Bill Text: TX HB3752 | 2021-2022 | 87th Legislature | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Relating to the offering of health benefit coverage by subsidiaries of the Texas Mutual Insurance Company.
Spectrum: Slight Partisan Bill (Republican 8-5)
Status: (Passed) 2021-06-18 - Effective on 9/1/21 [HB3752 Detail]
Download: Texas-2021-HB3752-Introduced.html
Bill Title: Relating to the offering of health benefit coverage by subsidiaries of the Texas Mutual Insurance Company.
Spectrum: Slight Partisan Bill (Republican 8-5)
Status: (Passed) 2021-06-18 - Effective on 9/1/21 [HB3752 Detail]
Download: Texas-2021-HB3752-Introduced.html
By: Frank | H.B. No. 3752 |
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relating to the provision of health benefits coverage through the | ||
creation of the Texas Mutual Health Coverage Plan. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Section 2054.001, Insurance Code, is amended to | ||
read as follows: | ||
Sec. 2054.001. DEFINITIONS. In this chapter: | ||
(1) "Board" means the board of directors of the | ||
company. | ||
(2) Repealed by Acts 2007, 80th Leg., R.S., Ch. 730, | ||
Sec. 3B.056, eff. September 1, 2007. | ||
(3) "Company" means the Texas Mutual Insurance | ||
Company. | ||
(4) "Workers' compensation insurance" means insurance | ||
for a risk under: | ||
(A) Subtitle A, Title 5, Labor Code; | ||
(B) Chapter 504, Labor Code; | ||
(C) the Longshore and Harbor Workers' | ||
Compensation Act (33 U.S.C. Section 901 et seq.); | ||
(D) the Federal Mine Safety and Health Act of | ||
1977 (30 U.S.C. Section 801 et seq.); | ||
(E) the Defense Base Act (42 U.S.C. Sections | ||
1651-1654); | ||
(F) the federal Employers' Liability Act (45 | ||
U.S.C. Section 51 et seq.); | ||
(G) the Nonappropriated Fund Instrumentalities | ||
Act (5 U.S.C. Sections 8171-8173); | ||
(H) the Outer Continental Shelf Lands Act (43 | ||
U.S.C. Section 1331 et seq.); or | ||
(I) the Merchant Marine Act of 1920 (46 App. | ||
U.S.C. Section 861 et seq.). | ||
(5) "Texas Mutual Health Coverage Plan" means a health | ||
benefit plan offered to individual residents or small employers in | ||
the state outside of the workers' compensation marketplace. | ||
(6) "Small employer" means a person who employed an | ||
average of at least two employees but not more than 50 employees on | ||
business days during the preceding calendar year and who employs at | ||
least two employees on the first day of the plan year. For purposes | ||
of this definition, a partnership is the employer of a partner. | ||
This term applies only to the company's health benefits coverage | ||
business. | ||
SECTION 2. Section 2054.151, Insurance Code, is amended to | ||
read as follows: | ||
Sec. 2054.151. PURPOSE OF COMPANY. The company shall: | ||
(1) serve as a competitive force in the workers' | ||
compensation and health benefit marketplaces; | ||
(2) guarantee the availability of workers' | ||
compensation insurance in this state; |
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(3) serve as an insurer of last resort as provided by | ||
Subchapter H |
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(4) offer a competitive health coverage option to | ||
residents and small employers of this state. | ||
SECTION 3. Section 2054.152, Insurance Code, is amended to | ||
read as follows: | ||
Sec. 2054.152. PAYMENT OF TAXES, FEES, AND OTHER CHARGES. | ||
The company shall pay the following in the same manner as a domestic | ||
mutual insurance company authorized to engage in the business of | ||
insurance and to write workers' compensation insurance or health | ||
benefit coverage in this state: | ||
(1) taxes, including maintenance and premium taxes; | ||
(2) fees; and | ||
(3) payments due in lieu of taxes. | ||
SECTION 4. Section 2054.155, Insurance Code, is amended to | ||
read as follows: | ||
Sec. 2054.155. REQUIRED RESERVES. The company shall | ||
establish and maintain reserves for losses on an actuarily sound | ||
basis in accordance with Chapter 424 as applicable and Chapter 426. | ||
SECTION 5. Subchapter G, Chapter Section 2054, Insurance | ||
