Bill Text: TX HB2082 | 2023-2024 | 88th Legislature | Introduced
Bill Title: Relating to insurance regulation of a prepaid health care plan for certain individuals with low income.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2023-03-08 - Referred to Health Care Reform, Select [HB2082 Detail]
Download: Texas-2023-HB2082-Introduced.html
| By: Jetton | H.B. No. 2082 | |
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| relating to insurance regulation of a prepaid health care plan for | ||
| certain individuals with low income. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Subtitle K, Title 8, Insurance Code, is amended | ||
| by adding Chapter 1683 to read as follows: | ||
| CHAPTER 1683. PREPAID HEALTH CARE PLAN FOR CERTAIN INDIVIDUALS | ||
| WITH LOW INCOME | ||
| Sec. 1683.001. INSURANCE REGULATION OF PREPAID HEALTH CARE | ||
| PLAN FOR CERTAIN INDIVIDUALS WITH LOW INCOME. A plan for providing | ||
| health care to individuals with low income on a prepaid basis is not | ||
| considered to be engaging in the business of insurance if: | ||
| (1) eligibility in the plan is limited to: | ||
| (A) individuals not covered under any other group | ||
| insurance or health benefit plan arrangement whose incomes are at | ||
| or below 400 percent of the federal poverty level and who are: | ||
| (i) employed by a business employing 200 or | ||
| fewer eligible individuals; or | ||
| (ii) engaged in domestic service in private | ||
| households; and | ||
| (B) dependents of individuals described by | ||
| Paragraph (A); | ||
| (2) the plan is operated on a nonprofit basis under the | ||
| sponsorship of a nonprofit organization; | ||
| (3) covered primary care services are provided to | ||
| enrollees by health care practitioners who: | ||
| (A) have agreed to provide their services for | ||
| free or nominal reimbursement for out-of-pocket expenses or | ||
| expendable supplies directly related to, and incurred as a result | ||
| of, the service provided to the enrollee; and | ||
| (B) are either: | ||
| (i) health care practitioners on staff of | ||
| the sponsoring organization; or | ||
| (ii) volunteer practitioners recruited | ||
| from a county medical society; | ||
| (4) payments to outside contractors for marketing, | ||
| claims administration, and similar services total not more than 10 | ||
| percent of the total charges imposed by the plan; | ||
| (5) the plan has received the approval and endorsement | ||
| of the county medical society in consultation with the Texas | ||
| Medical Association; | ||
| (6) except as provided by Subdivision (3), the plan | ||
| does not pay a portion of any fees or charges imposed under the plan | ||
| directly or indirectly as salary to an officer or director of the | ||
| sponsoring nonprofit organization; and | ||
| (7) the sponsoring nonprofit organization files an | ||
| annual report with the commissioner in the form and manner | ||
| prescribed by the commissioner not later than the 90th day after the | ||
| end of the corporation's fiscal year that includes: | ||
| (A) the number of plan enrollees; | ||
| (B) the total number of services provided under | ||
| the plan; | ||
| (C) the plan's financial statements; | ||
| (D) the administrative costs and salaries paid by | ||
| the plan; and | ||
| (E) any other information reasonably requested | ||
| by the commissioner. | ||
| SECTION 2. This Act takes effect September 1, 2023. | ||
