Bill Text: TX HB508 | 2021-2022 | 87th Legislature | Introduced


Bill Title: Relating to health benefit plan coverage of preexisting conditions.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Introduced - Dead) 2021-03-01 - Referred to Insurance [HB508 Detail]

Download: Texas-2021-HB508-Introduced.html
 
 
  By: Beckley H.B. No. 508
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to health benefit plan coverage of preexisting conditions.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subtitle G, Title 8, Insurance Code, is amended
  by adding Chapter 1509 to read as follows:
  CHAPTER 1509.  COVERAGE OF PREEXISTING CONDITIONS
         Sec. 1509.001.  DEFINITION.  In this chapter, "preexisting
  condition" means a condition present before the effective date of
  an individual's coverage under a health benefit plan.
         Sec. 1509.002.  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 offered 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. 1509.003.  EXCEPTIONS. (a)  This chapter does not apply
  to:
               (1)  a plan that provides coverage:
                     (A)  for wages or payments in lieu of wages for a
  period during which an employee is absent from work because of
  sickness or injury;
                     (B)  as a supplement to a liability insurance
  policy;
                     (C)  for credit insurance;
                     (D)  only for dental or vision care;
                     (E)  only for hospital expenses; or
                     (F)  only for indemnity for hospital confinement;
               (2)  a workers' compensation insurance policy; or
               (3)  medical payment insurance coverage provided under
  a motor vehicle insurance policy.
         (b)  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. 1509.004.  PREEXISTING CONDITION RESTRICTIONS
  PROHIBITED. Notwithstanding any other law, a health benefit plan
  issuer may not:
               (1)  deny coverage to or refuse to enroll an individual
  in a health benefit plan on the basis of a preexisting condition;
               (2)  limit or exclude coverage under the health benefit
  plan for treatment of the individual's preexisting condition
  otherwise covered under the plan; or
               (3)  charge the individual more for coverage than the
  health benefit plan issuer charges an individual who does not have a
  preexisting condition.
         SECTION 2.  If before implementing any provision of this Act
  a state agency determines that a waiver or authorization from a
  federal agency is necessary for implementation of that provision,
  the agency affected by the provision shall request the waiver or
  authorization and may delay implementing that provision until the
  waiver or authorization is granted.
         SECTION 3.  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 January 1, 2022.  A health benefit plan that is
  delivered, issued for delivery, or renewed 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 4.  This Act takes effect September 1, 2021.
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