Bill Text: TX HB739 | 2013-2014 | 83rd Legislature | Introduced


Bill Title: Relating to the creation of a voluntary consumer-directed health plan for certain individuals eligible to participate in the group benefits program provided under the Texas Employees Group Benefits Act and their qualified dependents.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2013-03-18 - Left pending in committee [HB739 Detail]

Download: Texas-2013-HB739-Introduced.html
  83R3710 KKR-D
 
  By: Crownover H.B. No. 739
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to the creation of a voluntary consumer-directed health
  plan for certain individuals eligible to participate in the group
  benefits program provided under the Texas Employees Group Benefits
  Act and their qualified dependents.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Chapter 1551, Insurance Code, is amended by
  adding Subchapter J to read as follows:
  SUBCHAPTER J. STATE CONSUMER-DIRECTED HEALTH PLAN
         Sec. 1551.451.  DEFINITIONS. In this subchapter:
               (1)  "High deductible health plan" means a health
  benefit plan that complies with Section 223(c), Internal Revenue
  Code of 1986, and other federal law.
               (2)  "Plan enrollee" means an employee or annuitant who
  is enrolled in the plan established under this subchapter.
               (3)  "Qualified medical expense" means an expense paid
  by a plan enrollee for medical care, as defined by Section 213(d),
  Internal Revenue Code of 1986, for the plan enrollee or the
  enrollee's dependents as defined by Section 152, Internal Revenue
  Code of 1986.
         Sec. 1551.452.  ESTABLISHMENT OF STATE CONSUMER-DIRECTED
  HEALTH PLAN. (a) The state consumer-directed health plan is
  established for the benefit of individuals eligible to participate
  in the group benefits program and those individuals' eligible
  dependents.
         (b)  The board of trustees may adopt rules necessary to
  administer this subchapter.  In implementing this subchapter the
  board shall:
               (1)  establish health savings accounts under this
  subchapter and administer or select an administrator for the
  accounts;
               (2)  finance or purchase a high deductible health plan
  that:
                     (A)  is an integral part of the state
  consumer-directed health plan; and
                     (B)  provides health benefit coverage, including
  preventive health care, to a plan enrollee in the state
  consumer-directed health plan and to the dependents of a plan
  enrollee in accordance with Section 1551.456; and
               (3)  provide to individuals eligible to participate in
  the group benefits program information regarding the option to
  participate in and operation of the state consumer-directed health
  plan established under this subchapter.
         (c)  If the board of trustees purchases a high deductible
  health plan under this subchapter, Sections 1551.215-1551.218
  apply to the high deductible health plan.
         (d)  In adopting rules and administering health savings
  accounts or selecting administrators for health savings accounts
  under this subchapter, the board of trustees shall ensure that the
  health savings accounts are qualified for appropriate federal tax
  exemptions.
         Sec. 1551.453.  PARTICIPATION IN STATE CONSUMER-DIRECTED
  HEALTH PLAN; EFFECT OF PARTICIPATION. (a) The board of trustees
  shall offer individuals eligible to participate in the basic
  coverage plan the option of waiving participation in the basic
  coverage plan and instead electing participation in the state
  consumer-directed health plan.
         (b)  For purposes of this chapter, participation in the state
  consumer-directed health plan is considered participation in the
  group benefits program, and Sections 1551.301, 1551.303, 1551.305,
  and 1551.306 apply to participation in the state consumer-directed
  health plan in the same manner that those sections apply to the
  basic coverage plan.
         Sec. 1551.454.  ACCOUNT ADMINISTRATOR. (a) The account
  administrator selected to administer a health savings account
  established under this subchapter must be a person:
               (1)  qualified to serve as trustee under Section
  223(d)(1)(B), Internal Revenue Code of 1986, and the rules adopted
  under that section; and
               (2)  experienced in administering health savings
  accounts or other similar trust accounts.
         (b)  An account administrator is the fiduciary of a plan
  enrollee who has a health savings account established under this
  subchapter.
         (c)  Section 1551.056(b) does not apply to the account
  administrator.
