BILL ANALYSIS C.S.H.B. 2290 By: Johnson Higher Education Committee Report (Substituted) BACKGROUND AND PURPOSE Universities and students are increasingly confronted by the rising cost of health care coverage. Although students in Texas can stay on their parents' health benefit plans until the age of 26, some states allow students to opt in to receive health care coverage through their university. Furthermore, many students who move away from their families to another state are confronted with the difficulty of finding in-network providers and new coverage. The bill author has informed the committee that allowing universities to provide health care coverage to students can help lower health plan costs and, thus, the overall cost of higher education. Current law does not expressly authorize or prohibit these plans. C.S.H.B. 2290 seeks to provide postsecondary educational institutions the authority to offer health care coverage to students and their families and sets out certain protections and procedures relating to these plans. CRIMINAL JUSTICE IMPACT It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision. RULEMAKING AUTHORITY It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution. ANALYSIS C.S.H.B. 2290 amends the Insurance Code to authorize a postsecondary educational institution, defined as a public, private, or independent institution of higher education, to offer in Texas higher education health benefits, defined as health benefits sponsored by a postsecondary educational institution, offered only to students enrolled at the institution and their family members, that are not provided through an insurance policy or other product the offering or issuance of which is regulated as the business of insurance in Texas, and that are deemed by the institution to be important in assisting its students and their families to live long and productive lives. The bill does the following with respect to a postsecondary educational institution that offers those benefits: prohibits the institution from requiring a student to enroll in the benefits; prohibits the institution from requiring a waiting period of more than six months for treatment of a preexisting condition otherwise included in the benefits, which is defined in the bill as a condition present before the effective date of an individual's enrollment in the benefit plan; and requires the institution to provide to an individual applying for the benefits written notice that the benefits are not provided through an insurance policy or other product the offering or issuance of which is regulated as the business of insurance in Texas. The bill requires an individual to sign and return to the postsecondary educational institution such notice before the individual may enroll in the benefits and requires the institution to maintain a copy of the signed notice for the duration of the term during which the benefits are provided to the individual and provide a copy of the notice to the individual on their request. C.S.H.B. 2290 establishes that, for the purposes of offering higher education health benefits, a postsecondary educational institution that acts in accordance with the bill's provisions is not a health insurer and is not engaging in the business of health insurance in Texas. The bill, with respect to a postsecondary educational institution that offers higher education health benefits, does the following: requires the institution to register with the Texas Department of Insurance and provide information as needed to facilitate compliance with statutory provisions governing out‑of-network claim dispute resolution, as applicable to certain benefit plans subject to balance billing prohibitions and out-of-network claim dispute resolution; authorizes the institution to contract with a company authorized to engage in the business of insurance in Texas that is not under common control with the institution to: o transfer to that company all or a portion of the organization's risks arising from the benefits; or o obtain insurance coverage from the company guarantying the institution's obligations arising from the benefits; and requires the institution to administer the benefits in a manner that is actuarially sound by: o obtaining an actuarial opinion from an actuary who is a fellow of the Society of Actuaries or a member of the American Academy of Actuaries that recommends the amount of cash reserves and the level of specific and aggregate stop-loss insurance the postsecondary educational institution should maintain for purposes of administering the benefits; and o maintaining the levels of cash reserves and stop-loss insurance recommended by that actuarial opinion. C.S.H.B. 2290 subjects a health benefit plan offered by a postsecondary educational institution under the bill's provisions to the applicability of statutory provisions relating to the balance billing prohibitions and out-of-network claim dispute resolution for certain plans. EFFECTIVE DATE On passage, or, if the bill does not receive the necessary vote, September 1, 2025. COMPARISON OF INTRODUCED AND SUBSTITUTE While C.S.H.B. 2290 may differ from the introduced in minor or nonsubstantive ways, the following summarizes the substantial differences between the introduced and committee substitute versions of the bill. While both the introduced and the substitute pertain to public, private, or independent institutions of higher education, the substitute refers to such institutions as postsecondary educational institutions, whereas the introduced did not. The substitute includes provisions absent from the introduced relating to the following with respect to a postsecondary educational institution that offers higher education health benefits: the prohibition against an institution requiring a student to enroll in the benefits; and the requirement for an institution to administer the benefits in a manner that is actuarially sound by taking certain actions. Both the substitute and the introduced define "higher education health benefits" but the substitute revises the introduced version's definition by removing the option that such a benefit be sponsored by an affiliate of the institution.
