89R5875 SCR-F
	By: Dean	H.B. No. 139

	A BILL TO BE ENTITLED
	AN ACT
	relating to employer health benefit plans that do not include
	state-mandated health benefits.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  Subtitle G, Title 8, Insurance Code, is amended
	by adding Chapter 1506 to read as follows:
	CHAPTER 1506.  EMPLOYER CHOICE OF BENEFITS PLANS
	SUBCHAPTER A.  GENERAL PROVISIONS
	Sec. 1506.001.  DEFINITIONS. In this chapter:
	(1)  "Employer choice of benefits plan" means a group
	health benefit plan offered to an employer that, wholly or partly,
	does not offer or provide state-mandated health benefits, but that
	provides creditable coverage as defined by Section 1205.004(a) or
	1501.102(a).
	(2)  "Health benefit plan issuer" means any entity
	authorized under this code or another insurance law of this state to
	provide health insurance or health benefits in this state.  The term
	includes an insurance company, a group hospital service corporation
	operating under Chapter 842, a health maintenance organization
	operating under Chapter 843, and a stipulated premium company
	operating under Chapter 844.
	(3)  "State-mandated health benefits" means coverage
	or another feature required under this code or other laws of this
	state to be provided in a group health benefit plan that:
	(A)  includes coverage for specific health care
	services or benefits;
	(B)  places limitations or restrictions on
	deductibles, coinsurance, copayments, or any annual or lifetime
	maximum benefit amounts, including limitations provided by
	commissioner rule;
	(C)  includes a specific category of licensed
	health care practitioner from whom an enrollee is entitled to
	receive care;
	(D)  requires standard provisions or rights that
	are unrelated to a specific health illness, injury, or condition of
	an enrollee; or
	(E)  requires the health benefit plan to exceed
	federal requirements.
	Sec. 1506.002.  RULES. The commissioner shall adopt rules
	necessary to implement this chapter.
	SUBCHAPTER B.  EMPLOYER CHOICE OF BENEFITS PLANS
	Sec. 1506.101.  PLANS AUTHORIZED. (a)  A health benefit plan
	issuer may offer one or more employer choice of benefits plans.
	(b)  An employer choice of benefits plan must include
	coverage for essential health benefits as defined by 42 C.F.R.
	Section 440.347.
	Sec. 1506.102.  NOTICE TO ENROLLEES. (a)  Each written
	application to enroll in an employer choice of benefits plan must
	contain the following language at the beginning of the document in
	bold type:
	"You have the option to enroll in this Employer Choice
	of Benefits Plan that, either wholly or partly, does not provide
	state-mandated health benefits normally required in health benefit
	plans in Texas.  This employer health benefit plan may provide a
	more affordable health benefit plan for you, although, at the same
	time, it may provide you with fewer health benefits than those
	normally included as state-mandated health benefits in health
	benefit plans in Texas.  If you choose this employer health benefit
	plan, please consult with your insurance agent to discover which
	state-mandated health benefits are excluded from this health
	benefit plan."
	(b)  Each employer choice of benefits plan must contain the
	following language at the beginning of the document in bold type:
	"This Employer Choice of Benefits Plan, either wholly
	or partly, does not provide state-mandated health benefits normally
	required in health benefit plans in Texas.  This employer health
	benefit plan may provide a more affordable health benefit plan for
	you, although, at the same time, it may provide you with fewer
	health benefits than those normally included as state-mandated
	health benefits in health benefit plans in Texas.  Please consult
	with your insurance agent to discover which state-mandated health
	benefits are excluded from this health benefit plan."
	Sec. 1506.103.  DISCLOSURE STATEMENT. (a)  Before a health
	benefit plan issuer may contract to provide an employer choice of
	benefits plan to an employer, the issuer must provide the employer
	with a written disclosure statement that:
	(1)  acknowledges that the employer health benefit plan
	being contracted for does not provide some or all state-mandated
	health benefits; and
	(2)  lists those state-mandated health benefits not
	included in the plan.
	(b)  An employer entering into an initial contract for an
	employer choice of benefits plan must sign the disclosure statement
	provided by the health benefit plan issuer under Subsection (a) and
	return the statement to the issuer.
	(c)  A health benefit plan issuer shall:
	(1)  retain the signed disclosure statement in the
	health benefit plan issuer's records; and
	(2)  on request from the commissioner, provide the
	signed disclosure statement to the department.
	Sec. 1506.104.  ADDITIONAL HEALTH BENEFIT PLANS. A health
	benefit plan issuer that offers one or more employer choice of
	benefits plans must also offer employers at least one group health
	benefit plan that provides state-mandated health benefits and is
	otherwise authorized by this code.
	Sec. 1506.105.  COVERAGE EXEMPT FROM INSURANCE LAW. An
	employer choice of benefits plan provided under this chapter is
	exempt from any other insurance law, including common law, that
	does not expressly apply to the plan or this chapter.
	SECTION 2.  This Act takes effect immediately if it receives
	a vote of two-thirds of all the members elected to each house, as
	provided by Section 39, Article III, Texas Constitution.  If this
	Act does not receive the vote necessary for immediate effect, this
	Act takes effect September 1, 2025.