Texas 2025 - 89th Regular

Texas Senate Bill SB1409 Compare Versions

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1	1	By: Parker S.B. No. 1409
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6	6	A BILL TO BE ENTITLED
7	7	AN ACT
8	8	relating to health benefits offered by postsecondary educational
9	9	institutions to students and their families.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Section 1275.002, Insurance Code, is amended to
12	12	read as follows:
13	13	Sec. 1275.002. APPLICABILITY OF CHAPTER. This chapter
14	14	applies only to:
15	15	(1) a health benefit plan offered by a nonprofit
16	16	agricultural organization under Chapter 1682; [and]
17	17	(2) a health benefit plan:
18	18	(A) that is a self-insured or self-funded plan
19	19	established by an employer for the benefit of the employer's
20	20	employees in accordance with the Employee Retirement Income
21	21	Security Act of 1974 (29 U.S.C. Section 1001 et seq.); and
22	22	(B) for which the plan sponsor has made an
23	23	election, submitted to the commissioner in the form and manner
24	24	prescribed by the commissioner, to apply this chapter to the plan
25	25	for the relevant plan year; and
26	26	(3) a health benefit plan offered by a postsecondary
27	27	educational institution under Chapter 1683.
28	28	SECTION 2. Subtitle K, Title 8, Insurance Code, is amended
29	29	by adding Chapter 1683 to read as follows:
30	30	CHAPTER 1683. HEALTH BENEFITS PROVIDED BY CERTAIN POSTSECONDARY
31	31	EDUCATIONAL INSTITUTIONS
32	32	Sec. 1683.001. DEFINITIONS. In this chapter:
33	33	(1) "Higher education health benefits" means health
34	34	benefits:
35	35	(A) sponsored by a postsecondary educational
36	36	institution;
37	37	(B) offered only to:
38	38	(i) students enrolled at the postsecondary
39	39	educational institution; and
40	40	(ii) family members of students enrolled at
41	41	the postsecondary educational institution;
42	42	(C) that are not provided through an insurance
43	43	policy or other product the offering or issuance of which is
44	44	regulated as the business of insurance in this state; and
45	45	(D) that are deemed by the postsecondary
46	46	educational institution to be important in assisting its students
47	47	and their families to live long and productive lives.
48	48	(2) "Postsecondary educational institution" means an
49	49	institution of higher education or a private or independent
50	50	institution of higher education, as those terms are defined by
51	51	Section 61.003, Education Code.
52	52	(3) "Preexisting condition" means a condition present
53	53	before the effective date of an individual's enrollment in higher
54	54	education health benefits.
55	55	Sec. 1683.002. HIGHER EDUCATION HEALTH BENEFITS
56	56	AUTHORIZED. A postsecondary educational institution may offer in
57	57	this state higher education health benefits. A postsecondary
58	58	educational institution that offers higher education health
59	59	benefits under this chapter may not require a student to enroll in
60	60	the benefits.
61	61	Sec. 1683.003. WAITING PERIOD FOR PREEXISTING CONDITION.
62	62	Notwithstanding any other provision of this chapter, a
63	63	postsecondary educational institution that offers higher education
64	64	health benefits may not require a waiting period of more than six
65	65	months for treatment of a preexisting condition otherwise included
66	66	in higher education health benefits.
67	67	Sec. 1683.004. REQUIRED DISCLOSURE FOR HIGHER EDUCATION
68	68	HEALTH BENEFITS. (a) A postsecondary educational institution that
69	69	offers higher education health benefits must provide to an
70	70	individual applying for higher education health benefits written
71	71	notice that the benefits are not provided through an insurance
72	72	policy or other product the offering or issuance of which is
73	73	regulated as the business of insurance in this state.
74	74	(b) An individual must sign and return to the postsecondary
75	75	educational institution the notice described by Subsection (a)
76	76	before the individual may enroll in higher education health
77	77	benefits. The postsecondary educational institution must:
78	78	(1) maintain a copy of the signed written notice for
79	79	the duration of the term during which the higher education health
80	80	benefits are provided to the individual; and
81	81	(2) at the request of the individual, provide a copy of
82	82	the written notice to the individual.
83	83	Sec. 1683.005. POSTSECONDARY EDUCATIONAL INSTITUTION NOT
84	84	ENGAGED IN BUSINESS OF HEALTH INSURANCE; REGISTRATION REQUIRED.
85	85	(a) Notwithstanding any other provision of this code, for the
86	86	purposes of offering higher education health benefits, a
87	87	postsecondary educational institution that acts in accordance with
88	88	this chapter is not a health insurer and is not engaging in the
89	89	business of health insurance in this state.
90	90	(b) A postsecondary educational institution that offers
91	91	higher education health benefits must register with the department
92	92	and provide information as needed to facilitate compliance with
93	93	Chapter 1467, as applicable to those benefits under Section
94	94	1275.004.
95	95	Sec. 1683.006. RISK TRANSFER OR COVERAGE. A postsecondary
96	96	educational institution that offers higher education health
97	97	benefits under this chapter may contract with a company authorized
98	98	to engage in the business of insurance in this state that is not
99	99	under common control with the postsecondary educational
100	100	institution to:
101	101	(1) transfer to that company all or a portion of the
102	102	organization's risks arising from higher education health benefits
103	103	offered under this chapter; or
104	104	(2) obtain insurance coverage from the company
105	105	guarantying the postsecondary educational institution's
106	106	obligations arising from higher education health benefits offered
107	107	under this chapter.
108	108	Sec. 1683.007. ACTUARIAL SOUNDNESS. (a) A postsecondary
109	109	educational institution that offers higher education health
110	110	benefits under this chapter shall administer the benefits in a
111	111	manner that is actuarially sound.
112	112	(b) The postsecondary educational institution shall ensure
113	113	the higher education health benefits offered by the postsecondary
114	114	educational institution are actuarially sound by:
115	115	(1) obtaining an actuarial opinion from an actuary who
116	116	is a fellow of the Society of Actuaries or a member of the American
117	117	Academy of Actuaries that recommends the amount of cash reserves
118	118	and the level of specific and aggregate stop-loss insurance the
119	119	postsecondary educational institution should maintain for purposes
120	120	of administering the benefits; and
121	121	(2) maintaining the levels of cash reserves and
122	122	stop-loss insurance recommended by the actuarial opinion obtained
123	123	under Subdivision (1).
124	124	SECTION 3. This Act takes effect immediately if it receives
125	125	a vote of two-thirds of all the members elected to each house, as
126	126	provided by Section 39, Article III, Texas Constitution. If this
127	127	Act does not receive the vote necessary for immediate effect, this
128	128	Act takes effect September 1, 2025.