Bill Text: TX HB3985 | 2019-2020 | 86th Legislature | Introduced
Bill Title: Relating to the provision of certain historical claims data and other information to school districts and other participating entities in the Texas school employees uniform group health coverage program.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Engrossed - Dead) 2019-05-10 - Referred to State Affairs [HB3985 Detail]
Download: Texas-2019-HB3985-Introduced.html
86R10765 MEW-D | ||
By: Leach | H.B. No. 3985 |
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relating to the provision of certain historical claims data and | ||
other information to school districts and other participating | ||
entities in the Texas school employees uniform group health | ||
coverage program. | ||
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
SECTION 1. Subchapter A, Chapter 1579, Insurance Code, is | ||
amended by adding Section 1579.009 to read as follows: | ||
Sec. 1579.009. PARTICIPATING ENTITY REQUEST FOR CERTAIN | ||
INFORMATION. (a) Subject to Subsection (b), the trustee shall | ||
provide to a participating entity any historical claims data, | ||
enrollment information, or other relevant information available to | ||
the trustee as requested by the entity in connection with a search | ||
for alternative health benefit plan coverage for the entity's | ||
employees and the employees' dependents. The information provided | ||
must include, for each tier of group coverage and for the five-year | ||
period preceding the date of the request: | ||
(1) the monthly claims experience history; | ||
(2) information concerning the type of illness or | ||
injury and the ongoing status of the illness or injury for: | ||
(A) each medical claim that exceeds $50,000; and | ||
(B) each related series of medical claims for the | ||
same covered individual and for the same diagnosis that exceeds | ||
$50,000; | ||
(3) any other information requested by the | ||
participating entity concerning covered individuals who are | ||
responsible for a claim or claims that total a large amount, as | ||
specified by the requesting participating entity; | ||
(4) information concerning prescription drug claims | ||
and costs; and | ||
(5) plan enrollment. | ||
(b) The information provided by the trustee under this | ||
section may not include any personally identifying information of a | ||
covered individual, including any information that would identify a | ||
named covered individual as having a particular medical condition. | ||
(c) The trustee shall provide the information requested | ||
under this section at no cost to the requesting participating | ||
entity. | ||
SECTION 2. 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, 2019. |