86R6927 MEW-D
	By: Martinez Fischer	H.B. No. 2114

	A BILL TO BE ENTITLED
	AN ACT
	relating to health benefit plan coverage of preexisting conditions.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  Subtitle G, Title 8, Insurance Code, is amended
	by adding Chapter 1509 to read as follows:
	CHAPTER 1509. COVERAGE OF PREEXISTING CONDITIONS
	Sec. 1509.001.  DEFINITION. In this chapter, "preexisting
	condition" means a condition present before the effective date of
	an individual's coverage under a health benefit plan.
	Sec. 1509.002.  APPLICABILITY OF CHAPTER. (a)  This chapter
	applies only to a health benefit plan that provides benefits for
	medical or surgical expenses incurred as a result of a health
	condition, accident, or sickness, including an individual, group,
	blanket, or franchise insurance policy or insurance agreement, a
	group hospital service contract, or an individual or group evidence
	of coverage or similar coverage document that is offered by:
	(1)  an insurance company;
	(2)  a group hospital service corporation operating
	under Chapter 842;
	(3)  a health maintenance organization operating under
	Chapter 843;
	(4)  an approved nonprofit health corporation that
	holds a certificate of authority under Chapter 844;
	(5)  a multiple employer welfare arrangement that holds
	a certificate of authority under Chapter 846;
	(6)  a stipulated premium company operating under
	Chapter 884;
	(7)  a fraternal benefit society operating under
	Chapter 885;
	(8)  a Lloyd's plan operating under Chapter 941; or
	(9)  an exchange operating under Chapter 942.
	(b)  Notwithstanding any other law, this chapter applies to:
	(1)  a small employer health benefit plan subject to
	Chapter 1501, including coverage provided through a health group
	cooperative under Subchapter B of that chapter;
	(2)  a standard health benefit plan issued under
	Chapter 1507;
	(3)  a basic coverage plan under Chapter 1551;
	(4)  a basic plan under Chapter 1575;
	(5)  a primary care coverage plan under Chapter 1579;
	(6)  a plan providing basic coverage under Chapter
	1601;
	(7)  health benefits provided by or through a church
	benefits board under Subchapter I, Chapter 22, Business
	Organizations Code;
	(8)  group health coverage made available by a school
	district in accordance with Section 22.004, Education Code;
	(9)  the state Medicaid program, including the Medicaid
	managed care program operated under Chapter 533, Government Code;
	(10)  the child health plan program under Chapter 62,
	Health and Safety Code;
	(11)  a regional or local health care program operated
	under Section 75.104, Health and Safety Code;
	(12)  a self-funded health benefit plan sponsored by a
	professional employer organization under Chapter 91, Labor Code;
	(13)  county employee group health benefits provided
	under Chapter 157, Local Government Code; and
	(14)  health and accident coverage provided by a risk
	pool created under Chapter 172, Local Government Code.
	(c)  This chapter applies to coverage under a group health
	benefit plan provided to a resident of this state regardless of
	whether the group policy, agreement, or contract is delivered,
	issued for delivery, or renewed in this state.
	Sec. 1509.003.  EXCEPTIONS. (a)  This chapter does not apply
	to:
	(1)  a plan that provides coverage:
	(A)  for wages or payments in lieu of wages for a
	period during which an employee is absent from work because of
	sickness or injury;
	(B)  as a supplement to a liability insurance
	policy;
	(C)  for credit insurance;
	(D)  only for dental or vision care;
	(E)  only for hospital expenses; or
	(F)  only for indemnity for hospital confinement;
	(2)  a workers' compensation insurance policy; or
	(3)  medical payment insurance coverage provided under
	a motor vehicle insurance policy.
	(b)  This chapter does not apply to an individual health
	benefit plan issued on or before March 23, 2010, that has not had
	any significant changes since that date that reduce benefits or
	increase costs to the individual.
	Sec. 1509.004.  PREEXISTING CONDITION RESTRICTIONS
	PROHIBITED. Notwithstanding any other law, a health benefit plan
	issuer may not:
	(1)  deny coverage to or refuse to enroll an individual
	in a health benefit plan on the basis of a preexisting condition;
	(2)  limit or exclude coverage under the health benefit
	plan for treatment of the individual's preexisting condition
	otherwise covered under the plan; or
	(3)  charge the individual more for coverage than the
	health benefit plan issuer charges an individual who does not have a
	preexisting condition.
	SECTION 2.  If before implementing any provision of this Act
	a state agency determines that a waiver or authorization from a
	federal agency is necessary for implementation of that provision,
	the agency affected by the provision shall request the waiver or
	authorization and may delay implementing that provision until the
	waiver or authorization is granted.
	SECTION 3.  The change in law made by this Act applies only
	to a health benefit plan that is delivered, issued for delivery, or
	renewed on or after January 1, 2020. A health benefit plan that is
	delivered, issued for delivery, or renewed before January 1, 2020,
	is governed by the law as it existed immediately before the
	effective date of this Act, and that law is continued in effect for
	that purpose.
	SECTION 4.  This Act takes effect September 1, 2019.