Bill Text: TX HB135 | 2017 | 85th Legislature 1st Special Session | Introduced
Bill Title: Relating to health benefit plan coverage for certain essential health benefits.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2017-07-20 - Referred to Insurance [HB135 Detail]
Download: Texas-2017-HB135-Introduced.html
| 85S10330 MEW-D | ||
| By: Walle | H.B. No. 135 | |
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| relating to health benefit plan coverage for certain essential | ||
| health benefits. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Subtitle E, Title 8, Insurance Code, is amended | ||
| by adding Chapter 1380 to read as follows: | ||
| CHAPTER 1380. COVERAGE OF ESSENTIAL HEALTH BENEFITS | ||
| Sec. 1380.001. APPLICABILITY OF CHAPTER. (a) This chapter | ||
| applies only to a health benefit plan that provides benefits for | ||
| medical or surgical expenses incurred as a result of a health | ||
| condition, accident, or sickness, including an individual, group, | ||
| blanket, or franchise insurance policy or insurance agreement, a | ||
| group hospital service contract, or an individual or group evidence | ||
| of coverage or similar coverage document that is issued by: | ||
| (1) an insurance company; | ||
| (2) a group hospital service corporation operating | ||
| under Chapter 842; | ||
| (3) a health maintenance organization operating under | ||
| Chapter 843; | ||
| (4) an approved nonprofit health corporation that | ||
| holds a certificate of authority under Chapter 844; | ||
| (5) a multiple employer welfare arrangement that holds | ||
| a certificate of authority under Chapter 846; | ||
| (6) a stipulated premium company operating under | ||
| Chapter 884; | ||
| (7) a fraternal benefit society operating under | ||
| Chapter 885; | ||
| (8) a Lloyd's plan operating under Chapter 941; or | ||
| (9) an exchange operating under Chapter 942. | ||
| (b) Notwithstanding any other law, this chapter applies to: | ||
| (1) a small employer health benefit plan subject to | ||
| Chapter 1501, including coverage provided through a health group | ||
| cooperative under Subchapter B of that chapter; | ||
| (2) a standard health benefit plan issued under | ||
| Chapter 1507; | ||
| (3) a basic coverage plan under Chapter 1551; | ||
| (4) a basic plan under Chapter 1575; | ||
| (5) a primary care coverage plan under Chapter 1579; | ||
| (6) a plan providing basic coverage under Chapter | ||
| 1601; | ||
| (7) health benefits provided by or through a church | ||
| benefits board under Subchapter I, Chapter 22, Business | ||
| Organizations Code; | ||
| (8) group health coverage made available by a school | ||
| district in accordance with Section 22.004, Education Code; | ||
| (9) the state Medicaid program, including the Medicaid | ||
| managed care program operated under Chapter 533, Government Code; | ||
| (10) the child health plan program under Chapter 62, | ||
| Health and Safety Code; | ||
| (11) a regional or local health care program operated | ||
| under Section 75.104, Health and Safety Code; | ||
| (12) a self-funded health benefit plan sponsored by a | ||
| professional employer organization under Chapter 91, Labor Code; | ||
| (13) county employee group health benefits provided | ||
| under Chapter 157, Local Government Code; and | ||
| (14) health and accident coverage provided by a risk | ||
| pool created under Chapter 172, Local Government Code. | ||
| (c) This chapter applies to coverage under a group health | ||
| benefit plan provided to a resident of this state regardless of | ||
| whether the group policy, agreement, or contract is delivered, | ||
| issued for delivery, or renewed in this state. | ||
| Sec. 1380.002. EXCEPTION. This chapter does not apply to an | ||
| individual health benefit plan issued on or before March 23, 2010, | ||
| that has not had any significant changes since that date that reduce | ||
| benefits or increase costs to the individual. | ||
| Sec. 1380.003. REQUIRED COVERAGE FOR ESSENTIAL HEALTH | ||
| BENEFITS. A health benefit plan must provide coverage for the | ||
| essential health benefits listed in 42 U.S.C. Section 18022(b)(1), | ||
| as that section existed on January 1, 2017, and other benefits | ||
| identified by the United States secretary of health and human | ||
| services as essential health benefits as of that date. | ||
| SECTION 2. The change in law made by this Act applies only | ||
| to a health benefit plan that is delivered, issued for delivery, or | ||
| renewed on or after April 1, 2018. A health benefit plan that is | ||
| delivered, issued for delivery, or renewed before April 1, 2018, is | ||
| governed by the law as it existed immediately before the effective | ||
| date of this Act, and that law is continued in effect for that | ||
| purpose. | ||
| SECTION 3. This Act takes effect December 1, 2017. | ||
