By: Oliverson, et al. (Senate Sponsor - Hancock)	H.B. No. 3923
	(In the Senate - Received from the House May 5, 2021;
	May 10, 2021, read first time and referred to Committee on Business &
	Commerce; May 20, 2021, reported favorably by the following vote:
	Yeas 9, Nays 0; May 20, 2021, sent to printer.)
Click here to see the committee vote

	A BILL TO BE ENTITLED
	AN ACT
	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)  This section applies only to a
	multiple employer welfare arrangement:
	(1)  that was issued an initial certificate of
	authority under Section 846.054 on or after January 1, 2022; or
	(2)  that elects to be bound by this section in the
	manner prescribed by the commissioner.
	(b)  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.
	(c)  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 846.052(b), Insurance Code, is amended
	to read as follows:
	(b)  The application form must be completed and submitted
	along with all information required by the commissioner, including:
	(1)  a copy of each organizational document;
	(2)  current financial statements of the arrangement;
	(3)  a fully detailed statement indicating the plan
	under which the arrangement proposes to transact business;
	(4)  an initial actuarial opinion in compliance with
	the requirements of Section 846.153(a)(2) and subject to Section
	846.157(b); and
	(5)  demonstration [a statement] by the applicant
	[certifying] that the arrangement is in compliance with all
	applicable federal and state laws [provisions of the Employee
	Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et
	seq.)].
	SECTION 3.  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)  for a multiple employer welfare arrangement to
	which Section 846.0035 applies, 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:
	(1)  be engaged in substantial activity for its
	members other than sponsorship of an employee welfare benefit plan;
	and
	(2)  if Section 846.0035 does not apply to the multiple
	employer welfare arrangement, have been in existence for at least
	two years before engaging in any activities relating to providing
	employee health benefits to its members.
	(d-1)  For purposes of a multiple employer welfare
	arrangement to which Section 846.0035 applies, 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 4.  This Act takes effect September 1, 2021.
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