Bill Text: TX SB789 | 2017-2018 | 85th Legislature | Introduced
Bill Title: Relating to the administration of and benefits payable under the Texas School Employees Uniform Group Health Coverage Act.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2017-02-22 - Referred to State Affairs [SB789 Detail]
Download: Texas-2017-SB789-Introduced.html
85R7477 BEE-F | ||
By: Huffman | S.B. No. 789 |
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relating to the administration of and benefits payable under the | ||
Texas School Employees Uniform Group Health Coverage Act. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 1579.002(4), Insurance Code, is amended | ||
to read as follows: | ||
(4) "Health coverage plan" means any [ |
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pay or reimburse [ |
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SECTION 2. Subchapter A, Chapter 1579, Insurance Code, is | ||
amended by adding Section 1579.0025 to read as follows: | ||
Sec. 1579.0025. REFERENCES TO PRIMARY CARE COVERAGE PLAN. | ||
A reference in this code to a "primary care coverage plan" under | ||
this chapter means the health coverage plan provided under Section | ||
1579.101. | ||
SECTION 3. The heading to Subchapter C, Chapter 1579, | ||
Insurance Code, is amended to read as follows: | ||
SUBCHAPTER C. COVERAGES; HEALTH SAVINGS ACCOUNTS | ||
SECTION 4. The heading to Section 1579.101, Insurance Code, | ||
is amended to read as follows: | ||
Sec. 1579.101. HEALTH COVERAGE PLAN [ |
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SECTION 5. Section 1579.101(a), Insurance Code, is amended | ||
to read as follows: | ||
(a) The trustee [ |
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and make available a high deductible health coverage plan to be | ||
offered to eligible [ |
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participating entities [ |
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dependents and that provides for, pays for, or reimburses expenses | ||
for health care services that the trustee considers advisable. | ||
SECTION 6. Subchapter C, Chapter 1579, Insurance Code, is | ||
amended by adding Section 1579.109 to read as follows: | ||
Sec. 1579.109. HEALTH SAVINGS ACCOUNT PROGRAM. The trustee | ||
may establish or contract for and make available a health savings | ||
account program to be offered to eligible employees and their | ||
eligible dependents. | ||
SECTION 7. Subchapter D, Chapter 1579, Insurance Code, is | ||
amended by adding Sections 1579.1511, 1579.1521, and 1579.1531 to | ||
read as follows: | ||
Sec. 1579.1511. PARTICIPATION OF ENTITIES WITH 1,000 OR | ||
FEWER EMPLOYEES. (a) Except as provided by Section 1579.1521(b), a | ||
participating entity that had 1,000 or fewer employees on January | ||
1, 2017, is required to continue to participate in the program on | ||
and after September 1, 2018, unless the participating entity makes | ||
a one-time election to discontinue its participation in the program | ||
effective September 1, 2018. | ||
(b) An entity eligible to become a participating entity that | ||
had 1,000 or fewer employees on January 1, 2017, may make a one-time | ||
election to participate in the program effective September 1, 2018. | ||
(c) An entity otherwise eligible to become a participating | ||
entity that is established after January 1, 2017, and has 1,000 or | ||
fewer employees on the date the entity begins operating may make a | ||
one-time election to participate in the program effective on: | ||
(1) the earliest September 1 that occurs after the | ||
first anniversary of the date the entity begins operating; or | ||
(2) an earlier date if approved by the trustee. | ||
(d) An entity otherwise eligible to become a participating | ||
entity that had more than 1,000 employees on January 1, 2017, that | ||
subsequently has 1,000 or fewer employees for five consecutive | ||
years may make a one-time election to participate in the program. | ||
(e) The trustee shall prescribe the time and manner for | ||
making an election under this section. | ||
Sec. 1579.1521. PARTICIPATION OF ENTITIES WITH MORE THAN | ||
1,000 EMPLOYEES. (a) An entity that has more than 1,000 employees | ||
on January 1, 2017, may not participate in the program on or after | ||
September 1, 2018. | ||
(b) An entity that continued to participate in or elected to | ||
