Bill Text: TX HB3923 | 2021-2022 | 87th Legislature | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Relating to multiple employer welfare arrangements.
Spectrum: Slight Partisan Bill (Republican 9-3)
Status: (Engrossed - Dead) 2021-05-26 - Placed on intent calendar [HB3923 Detail]
Download: Texas-2021-HB3923-Introduced.html
Bill Title: Relating to multiple employer welfare arrangements.
Spectrum: Slight Partisan Bill (Republican 9-3)
Status: (Engrossed - Dead) 2021-05-26 - Placed on intent calendar [HB3923 Detail]
Download: Texas-2021-HB3923-Introduced.html
87R5122 RDS-F | ||
By: Oliverson | H.B. No. 3923 |
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relating to multiple employer welfare arrangements. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subchapter A, Chapter 846, Insurance Code, is | ||
amended by adding Section 846.0035 to read as follows: | ||
Sec. 846.0035. APPLICABILITY OF CERTAIN LAWS TO ASSOCIATION | ||
PROVIDING HEALTH BENEFITS. (a) A multiple employer welfare | ||
arrangement that provides a comprehensive health benefit plan, as | ||
determined by the commissioner, is subject to the following laws as | ||
if the arrangement were an insurer, individuals entitled to | ||
coverage under the plan were insureds, and the health benefits were | ||
provided through an insurance policy: | ||
(1) Chapter 421; | ||
(2) Chapter 422; | ||
(3) Subchapters C, F, and K, Chapter 1451; and | ||
(4) Chapter 4201. | ||
(b) A multiple employer welfare arrangement that provides a | ||
comprehensive health benefit plan, as determined by the | ||
commissioner, that is determined by the commissioner to be | ||
structured in the manner of a preferred provider benefit plan or an | ||
exclusive provider benefit plan as defined in Section 1301.001 is | ||
subject to the following laws as if the arrangement were an insurer, | ||
individuals entitled to coverage under the plan were insureds, and | ||
the health benefits were provided through an insurance policy: | ||
(1) Chapter 1301; and | ||
(2) Chapter 1467. | ||
SECTION 2. Section 846.053, Insurance Code, is amended by | ||
amending Subsections (b) and (c) and adding Subsection (d-1) to | ||
read as follows: | ||
(b) The employers in the multiple employer welfare | ||
arrangement must: | ||
(1) be members of an association or group of five or | ||
more businesses that are in the same trade or industry, including | ||
closely related businesses that provide support, services, or | ||
supplies primarily to that trade or industry; or | ||
(2) each have a principal place of business in the same | ||
region that does not exceed the boundaries of this state or the | ||
boundaries of a metropolitan statistical area designated by the | ||
United States Office of Management and Budget. | ||
(c) If the employers in the multiple employer welfare | ||
arrangement are members of an association, the association must[ |
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members other than sponsorship of an employee welfare benefit | ||
plan[ |
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(d-1) A working owner of a trade or business without | ||
employees may qualify as both an employer and as an employee of the | ||
trade or industry for the purposes of this section. In this | ||
subsection, "working owner" means an individual who: | ||
(1) has an ownership right of any nature in a trade or | ||
business, whether incorporated or unincorporated, including a | ||
partner and other self-employed individual; | ||
(2) earns wages or self-employment income from the | ||
trade or business for providing personal services to the trade or | ||
business; and | ||
(3) either: | ||
(A) works on average at least 20 hours per week or | ||
at least 80 hours per month providing personal services to the | ||
working owner's trade or business; or | ||
(B) has wages or self-employment income from the | ||
individual's trade or business that at least equals the | ||
individual's cost of coverage for participation by the individual | ||
and any covered beneficiaries in the group health plan sponsored by | ||
the group or association in which the individual is participating. | ||
SECTION 3. Section 846.0035, Insurance Code, as added by | ||
this Act, applies only to a health benefit plan provided under an | ||
agreement entered into or renewed on or after January 1, 2022. | ||
SECTION 4. Section 846.053, Insurance Code, as amended by | ||
this Act, applies only to an application for a certificate of | ||
authority as a multiple employer welfare arrangement submitted on | ||
or after January 1, 2022. An application submitted before January | ||
1, 2022, 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 5. This Act takes effect September 1, 2021. |