         Sec. 1551.455.  PARTICIPATION IN PROGRAM. (a) Each
  individual eligible to participate in the basic coverage may choose
  instead to participate in the state consumer-directed health plan
  if the plan enrollee is an eligible individual under Section
  223(c)(1), Internal Revenue Code of 1986. The dependents of a plan
  enrollee may participate in the state consumer-directed health plan
  in accordance with Section 1551.456.
         (b)  A plan enrollee must waive basic plan coverage to be
  enrolled in a high deductible health plan.
         (c)  Participation in the state consumer-directed health
  plan qualifies a plan enrollee to receive a contribution to a health
  savings account under Section 1551.458. An individual who elects
  not to participate in the plan is not eligible to receive a
  contribution under that section.
         (d)  A plan enrollee is subject to Subchapter H in the same
  manner as an individual who participates in the basic coverage
  offered under the group benefits program.
         (e)  Under this section, the board of trustees has exclusive
  authority to determine an individual's eligibility to participate
  in the state consumer-directed health plan and may adopt rules
  regarding eligibility to participate in the plan.
         Sec. 1551.456.  COVERAGE FOR DEPENDENTS; REQUIRED
  CONTRIBUTIONS. (a) Subject to Subsection (d), a plan enrollee is
  entitled to obtain for the enrollee's dependents coverage in the
  state consumer-directed health plan in the manner determined by the
  board of trustees.
         (b)  The plan enrollee shall make any required contribution
  payments for the dependent coverage in the manner prescribed by the
  board of trustees.
         (c)  Amounts contributed by a plan enrollee under this
  section may be:
               (1)  used to pay the cost of coverage in the high
  deductible health plan not paid by the state under Section
  1551.458(b); or
               (2)  allocated by the board of trustees to an enrollee's
  health savings account in the manner described by Section
  1551.458(c).
         (d)  A covered dependent of a plan enrollee:
               (1)  is subject to Subchapter H in the same manner as a
  dependent who is covered by the basic coverage offered under the
  group benefits program; and
               (2)  must be a dependent for purposes of this chapter.
         Sec. 1551.457.  IDENTIFICATION CARDS FOR PLAN ENROLLEES.
  (a) The board of trustees or the account administrator, as
  applicable, shall issue to each plan enrollee an identification
  card.
         (b)  The board of trustees or the account administrator, as
  applicable, shall issue a duplicate identification card to each
  plan enrollee's dependent for whom qualified medical expenses may
  be paid out of a health savings account established under this
  subchapter.
         Sec. 1551.458.  STATE CONTRIBUTION. (a)  For each plan
  enrollee, from the state contribution that would otherwise be made
  for basic coverage for the enrollee, the state shall annually
  contribute to a high deductible health plan provided under this
  subchapter the amount that is necessary to pay the cost of coverage
  under the high deductible health plan and does not exceed the amount
  the state annually contributes for a full-time or part-time
  employee, as applicable, who is covered by the basic coverage.
         (b)  For each plan enrollee's dependent covered under this
  subchapter from the state contribution that would otherwise be made
  for basic coverage for the dependent, the state shall annually
  contribute to a high deductible health plan provided under this
  subchapter the same percentage of the cost of coverage under the
  high deductible health plan as the state annually contributes for
  dependent coverage in the basic coverage.
         (c)  Before each plan year, the board of trustees may
  determine how to allocate to an enrollee's health savings account
  the portion, if any, of the state contribution that would otherwise
  be made for basic coverage for the enrollee and that remains after
  payment for coverage under Subsection (a) or (b).
         (d)  For a calendar year, the amount of any allocations made
  under Subsection (c) and Section 1551.456(c)(2), in the aggregate,
  may not exceed the sum of the monthly limitations imposed by federal
  law for health savings accounts.
         Sec. 1551.459.  PLAN ENROLLEE CONTRIBUTIONS. (a) Each plan
  enrollee, in accordance with Section 1551.305, shall contribute any
  amount required to cover the selected participation in the high
  deductible health plan that exceeds the state contribution amount
  under Section 1551.458.
