88R1763 SCL-D
By: Menéndez S.B. No. 451
A BILL TO BE ENTITLED
AN ACT
relating to consumer protections for accident and health insurance
that excludes coverage for preexisting conditions.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle A, Title 8, Insurance Code, is amended
by adding Chapter 1223 to read as follows:
CHAPTER 1223. PREEXISTING CONDITION COVERAGE EXCLUSIONS
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 1223.001. APPLICABILITY OF CHAPTER. This chapter
applies to an individual or group accident and health insurance
policy that excludes coverage for preexisting conditions,
including:
(1) an individual accident and health insurance policy
governed by Chapter 1201;
(2) a group accident and health insurance policy
governed by Chapter 1251; or
(3) a short-term limited-duration insurance policy
governed by Chapter 1509.
Sec. 1223.002. RULES. The commissioner may adopt rules
necessary to implement this chapter.
SUBCHAPTER B. DISCLOSURE AND TERMINATION REQUIREMENTS
Sec. 1223.051. HEALTH INFORMATION DISCLOSURE REQUIRED. (a)
An insurance policy governed by this chapter may not exclude
coverage for a preexisting condition unless the application or
enrollment form for the policy requires disclosure of prior
illness, disease, or physical conditions or of prior medical care
and treatment.
(b) An insurer may not require a disclosure of the health
information of an applicant's or enrollee's family member in an
application or enrollment form for an insurance policy governed by
this chapter unless the family member is also seeking coverage
under the policy.
Sec. 1223.052. TERMINATION REQUIREMENTS. (a) An insurer
may not terminate an insurance policy governed by this chapter
before the expiration date except for:
(1) failure to pay the premium or other applicable
charges for coverage;
(2) material failure to abide by rules, policies, or
procedures of the plan;
(3) fraud or misrepresentation affecting coverage;
(4) a request from the policyholder to cancel
coverage; or
(5) a cause for termination the commissioner
determines is not objectionable.
(b) If an insurer terminates an insurance policy governed by
this chapter before the policy expiration date, the insurer must
send written notice to the insured that includes:
(1) the specific reason the policy was terminated; and
(2) notice that the insured may file a complaint with
the department if the insured believes that the policy was
inappropriately terminated.
SECTION 2. Not later than January 1, 2024, the commissioner
of insurance shall adopt rules necessary to implement Chapter 1223,
Insurance Code, as added by this Act.
SECTION 3. Chapter 1223, Insurance Code, as added by this
Act, applies only to an insurance policy delivered, issued for
delivery, or renewed on or after January 1, 2024.
SECTION 4. This Act takes effect September 1, 2023.