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AN ACT
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relating to provision of health-related services, health care |
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information, and incentives promoting disease prevention, |
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wellness, and health by certain insurers and related entities and |
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certain health care providers. |
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�������BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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�������SECTION�1.��Section 541.058, Insurance Code, is amended to |
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read as follows: |
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�������Sec.�541.058.��CERTAIN PRACTICES NOT CONSIDERED |
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DISCRIMINATION OR INDUCEMENT. (a) �In this section: |
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�������������(1)��"Health-related services" means services that are |
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available in connection with an accident and health insurance |
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policy or certificate or an evidence of coverage and that are |
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directed to an individual's health improvement or maintenance. |
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�������������(2)��"Health-related information" means that |
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information that is directed to an individual's health improvement |
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or maintenance or to costs associated with particular options |
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available in connection with an accident and health insurance |
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policy or certificate or an evidence of coverage. |
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�������(b)��It is not a rebate or discrimination prohibited by |
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Section 541.056(a) or 541.057: |
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�������������(1)��for a life insurance or life annuity contract, to |
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pay a bonus to a policyholder or otherwise abate the policyholder's |
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premiums in whole or in part out of surplus accumulated from |
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nonparticipating insurance policies if the bonus or abatement: |
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�������������������(A)��is fair and equitable to policyholders; and |
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�������������������(B)��is in the best interests of the insurer and |
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its policyholders; |
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�������������(2)��for a life insurance policy issued on the |
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industrial debit plan, to make to a policyholder who has |
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continuously for a specified period made premium payments directly |
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to the insurer's office an allowance in an amount that fairly |
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represents the saving in collection expenses; |
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�������������(3)��for a group insurance policy, to readjust the rate |
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of premium based on the loss or expense experience under the policy |
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at the end of a policy year if the adjustment is retroactive for |
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only that policy year; [or] |
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�������������(4)��for a life annuity contract, to waive surrender |
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charges under the contract when the contract holder exchanges that |
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contract for another annuity contract issued by the same insurer if |
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the waiver and the exchange are fully, fairly, and accurately |
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explained to the contract holder in a manner that is not deceptive |
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or misleading; |
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�������������(5)��in connection with an accident and health |
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insurance policy, to provide to policy or certificate holders, in |
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addition to benefits under the terms of the insurance contract, |
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health-related services or health-related information, or to |
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disclose the availability of those additional services and |
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information to prospective policy or certificate holders; or |
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�������������(6)��in connection with a health maintenance |
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organization evidence of coverage, to provide to enrollees, in |
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addition to benefits under the evidence of coverage, health-related |
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services or health-related information, or to disclose the |
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availability of those additional services and information to |
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prospective enrollees or contract holders. |
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�������SECTION�2.��Subchapter A, Chapter 1201, Insurance Code, is |
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amended by adding Section 1201.013 to read as follows: |
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�������Sec.�1201.013.��PROGRAMS PROMOTING DISEASE PREVENTION, |
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WELLNESS, AND HEALTH. �(a)��An insurer issuing an accident and |
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health insurance policy may establish premium discounts, rebates, |
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or a reduction in otherwise applicable copayments, coinsurance, or |
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deductibles, or any combination of these incentives, for an insured |
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who participates in programs promoting disease prevention, |
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wellness, and health. |
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�������(b)��A discount, rebate, or reduction established under this |
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section does not violate Section 541.056(a). |
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�������SECTION�3.��Section 1501.107(a), Insurance Code, is amended |
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to read as follows: |
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�������(a)��A small or large employer health benefit plan issuer may |
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establish premium discounts, rebates, or a reduction in otherwise |
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applicable copayments, coinsurance, or deductibles, or any |
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combination of these incentives, in return for participation in |
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[adherence to] programs promoting [of health promotion and] disease |
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prevention, wellness, and health. |
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�������SECTION�4.��This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution.��If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2007. |
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____________________________________________________________ |
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���President of the SenateSpeaker of the House������ |
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�������I certify that H.B. No. 2252 was passed by the House on April |
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4, 2007, by the following vote:��Yeas 139, Nays 0, 1 present, not |
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voting. |
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______________________________ |
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Chief Clerk of the House��� |
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�������I certify that H.B. No. 2252 was passed by the Senate on May |
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3, 2007, by the following vote:��Yeas 31, Nays 0. |
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______________________________ |
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Secretary of the Senate���� |
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APPROVED:��_____________________ |
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APPROVED:��_____________________ |
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�������������������Date���������� |
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� |
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� |
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����������_____________________ |
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�����������������Governor������� |