Texas 2023 - 88th Regular

Texas House Bill HB3034 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New	Differences
1	1	88R12290 CJD-D
2	2	By: Talarico H.B. No. 3034
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to notice regarding nonemergency ambulance and certain
8	8	nonemergency health care coverage in health benefit plans.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Chapter 1210, Insurance Code, is amended to read
11	11	as follows:
12	12	CHAPTER 1210. NOTICE OF CERTAIN POLICY PROVISIONS
13	13	SUBCHAPTER A. NOTICE OF PROVISIONS RELATED TO RENEWAL OR NONRENEWAL
14	14	Sec. 1210.001. NOTICE REQUIRED. A policy, contract, or
15	15	certificate of insurance that insures against loss resulting from
16	16	sickness or accidental bodily injury and that is subject to an
17	17	increase in the premium at time of renewal or to nonrenewal on the
18	18	insured attaining a certain age may not be delivered, issued, or
19	19	used in this state unless the document contains on the first page
20	20	above the policy provisions a printed notice in 10-point type that
21	21	states that the policy, contract, or certificate is subject to
22	22	either or both conditions.
23	23	SUBCHAPTER B. AMBULANCE AND CERTAIN NONEMERGENCY HEALTH CARE
24	24	COVERAGE PROVISIONS
25	25	Sec. 1210.011. DEFINITION. In this subchapter, "emergency
26	26	medical services personnel" has the meaning assigned by Section
27	27	773.003, Health and Safety Code.
28	28	Sec. 1210.012. APPLICABILITY OF SUBCHAPTER. (a) This
29	29	subchapter applies only to a health benefit plan that provides
30	30	benefits for medical or surgical expenses incurred as a result of a
31	31	health condition, accident, or sickness, including an individual,
32	32	group, blanket, or franchise insurance policy or insurance
33	33	agreement, a group hospital service contract, or an individual or
34	34	group evidence of coverage or similar coverage document that is
35	35	offered by:
36	36	(1) an insurance company;
37	37	(2) a group hospital service corporation operating
38	38	under Chapter 842;
39	39	(3) a health maintenance organization operating under
40	40	Chapter 843;
41	41	(4) an approved nonprofit health corporation
42	42	that holds a certificate of authority under Chapter 844;
43	43	(5) a multiple employer welfare arrangement that holds
44	44	a certificate of authority under Chapter 846;
45	45	(6) a stipulated premium company operating under
46	46	Chapter 884;
47	47	(7) a fraternal benefit society operating under
48	48	Chapter 885;
49	49	(8) a Lloyd's plan operating under Chapter 941; or
50	50	(9) an exchange operating under Chapter 942.
51	51	(b) Notwithstanding any other law, this subchapter applies
52	52	to:
53	53	(1) a small employer health benefit plan subject to
54	54	Chapter 1501, including coverage provided through a health group
55	55	cooperative under Subchapter B of that chapter;
56	56	(2) a standard health benefit plan issued under
57	57	Chapter 1507;
58	58	(3) a basic coverage plan under Chapter 1551;
59	59	(4) a basic plan under Chapter 1575;
60	60	(5) a primary care coverage plan under Chapter 1579;
61	61	(6) a plan providing basic coverage under Chapter
62	62	1601;
63	63	(7) nonprofit agricultural organization health
64	64	benefits offered by a nonprofit agricultural organization under
65	65	Chapter 1682;
66	66	(8) alternative health benefit coverage offered by a
67	67	subsidiary of the Texas Mutual Insurance Company under Subchapter
68	68	M, Chapter 2054;
69	69	(9) health benefits provided by or through a church
70	70	benefits board under Subchapter I, Chapter 22, Business
71	71	Organizations Code;
72	72	(10) the state Medicaid program, including the
73	73	Medicaid managed care program operated under Chapter 533,
74	74	Government Code;
75	75	(11) the child health plan program under Chapter 62,
76	76	Health and Safety Code;
77	77	(12) a regional or local health care program operated
78	78	under Section 75.104, Health and Safety Code;
79	79	(13) a self-funded health benefit plan sponsored by a
80	80	professional employer organization under Chapter 91, Labor Code;
81	81	(14) county employee group health benefits provided
82	82	under Chapter 157, Local Government Code; and
83	83	(15) health and accident coverage provided by a risk
84	84	pool created under Chapter 172, Local Government Code.
85	85	Sec. 1210.013. NOTICE REQUIRED. (a) This section applies
86	86	only with respect to a health benefit plan that does not provide
87	87	coverage for nonemergency ambulance services or nonemergency
88	88	health care services provided by emergency medical services
89	89	personnel.
90	90	(b) A health benefit plan issuer or administrator shall
91	91	provide written notice in the form and manner prescribed by the
92	92	commissioner in an explanation of benefits provided to an enrollee
93	93	that the enrollee's plan does not cover nonemergency ambulance
94	94	services or nonemergency health care services provided by emergency
95	95	medical services personnel.
96	96	SECTION 2. If before implementing any provision of this Act
97	97	a state agency determines that a waiver or authorization from a
98	98	federal agency is necessary for implementation of that provision,
99	99	the agency affected by the provision shall request the waiver or
100	100	authorization and may delay implementing the provision until the
101	101	waiver or authorization is granted.
102	102	SECTION 3. This Act takes effect September 1, 2023.