Bill Text: TX HB4105 | 2017-2018 | 85th Legislature | Introduced
Bill Title: Relating to certain information reported to the Texas Department of Insurance by insurers, other entities, and individuals in connection with employee benefit plans; creating an offense.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2017-04-25 - Left pending in committee [HB4105 Detail]
Download: Texas-2017-HB4105-Introduced.html
85R13746 SMT-D | ||
By: Muñoz, Jr. | H.B. No. 4105 |
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relating to certain information reported to the Texas Department of | ||
Insurance by insurers, other entities, and individuals in | ||
connection with employee benefit plans; creating an offense. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Chapter 38, Insurance Code, is amended by adding | ||
Subchapter J to read as follows: | ||
SUBCHAPTER J. CERTAIN DISCLOSURES REQUIRED | ||
Sec. 38.451. DEFINITION. For purposes of this subchapter, | ||
"regulated entity" means an entity authorized under this code or | ||
another insurance law of this state to provide employee benefit | ||
plans, including health benefits described by Section 38.452. The | ||
term includes: | ||
(1) an insurance company; | ||
(2) a health benefit plan issuer; | ||
(3) a group hospital service corporation operating | ||
under Chapter 842; | ||
(4) a health maintenance organization operating under | ||
Chapter 843; | ||
(5) an approved nonprofit health corporation that | ||
holds a certificate of authority under Chapter 844; | ||
(6) a multiple employer welfare arrangement that holds | ||
a certificate of authority under Chapter 846; | ||
(7) a fraternal benefit society operating under | ||
Chapter 885; | ||
(8) a stipulated premium company operating under | ||
Chapter 884; | ||
(9) a Lloyd's plan operating under Chapter 941; | ||
(10) a reciprocal exchange operating under Chapter | ||
942; and | ||
(11) an entity not authorized under this code or | ||
another insurance law of this state that contracts directly for | ||
health care services on a risk-sharing basis, including a | ||
capitation basis. | ||
Sec. 38.452. APPLICABILITY. (a) This subchapter applies | ||
to any life, health, or accident coverage provided as a benefit to | ||
an employee of an employer, including: | ||
(1) a health insurance policy or health benefit plan; | ||
(2) a small employer health benefit plan written under | ||
Chapter 1501; | ||
(3) a standard health benefit plan issued under | ||
Chapter 1507; | ||
(4) a coverage plan under Chapter 1551; | ||
(5) a plan under Chapter 1575; | ||
(6) a coverage plan under Chapter 1579; | ||
(7) a plan under Chapter 1601; | ||
(8) group health coverage made available by a school | ||
district in accordance with Section 22.004, Education Code; | ||
(9) a self-funded health benefit plan sponsored by a | ||
professional employer organization under Chapter 91, Labor Code; | ||
(10) health and accident coverage provided by a risk | ||
pool created under Chapter 172, Local Government Code; | ||
(11) a health benefit plan that provides coverage: | ||
(A) for a specified disease or for another | ||
limited benefit; | ||
(B) for accidental death or dismemberment; | ||
(C) for wages or payments in lieu of wages for a | ||
period during which an employee is absent from work because of | ||
sickness or injury; | ||
(D) as a supplement to a liability insurance | ||
policy; | ||
(E) for credit insurance; | ||
(F) for dental or vision care; | ||
(G) for hospital expenses; or | ||
(H) for indemnity for hospital confinement; and | ||
(12) a long-term care insurance policy. | ||
(b) This subchapter applies without regard to whether the | ||
employee's employer pays any part of the cost of the employee | ||
benefit. | ||
Sec. 38.453. DISCLOSURE BY REGULATED ENTITY. On a form | ||
prescribed by the commissioner under Section 38.455, a regulated | ||
entity shall disclose to the department any fee, payment, or other | ||
compensation paid to an individual or entity in connection with an | ||
employee benefit plan offered or sold to provide benefits to | ||
employees of an employer by the regulated entity. | ||
Sec. 38.454. DISCLOSURE BY INDIVIDUAL. (a) On a form | ||
prescribed by the commissioner under Section 38.455, an individual | ||
or entity who receives a fee, payment, or other compensation from a | ||
regulated entity or from an employer in connection with the offer or | ||
sale of an employee benefit plan shall disclose to the department: | ||
(1) any fee, payment, or compensation paid by the | ||
employer; and | ||
(2) any fee sharing or distribution of any part of the | ||
compensation to any other individual or entity. | ||
(b) An individual or entity who knowingly fails to comply | ||
with Subsection (a) commits an offense. An offense under this | ||
section is a Class C misdemeanor. | ||
Sec. 38.455. DUTIES OF THE COMMISSIONER. (a) The | ||
commissioner by rule shall prescribe the forms on which a regulated | ||
entity or individual makes the disclosure required under Sections | ||
38.453 and 38.454. In prescribing the form, the commissioner shall | ||
consider the Internal Revenue Service Form 5500, Schedule A. | ||
(b) The commissioner may by rule exempt from the disclosure | ||
requirements under this subchapter a disclosure in connection with | ||
certain employers or employee benefit plans based on the size of the | ||
employer or benefit plan. | ||
SECTION 2. Subchapter J, Chapter 38, Insurance Code, as | ||
added by this Act, applies only to compensation in connection with | ||
an employee benefit plan paid on or after the effective date of this | ||
Act. | ||
SECTION 3. This Act takes effect September 1, 2017. |