Bill Text: TX HB3989 | 2019-2020 | 86th Legislature | Introduced
Bill Title: Relating to a pilot program for the provision of health coverage for school district employees in certain school districts.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Introduced - Dead) 2019-03-21 - Referred to Public Education [HB3989 Detail]
Download: Texas-2019-HB3989-Introduced.html
| 86R10801 MEW-D | ||
| By: Leach | H.B. No. 3989 | |
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| relating to a pilot program for the provision of health coverage for | ||
| school district employees in certain school districts. | ||
| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | ||
| SECTION 1. Chapter 1579, Insurance Code, is amended by | ||
| adding Subchapter H to read as follows: | ||
| SUBCHAPTER H. PILOT PROGRAM | ||
| Sec. 1579.351. ELIGIBILITY FOR PILOT PROGRAM. A school | ||
| district, including a school district required to participate in | ||
| the program under Section 1579.151, is eligible to participate in | ||
| the pilot program under this subchapter, provided that the school | ||
| district meets the requirements imposed by this subchapter for | ||
| participation in the pilot program. | ||
| Sec. 1579.352. CONSORTIUM. School districts considering | ||
| participating in the pilot program under this subchapter shall | ||
| establish a consortium to consider alternative health benefit plan | ||
| coverage for employees of consortium districts. | ||
| Sec. 1579.353. DISTRICT REQUEST FOR PROGRAM INFORMATION. | ||
| (a) On request of a school district that is a member of a consortium | ||
| established under Section 1579.352, and subject to Subsection (b), | ||
| the trustee shall provide to the consortium school district any | ||
| historical claims data, enrollment information, or other relevant | ||
| information available to the trustee as requested by the district | ||
| in connection with a search for alternative health benefit plan | ||
| coverage for the district'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 district | ||
| concerning covered individuals who are responsible for a claim or | ||
| claims that total a large amount, as specified by the requesting | ||
| district; | ||
| (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 school district. | ||
| (d) If the trustee does not comply with the requirements of | ||
| this section, the requesting school district may bring a suit in a | ||
| district court in Travis County or in the county in which the | ||
| district is located to compel the trustee's compliance. | ||
| (e) If the school district prevails, the trustee shall pay | ||
| all court costs and attorney's fees incurred by the district in | ||
| connection with a suit brought under Subsection (d). | ||
| Sec. 1579.354. PARTICIPATION IN PILOT PROGRAM; WITHDRAWAL | ||
| FROM GROUP PROGRAM. (a) After a consortium of school districts | ||
| established under Section 1579.352 obtains options for alternative | ||
| health benefit plan coverage for employees of consortium districts, | ||
| each school district in the consortium may elect to withdraw from | ||
| the uniform group coverage program established under this chapter | ||
| by notifying the trustee in writing that the school district is | ||
| withdrawing from the group program and may participate in the pilot | ||
| program under this subchapter. | ||
| (b) Each consortium district that withdraws from the group | ||
| program to participate in the pilot program under this subchapter: | ||
| (1) must obtain health coverage for the district's | ||
| employees through the open market; and | ||
| (2) may use any purchasing method, including an | ||
| interlocal cooperative purchasing agreement, to purchase health | ||
| coverage for the district's employees. | ||
| Sec. 1579.355. MIXED METHOD STUDY. (a) Consortium school | ||
| districts that withdraw from the group program under Section | ||
| 1579.354 must create a mixed method study, using qualitative and | ||
| quantitative data, of the health coverage provided to the | ||
| district's employees under the pilot program. | ||
| (b) A consortium school district must report to the | ||
| legislature the results of the district's study under Subsection | ||
| (a) and, based on the results of the study, provide information | ||
| regarding the viability of providing health coverage using a | ||
| regional cohort method for school districts across the state. | ||
| Sec. 1579.356. RETURN TO GROUP PROGRAM. A school district | ||
| that withdraws from the group program under Section 1579.354 and | ||
| participates in the pilot program under this subchapter may resume | ||
| participation in the group program effective not earlier than the | ||
| fourth anniversary of the effective date of withdrawal. | ||
| SECTION 2. This Act takes effect September 1, 2019. | ||
