HBA-TBM H.B. 2191 77(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 2191
By: Averitt
Insurance
3/18/2001
Introduced



BACKGROUND AND PURPOSE 

The Texas Health Insurance Risk Pool (pool) was created to provide access
to quality health care for Texans facing critical problems with the
availability and cost of health care coverage.  The pool is how Texas Meets
the requirements of the federal Health Insurance Portability and
Accountability Act.  Some sections of the Insurance Code may need to be
amended to clarify how the pool applies to persons eligible for coverage
under HIPAA and to ensure fair and efficient administration of the pool.
House Bill 2191 modifies provisions regarding eligibility requirements and
the administration of the Texas Health Insurance Risk Pool.   

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. 

ANALYSIS

House Bill 2191 amends the Insurance Code to add to the list of persons
eligible for health benefit plan coverage under the Texas Health Insurance
Risk Pool (pool) a Texas resident who provides to the pool evidence that
the resident had health insurance coverage under another state's qualified
Health Insurance Portability and Accountability Act health program that was
terminated not more than 63 days prior to application.  The bill also
provides that if a resident has been a permanent resident of the United
States for at least three continuous years, the resident is eligible under
existing eligibility requirements.  The bill provides that a person is not
eligible for coverage from the pool if the person has had prior coverage
with the pool terminated during the 12 months immediately preceding the
date of application for nonpayment of premiums or has had prior coverage
with the pool terminated for fraud.  The bill requires that coverage of a
person who ceases to meet the eligibility requirements be terminated on the
earlier of the premium due date that follows the date the pool determines
the person does not meet the eligibility requirements or the first day of
the month that follows the month in which the pool determines the person
does not meet the eligibility requirements.  The pool has sole discretion
to determine that a person does not meet the eligibility requirements.   

The bill provides that a person who is eligible for health insurance
benefits sponsored by an employer is not eligible for pool coverage.  An
insurer, agent, third party administrator, or other person licensed under
this code is prohibited from attempting placement in the pool of a person
who is eligible for employersponsored health insurance for the purpose of
separating the person from the employer-sponsored health insurance
benefits.  The bill provides that a violation of this provision is an
unfair method of competition and an unfair or deceptive act or practice
(Sec. 10, Art. 3.77).   

The bill provides that an assessment imposed against an insurer is due on a
date specified by the board of directors of the pool that may not be
earlier than the 30th day after the date on which prior written notice of
the assessment due is transmitted to the insurer.  Interest accrues on the
unpaid amount at a rate equal to the prime lending rate plus three percent.

 EFFECTIVE DATE

September 1, 2001.