participate in the program under Section 1579.1511 that | ||
subsequently has more than 1,000 employees for five consecutive | ||
years may not continue to participate in the program. The trustee | ||
shall prescribe the time and manner of a participating entity's | ||
exit from the program under this subsection. | ||
Sec. 1579.1531. PARTICIPATION BY ENTITIES IN RISK POOLS. | ||
(a) For purposes of determining the number of employees of an | ||
entity for purposes of Sections 1579.1511 and 1579.1521, members of | ||
a risk pool established under Chapter 172, Local Government Code, | ||
as provided by Section 22.004, Education Code, may elect to be | ||
treated as a single unit by notifying the trustee in the time and | ||
manner prescribed by the trustee. | ||
(b) Entities that make an election under this section, | ||
acting as a risk pool, have the same rights and are subject to the | ||
same restrictions under Sections 1579.1511 and 1579.1521 as an | ||
entity that does not make an election under this section. | ||
SECTION 8. Section 1579.202(b), Insurance Code, is amended | ||
to read as follows: | ||
(b) An employee described by Subsection (a) who applies for | ||
coverage during an open enrollment period prescribed by the trustee | ||
is automatically covered by the health [ |
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plan provided under Section 1579.101 unless the employee[ |
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SECTION 9. Sections 1579.203(a) and (c), Insurance Code, | ||
are amended to read as follows: | ||
(a) A participating employee may select coverage in the | ||
health [ |
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(c) If the combined contributions received from the state | ||
and the employing participating entity under Subchapter F exceed | ||
the cost of the [ |
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the employee may use the excess amount of contributions to [ |
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the cost of coverage for the employee's dependents. | ||
SECTION 10. Section 1579.204, Insurance Code, is amended to | ||
read as follows: | ||
Sec. 1579.204. CERTAIN PART-TIME EMPLOYEES. A part-time | ||
employee of a participating entity who is not a participating | ||
member in the Teacher Retirement System of Texas is eligible to | ||
participate in the program only if the employee pays all of the | ||
premiums and other costs associated with the [ |
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[ |
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SECTION 11. Section 1579.205, Insurance Code, is amended to | ||
read as follows: | ||
Sec. 1579.205. PAYMENT BY PARTICIPATING ENTITY. | ||
Notwithstanding Section 1579.204, a participating entity may pay | ||
any portion of what otherwise would be the employee share of | ||
premiums and other costs associated with the coverage for [ |
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SECTION 12. Section 1579.253, Insurance Code, is amended to | ||
read as follows: | ||
Sec. 1579.253. CONTRIBUTION BY EMPLOYEE. (a) An employee | ||
covered by the program shall pay that portion of the cost of | ||
coverage for [ |
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dependents that exceeds the amount of the state contribution under | ||
Section 1579.251 and the participating entity contribution under | ||
Section 1579.252. | ||
(b) The employee may pay the employee's contribution under | ||
this section [ |
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employee under Subchapter D, Chapter 22, Education Code. | ||
(c) Notwithstanding Subsection (a), a participating entity | ||
may pay any portion of what otherwise would be the employee share of | ||
premiums and other costs associated with the coverage for [ |
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SECTION 13. The following provisions of the Insurance Code | ||
are repealed: | ||
(1) Sections 1579.101(b), (c), and (d); | ||
(2) Sections 1579.102, 1579.151, 1579.152, and | ||
1579.153; | ||
(3) Section 1579.154(b); and | ||
(4) Section 1579.203(b). | ||
SECTION 14. The changes in law made by this Act apply only | ||
to health coverage provided under Chapter 1579, Insurance Code, | ||
beginning with the 2018 plan year. A plan year before the 2018 plan | ||
year 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 15. This Act takes effect September 1, 2017. |