BILL ANALYSIS
# BILL ANALYSIS
C.S.H.B. 2290
By: Johnson
Higher Education
Committee Report (Substituted)
C.S.H.B. 2290
By: Johnson
Higher Education
Committee Report (Substituted)
BACKGROUND AND PURPOSE Universities and students are increasingly confronted by the rising cost of health care coverage. Although students in Texas can stay on their parents' health benefit plans until the age of 26, some states allow students to opt in to receive health care coverage through their university. Furthermore, many students who move away from their families to another state are confronted with the difficulty of finding in-network providers and new coverage. The bill author has informed the committee that allowing universities to provide health care coverage to students can help lower health plan costs and, thus, the overall cost of higher education. Current law does not expressly authorize or prohibit these plans. C.S.H.B. 2290 seeks to provide postsecondary educational institutions the authority to offer health care coverage to students and their families and sets out certain protections and procedures relating to these plans.
CRIMINAL JUSTICE IMPACT It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision.
RULEMAKING AUTHORITY It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.
ANALYSIS C.S.H.B. 2290 amends the Insurance Code to authorize a postsecondary educational institution, defined as a public, private, or independent institution of higher education, to offer in Texas higher education health benefits, defined as health benefits sponsored by a postsecondary educational institution, offered only to students enrolled at the institution and their family members, that are not provided through an insurance policy or other product the offering or issuance of which is regulated as the business of insurance in Texas, and that are deemed by the institution to be important in assisting its students and their families to live long and productive lives. The bill does the following with respect to a postsecondary educational institution that offers those benefits: prohibits the institution from requiring a student to enroll in the benefits; prohibits the institution from requiring a waiting period of more than six months for treatment of a preexisting condition otherwise included in the benefits, which is defined in the bill as a condition present before the effective date of an individual's enrollment in the benefit plan; and requires the institution to provide to an individual applying for the benefits written notice that the benefits are not provided through an insurance policy or other product the offering or issuance of which is regulated as the business of insurance in Texas. The bill requires an individual to sign and return to the postsecondary educational institution such notice before the individual may enroll in the benefits and requires the institution to maintain a copy of the signed notice for the duration of the term during which the benefits are provided to the individual and provide a copy of the notice to the individual on their request. C.S.H.B. 2290 establishes that, for the purposes of offering higher education health benefits, a postsecondary educational institution that acts in accordance with the bill's provisions is not a health insurer and is not engaging in the business of health insurance in Texas. The bill, with respect to a postsecondary educational institution that offers higher education health benefits, does the following: requires the institution to register with the Texas Department of Insurance and provide information as needed to facilitate compliance with statutory provisions governing out‑of-network claim dispute resolution, as applicable to certain benefit plans subject to balance billing prohibitions and out-of-network claim dispute resolution; authorizes the institution to contract with a company authorized to engage in the business of insurance in Texas that is not under common control with the institution to: o transfer to that company all or a portion of the organization's risks arising from the benefits; or o obtain insurance coverage from the company guarantying the institution's obligations arising from the benefits; and requires the institution to administer the benefits in a manner that is actuarially sound by: o obtaining an actuarial opinion from an actuary who is a fellow of the Society of Actuaries or a member of the American Academy of Actuaries that recommends the amount of cash reserves and the level of specific and aggregate stop-loss insurance the postsecondary educational institution should maintain for purposes of administering the benefits; and o maintaining the levels of cash reserves and stop-loss insurance recommended by that actuarial opinion. C.S.H.B. 2290 subjects a health benefit plan offered by a postsecondary educational institution under the bill's provisions to the applicability of statutory provisions relating to the balance billing prohibitions and out-of-network claim dispute resolution for certain plans.
EFFECTIVE DATE On passage, or, if the bill does not receive the necessary vote, September 1, 2025.
COMPARISON OF INTRODUCED AND SUBSTITUTE While C.S.H.B. 2290 may differ from the introduced in minor or nonsubstantive ways, the following summarizes the substantial differences between the introduced and committee substitute versions of the bill. While both the introduced and the substitute pertain to public, private, or independent institutions of higher education, the substitute refers to such institutions as postsecondary educational institutions, whereas the introduced did not. The substitute includes provisions absent from the introduced relating to the following with respect to a postsecondary educational institution that offers higher education health benefits: the prohibition against an institution requiring a student to enroll in the benefits; and the requirement for an institution to administer the benefits in a manner that is actuarially sound by taking certain actions. Both the substitute and the introduced define "higher education health benefits" but the substitute revises the introduced version's definition by removing the option that such a benefit be sponsored by an affiliate of the institution.
