| 3 | 2 | | |
|---|
| 4 | 3 | | |
|---|
| 5 | 4 | | |
|---|
| 6 | 5 | | |
|---|
| 7 | 6 | | A BILL TO BE ENTITLED |
|---|
| 8 | 7 | | AN ACT |
|---|
| 9 | 8 | | relating to a group health benefit plan policy or contract holder's |
|---|
| 10 | 9 | | obligation to pay premiums on behalf of an individual after the |
|---|
| 11 | 10 | | individual's eligibility for group coverage terminates. |
|---|
| 12 | 11 | | BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
|---|
| 13 | 12 | | SECTION 1. Section 843.210, Insurance Code, is amended by |
|---|
| 14 | 13 | | adding Subsection (e) to read as follows: |
|---|
| 15 | 14 | | (e) If the group contract holder notifies the health |
|---|
| 16 | 15 | | maintenance organization of the termination of an enrollee's |
|---|
| 17 | 16 | | eligibility for coverage later than the end of the month in which |
|---|
| 18 | 17 | | the enrollee's eligibility for the group coverage terminated, the |
|---|
| 19 | 18 | | health maintenance organization may waive the contract holder's |
|---|
| 20 | 19 | | liability for premiums on the enrollee for any subsequent months, |
|---|
| 21 | 20 | | provided that no covered services were provided to the enrollee |
|---|
| 22 | 21 | | after the end of the month in which the enrollee's eligibility |
|---|
| 23 | 22 | | terminated. |
|---|
| 24 | 23 | | SECTION 2. Section 1301.0061, Insurance Code, is amended by |
|---|
| 25 | 24 | | adding Subsection (e) to read as follows: |
|---|
| 26 | 25 | | (e) If the group policyholder notifies the insurer of the |
|---|
| 27 | 26 | | termination of an individual's eligibility for coverage later than |
|---|
| 28 | 27 | | the end of the month in which the individual's eligibility for the |
|---|
| 29 | 28 | | group coverage terminated, the insurer may waive the policyholder's |
|---|
| 30 | 29 | | liability for premiums on the individual for any subsequent months, |
|---|
| 31 | 30 | | provided that no covered services were provided to the individual |
|---|
| 32 | 31 | | after the end of the month in which the individual's eligibility |
|---|
| 33 | 32 | | terminated. |
|---|
| 34 | 33 | | SECTION 3. This Act takes effect immediately if it receives |
|---|
| 35 | 34 | | a vote of two-thirds of all the members elected to each house, as |
|---|
| 36 | 35 | | provided by Section 39, Article III, Texas Constitution. If this |
|---|
| 37 | 36 | | Act does not receive the vote necessary for immediate effect, this |
|---|
| 38 | 37 | | Act takes effect September 1, 2025. |
|---|