HBA-TYH H.B. 1097 76(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 1097 By: Coleman Insurance 3/11/1999 Introduced BACKGROUND AND PURPOSE The Texas Health Insurance Risk Pool (pool) was established by the 71st Legislature to provide medically uninsurable Texans with access to quality health care. There are several ways Texas residents may become eligible for coverage through the pool. One method requires applicants to provide evidence of a notice of rejection or refusal to issue substantially similar insurance for health reasons by two insurers. Most health plans charge an application fee before they issue a refusal or rejection. These fees are a burden to some applicants and the applicant is left with the choice of paying the fees or forgoing participation in the pool. H.B. 1097 allows a pool applicant to establish eligibility by providing copies of two insurance plans that are substantially similar to the plan offered by the pool that the applicant would have qualified for if not for the diagnosed medical condition. Applicants would also have to submit certified copies of their medical records documenting their pre-existing condition. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that this bill does not expressly delegate any additional rulemaking authority to a state officer, department, agency, or institution. SECTION BY SECTION ANALYSIS SECTION 1. Amends Section 10(a), Article 3.77, Insurance Code, to require a person to be eligible for coverage from the Texas Health Insurance Risk Pool (pool) if, rather than simply providing evidence, the individual provides the following enumerated information to the board of directors of the pool: (1) a notice of rejection or refusal to issue substantially similar insurance for health reasons by two insurers, other than a rejection or refusal by an insurer offering only stop-loss, excess loss, or reinsurance coverage; (2) copies of the requirements of two insurance plans that are substantially similar to the plan offered by the pool, other than plans offering only stop-loss, excess loss, or reinsurance coverage, and a certified copy of the individual's medical record showing a pre-existing condition that together demonstrate the strong probability for refusal of individual's coverage under those insurance plans. Redesignates Subdivisions (2)-(5) to (3)-(6). Makes conforming and nonsubstantive changes. SECTION 2. Effective date: September 1, 1999. Makes application of this Act prospective. SECTION 3. Emergency clause.