Code, is amended to read as follows: | ||
SUBCHAPTER G. ISSUANCE OF WORKERS' COMPENSATION COVERAGE | ||
Sec. 2054.301. APPLICATION FOR COVERAGE. An application to | ||
the company for workers' compensation insurance coverage must be: | ||
(1) made on the form prescribed by the company; and | ||
(2) submitted directly by the applicant or by a | ||
general property and casualty agent on behalf of the applicant. | ||
Sec. 2054.302. POLICY FORMS. The company shall use the | ||
uniform policy and standard policy forms prescribed by the | ||
department under Section 2052.002. | ||
Sec. 2054.303. DENIAL OF COVERAGE BASED ON CREDIT RISK. The | ||
company may refuse to write workers' compensation insurance | ||
coverage for an applicant that the company identifies as a credit | ||
risk unless the applicant, before a policy is issued: | ||
(1) pays the total estimated premium and related | ||
charges; or | ||
(2) provides security for payment of the total | ||
estimated premium and related charges. | ||
Sec. 2054.304. CANCELLATION AND NONRENEWAL. The company | ||
may cancel or refuse to renew coverage on a workers' compensation | ||
policyholder as provided by Section 406.008, Labor Code. | ||
SECTION 6. The title of Subchapter H, Chapter Section 2054, | ||
Insurance Code, is amended to read as follows: | ||
SUBCHAPTER H. COMPANY AS WORKERS' COMPENSATION INSURER OF LAST | ||
RESORT | ||
SECTION 7. Chapter 2054, Insurance Code, is amended by | ||
adding Subchapter M to read as follows: | ||
SUBCHAPTER M. TEXAS MUTUAL HEALTH COVERAGE PLAN | ||
Sec. 2054.554 AUTHORITY TO DEVELOP AND OPERATE A HEALTH | ||
BENEFITS COVERAGE PLAN. (a) The company is authorized, based upon | ||
available funding, to develop, market, and operate a health | ||
benefits coverage plan to be offered to individuals who are | ||
residents of the state, or small employers. | ||
(b) The board shall adopt any necessary bylaws or rules, | ||
with approval of the Texas Department of Insurance Commissioner, to | ||
establish standards governing the individuals and small employers | ||
eligible to purchase a Texas Mutual Health Coverage plan, benefit | ||
packages and plan offerings, which may include high-deductible | ||
catastrophic care options and the use of health savings accounts | ||
and flexible spending accounts, and multitiered premiums. | ||
Sec. 2054.555. EXEMPTION. Notwithstanding any other | ||
provision of this code, this health benefit plan is not considered | ||
to be an insurance product and, as such, is not subject to | ||
applicable state and federal regulations governing traditional | ||
health insurance coverage. | ||
Sec. 2054.556. ANNUAL STATEMENT; FILING FEE FOR HEALTH | ||
BENEFITS COVERAGE BUSINESS. (a) Not later than March 1 of each | ||
year, the company shall: | ||
(1) prepare a statement showing the condition of the | ||
company as it relates to its health benefits coverage division on | ||
December 31 of the preceding year; and | ||
(2) deliver the statement to the department | ||
accompanied by a filing fee in the amount determined under the | ||
commissioner. | ||
(b) The statement must be under oath of two of the company's | ||
officers and show in detail the following information only as it | ||
relates to the company's health benefit coverage business: | ||
(1) the character of the company's assets and | ||
liabilities on December 31 of the preceding year; | ||
(2) the amount and character of business transacted | ||
and money received during the preceding year; | ||
(3) how money was spent during the preceding year; | ||
(4) the number and amount of the company's policies in | ||
force in this state on that date; and | ||
(5) the total amount of the company's coverage | ||
policies in force on that date. | ||
SECTION 8. This Act takes effect immediately if it receives | ||
a vote of two-thirds of all the members elected to each house, as | ||
provided by Section 39, Article III, Texas Constitution. If this | ||
Act does not receive the vote necessary for immediate effect, this | ||
Act takes effect September 1, 2021. |