Texas 2023 - 88th Regular

Texas House Bill HB3912 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New	Differences
1	1	88R14164 RDS-D
2	2	By: Morales Shaw H.B. No. 3912
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the applicability of health benefit plan cost-sharing
8	8	requirements for prescription insulin.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Sections 1358.101(a) and (c), Insurance Code,
11	11	are amended to read as follows:
12	12	(a) This subchapter applies only to a health benefit plan
13	13	that provides benefits for medical or surgical expenses incurred as
14	14	a result of a health condition, accident, or sickness, including an
15	15	individual, group, blanket, or franchise insurance policy or
16	16	insurance agreement, a group hospital service contract, or a small
17	17	or large employer group contract or similar coverage document that
18	18	is offered by:
19	19	(1) an insurance company;
20	20	(2) a group hospital service corporation operating
21	21	under Chapter 842;
22	22	(3) a fraternal benefit society operating under
23	23	Chapter 885;
24	24	(4) a stipulated premium company operating under
25	25	Chapter 884;
26	26	(5) a reciprocal exchange operating under Chapter 942;
27	27	(6) a health maintenance organization operating under
28	28	Chapter 843;
29	29	(7) a multiple employer welfare arrangement that holds
30	30	a certificate of authority under Chapter 846; [or]
31	31	(8) an approved nonprofit health corporation that
32	32	holds a certificate of authority under Chapter 844; or
33	33	(9) a Lloyd's plan operating under Chapter 941.
34	34	(c) Notwithstanding any provision in Chapter 1551, 1575,
35	35	1579, or 1601 or any other law, this subchapter applies to:
36	36	(1) a small employer health benefit plan subject to
37	37	Chapter 1501, including coverage provided through a health group
38	38	cooperative under Subchapter B of that chapter;
39	39	(2) a standard health benefit plan issued under
40	40	Chapter 1507;
41	41	(3) a basic coverage plan under Chapter 1551;
42	42	(4) [(2)] a basic plan under Chapter 1575;
43	43	(5) [(3)] a primary care coverage plan under Chapter
44	44	1579; [and]
45	45	(6) [(4)] basic coverage under Chapter 1601;
46	46	(7) nonprofit agricultural organization health
47	47	benefits offered by a nonprofit agricultural organization under
48	48	Chapter 1682;
49	49	(8) alternative health benefit coverage offered by a
50	50	subsidiary of the Texas Mutual Insurance Company under Subchapter
51	51	M, Chapter 2054;
52	52	(9) health benefits provided by or through a church
53	53	benefits board under Subchapter I, Chapter 22, Business
54	54	Organizations Code;
55	55	(10) a regional or local health care program operated
56	56	under Section 75.104, Health and Safety Code;
57	57	(11) a self-funded health benefit plan sponsored by a
58	58	professional employer organization under Chapter 91, Labor Code;
59	59	(12) county employee group health benefits provided
60	60	under Chapter 157, Local Government Code; and
61	61	(13) health and accident coverage provided by a risk
62	62	pool created under Chapter 172, Local Government Code.
63	63	SECTION 2. Section 1358.102, Insurance Code, is amended to
64	64	read as follows:
65	65	Sec. 1358.102. EXCEPTION. This subchapter does not apply
66	66	to:
67	67	(1) a health benefit plan that provides coverage:
68	68	(A) only for a specified disease or for another
69	69	single benefit;
70	70	(B) only for accidental death or dismemberment;
71	71	(C) 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	(D) as a supplement to a liability insurance
75	75	policy;
76	76	(E) for credit insurance;
77	77	(F) only for dental or vision care;
78	78	(G) only for hospital expenses; or
79	79	(H) only for indemnity for hospital confinement;
80	80	(2) a Medicare supplemental policy as defined by
81	81	Section 1882(g)(1), Social Security Act (42 U.S.C. Section 1395ss);
82	82	(3) medical payment insurance coverage provided under
83	83	a motor vehicle insurance policy;
84	84	(4) a long-term care insurance policy, including a
85	85	nursing home fixed indemnity policy, unless the commissioner
86	86	determines that the policy provides benefit coverage so
87	87	comprehensive that the policy is a health benefit plan as described
88	88	by Section 1358.101; or
89	89	(5) [health and accident coverage provided by a risk
90	90	pool created under Chapter 172, Local Government Code; or
91	91	[(6)] a workers' compensation insurance policy.
92	92	SECTION 3. The changes in law made by this Act apply only to
93	93	a health benefit plan that is delivered, issued for delivery, or
94	94	renewed on or after January 1, 2024. A health benefit plan
95	95	delivered, issued for delivery, or renewed before January 1, 2024,
96	96	is governed by the law as it existed immediately before the
97	97	effective date of this Act, and that law is continued in effect for
98	98	that purpose.
99	99	SECTION 4. This Act takes effect September 1, 2023.