participation by the individual
94	94	and any covered beneficiaries in the group health plan sponsored by
95	95	the group or association in which the individual is participating.
96	96	SECTION 4. This Act takes effect September 1, 2023.
97	97	______________________________ ______________________________
98	98	President of the Senate Speaker of the House
99	99	I certify that H.B. No. 290 was passed by the House on April
100	100	26, 2023, by the following vote: Yeas 149, Nays 0, 1 present, not
101	101	voting.
102	102	______________________________
103	103	Chief Clerk of the House
104	104	I certify that H.B. No. 290 was passed by the Senate on May
105	105	10, 2023, by the following vote: Yeas 30, Nays 0.
106	106	______________________________
107	107	Secretary of the Senate
108	108	APPROVED: _____________________
109	109	Date
110	110	_____________________
111	111	Governor