BACKGROUND AND PURPOSE
Universities and students are increasingly confronted by the rising cost of health care coverage. Although students in Texas can stay on their parents' health benefit plans until the age of 26, some states allow students to opt in to receive health care coverage through their university. Furthermore, many students who move away from their families to another state are confronted with the difficulty of finding in-network providers and new coverage. The bill author has informed the committee that allowing universities to provide health care coverage to students can help lower health plan costs and, thus, the overall cost of higher education. Current law does not expressly authorize or prohibit these plans. C.S.H.B. 2290 seeks to provide postsecondary educational institutions the authority to offer health care coverage to students and their families and sets out certain protections and procedures relating to these plans.
CRIMINAL JUSTICE IMPACT
It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision.
RULEMAKING AUTHORITY
It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.
ANALYSIS
C.S.H.B. 2290 amends the Insurance Code to authorize a postsecondary educational institution, defined as a public, private, or independent institution of higher education, to offer in Texas higher education health benefits, defined as health benefits sponsored by a postsecondary educational institution, offered only to students enrolled at the institution and their family members, that are not provided through an insurance policy or other product the offering or issuance of which is regulated as the business of insurance in Texas, and that are deemed by the institution to be important in assisting its students and their families to live long and productive lives. The bill does the following with respect to a postsecondary educational institution that offers those benefits:
prohibits the institution from requiring a student to enroll in the benefits;
prohibits the institution from requiring a waiting period of more than six months for treatment of a preexisting condition otherwise included in the benefits, which is defined in the bill as a condition present before the effective date of an individual's enrollment in the benefit plan; and
requires the institution to provide to an individual applying for the benefits written notice that the benefits are not provided through an insurance policy or other product the offering or issuance of which is regulated as the business of insurance in Texas.
The bill requires an individual to sign and return to the postsecondary educational institution such notice before the individual may enroll in the benefits and requires the institution to maintain a copy of the signed notice for the duration of the term during which the benefits are provided to the individual and provide a copy of the notice to the individual on their request.
C.S.H.B. 2290 establishes that, for the purposes of offering higher education health benefits, a postsecondary educational institution that acts in accordance with the bill's provisions is not a health insurer and is not engaging in the business of health insurance in Texas. The bill, with respect to a postsecondary educational institution that offers higher education health benefits, does the following:
requires the institution to register with the Texas Department of Insurance and provide information as needed to facilitate compliance with statutory provisions governing out‑of-network claim dispute resolution, as applicable to certain benefit plans subject to balance billing prohibitions and out-of-network claim dispute resolution;
authorizes the institution to contract with a company authorized to engage in the business of insurance in Texas that is not under common control with the institution to:
o transfer to that company all or a portion of the organization's risks arising from the benefits; or
o obtain insurance coverage from the company guarantying the institution's obligations arising from the benefits; and
requires the institution to administer the benefits in a manner that is actuarially sound by:
o obtaining an actuarial opinion from an actuary who is a fellow of the Society of Actuaries or a member of the American Academy of Actuaries that recommends the amount of cash reserves and the level of specific and aggregate stop-loss insurance the postsecondary educational institution should maintain for purposes of administering the benefits; and
o maintaining the levels of cash reserves and stop-loss insurance recommended by that actuarial opinion.
C.S.H.B. 2290 subjects a health benefit plan offered by a postsecondary educational institution under the bill's provisions to the applicability of statutory provisions relating to the balance billing prohibitions and out-of-network claim dispute resolution for certain plans.
EFFECTIVE DATE
On passage, or, if the bill does not receive the necessary vote, September 1, 2025.
COMPARISON OF INTRODUCED AND SUBSTITUTE
While C.S.H.B. 2290 may differ from the introduced in minor or nonsubstantive ways, the following summarizes the substantial differences between the introduced and committee substitute versions of the bill.
While both the introduced and the substitute pertain to public, private, or independent institutions of higher education, the substitute refers to such institutions as postsecondary educational institutions, whereas the introduced did not. The substitute includes provisions absent from the introduced relating to the following with respect to a postsecondary educational institution that offers higher education health benefits:
the prohibition against an institution requiring a student to enroll in the benefits; and
the requirement for an institution to administer the benefits in a manner that is actuarially sound by taking certain actions.
Both the substitute and the introduced define "higher education health benefits" but the substitute revises the introduced version's definition by removing the option that such a benefit be sponsored by an affiliate of the institution.