         (b)  A plan enrollee may contribute any amount allowed under
  federal law to the enrollee's health savings account in addition to
  receiving an allocation of the state contribution under Section
  1551.458.
         (c)  A plan enrollee shall make contributions under this
  section in the manner prescribed by the board of trustees.
         Sec. 1551.460.  COORDINATION WITH CAFETERIA PLAN.  (a)  The
  board of trustees has exclusive authority to determine the
  eligibility of a plan enrollee to participate in any flexible
  spending account that is part of a cafeteria plan offered under this
  chapter.
         (b)  The board of trustees may adopt rules regarding the
  eligibility of a plan enrollee to participate in any flexible
  spending account that is part of a cafeteria plan offered under this
  chapter.
         (c)  A plan enrollee may not participate in any flexible
  spending account that would disqualify the enrollee's health
  savings account from favorable tax treatment under federal law.
         Sec. 1551.461.  CONFIDENTIALITY OF RECORDS. To the extent
  allowed under federal law and subject to Section 1551.063, the
  board of trustees or the account administrator, as applicable, may
  disclose to a carrier information in an individual's records that
  the board of trustees or administrator determines is necessary to
  administer the state consumer-directed health plan.
         Sec. 1551.462.  EXEMPTION FROM EXECUTION; UNASSIGNABILITY.
  A state contribution to a health savings account or a high
  deductible health plan is exempt from execution and is unassignable
  in the same manner and to the same extent as is an amount described
  by Section 1551.011.
         Sec. 1551.463.  ASSISTANCE. Any state agency that the board
  of trustees considers appropriate shall assist the board in
  implementing and administering this subchapter.
         Sec. 1551.464.  EXPIRATION. This subchapter expires
  September 1, 2019.
         SECTION 2.  The Employees Retirement System of Texas shall
  develop the state consumer-directed health plan to be implemented
  under Chapter 1551, Insurance Code, as amended by this Act,
  including enrollment requirements, during the state fiscal
  biennium beginning September 1, 2013, with coverage beginning
  September 1, 2014.
         SECTION 3.  Not later than July 31, 2014, the Employees
  Retirement System of Texas shall provide written information to
  individuals eligible to participate in the state consumer-directed
  health plan under Chapter 1551, Insurance Code, as amended by this
  Act, that provides a general description of the requirements for
  the plan as adopted under Chapter 1551, Insurance Code, as amended
  by this Act.
         SECTION 4.  The Employees Retirement System of Texas shall
  develop and implement the health savings account program under
  Chapter 1551, Insurance Code, as amended by this Act, in a manner
  that is as revenue neutral as is possible.
         SECTION 5.  (a) Not later than January 1, 2019, the board of
  trustees of the Employees Retirement System of Texas shall submit a
  report to the governor, lieutenant governor, speaker of the house
  of representatives, and Legislative Budget Board concerning:
               (1)  the manner in which, and the level at which, plan
  enrollees use the coverage provided under the state
  consumer-directed health plan established under Subchapter J,
  Chapter 1551, Insurance Code, as added by this Act;
               (2)  whether the coverage provided under the state
  consumer-directed health plan established under Subchapter J,
  Chapter 1551, Insurance Code, as added by this Act, is more or less
  cost-effective for plan enrollees and the state than the coverage
  provided under the basic coverage plan under Chapter 1551,
  Insurance Code; and
               (3)  whether continuation of the state
  consumer-directed health plan established under Subchapter J,
  Chapter 1551, Insurance Code, as added by this Act, is feasible or
  desirable.
         (b)  The report required by this section may be submitted
  separately from, or included in, the annual report that is required
  under Section 1551.061, Insurance Code, and is submitted closest to
  January 1, 2019.
         SECTION 6.  It is the intent of the legislature that in
  implementing an optional consumer-directed health plan, the
  Employees Retirement System of Texas may not divide the self-funded
  risk pool of the state employees group benefits program provided
  under Chapter 1551, Insurance Code.
         SECTION 7.  This Act takes effect September 1, 2013.
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