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2005 Field Alert Reports

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Advertising

Texas HB 2613	Adopts the Interstate Insurance Product Regulation Compact.
Report Date: 06/27/05 Enacted: 6/18/05 Effective: Immediately Appears under "Advertising" and "Rates, Forms & Filings" Full Text

Annual Statements & General Financial Reporting

Texas SB 1591	Revises accountant practice requirements for certain audits of insurer financial reports.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: 9/1/05 Full Text

Benefits

Texas HB 1485	Requires health benefit plan coverage for screening tests for human papillomavirus and cervical cancer.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: 9/1/05 Full Text

Texas HB 1775	Defines the terms "actual charge" or "actual fee" under a specified disease policy.
Report Date: 06/27/05 Enacted: 6/18/05 Effective: 9/1/05 Full Text

Texas HB 1602

Provides that the Insurance Code shall not be construed to prevent an insurer, health maintenance organization, or other entity issuing a health insurance policy or certificate of coverage from applying deductible or copayment requirements to benefits, including state-mandated health benefits, in order to qualify the health insurance policy or certificate of coverage as a high deductible health plan.

Report Date: 06/06/05 Enacted: 5/24/05 Effective: 9/1/05 Full Text

Credentialing

Texas SB 155

Provides that the legislature finds that to ensure enrollees high quality care, many health benefit plan issuers voluntarily undergo a rigorous accreditation process conducted by nationally recognized accreditation organizations. To maintain accreditation, these health benefit plan issuers are subject to continuing review of their processes and standards. The legislature recognizes that many of these processes and standards are also reviewed by state agencies, resulting in increased agency costs and increased health benefit plan administrative costs. The purpose of this chapter is to allow appropriate recognition of accreditation by nationally recognized accreditation organizations and to foster coordination among state agencies.

Report Date: 06/27/05 Enacted: 6/17/05 Effective: 6/1/05 Full Text

Credit Insurance

Texas 28 TAC 1.3.FF.1.3.5001, .5002	Amends rules regarding credit life and accident and health policy definitions. Improves organization by putting all definitions into one section of the subchapter.
Report Date: 06/13/05 Adopted: 5/18/05 Effective: 6/7/05 Full Text

Texas 28 TAC 1.3.FF.2.3.5105	Amends rules regarding credit life and accident and health policies applications and policies. Updates citations.
Report Date: 06/13/05 Adopted: 5/18/05 Effective: 6/7/05 Full Text

Texas 28 TAC 1.3.FF.3.3.5201, .5202, .5206	Amends rules regarding credit life and accident and health policies filing and approval of forms and rates. Updates citations. Clarifies that the test of reasonableness applies to approved deviations, and that the loss ratio comparison is to be applied to rates that would exist if an approved deviation is allowed to become effective.
Report Date: 06/13/05 Adopted: 5/18/05 Effective: 6/7/05 Full Text

Texas 28 TAC 1.3.FF.5.3.5502	Amends rules pertaining to standards of benefits for credit accident and health insurance. Updates citations.
Report Date: 06/13/05 Adopted: 5/18/05 Effective: 6/7/05 Full Text

Texas 28 TAC 1.3.FF.6.3.5601, .5602 thru .5604, .5607, .5608, .5610	Amends rules pertaining to credit life, accident and health policies deviations procedures. Requires that a request for an approved deviation must be presented on form CI-DRF. Includes the credibility table. Updates citations.
Report Date: 06/13/05 Adopted: 5/18/05 Effective: 6/7/05 Full Text

Texas 28 TAC 1.3.FF.9.3.5901, .5905	Amends rules regarding credit life, accident and health policies premium refunds. Updates citations.
Report Date: 06/13/05 Adopted: 5/18/05 Effective: 6/7/05 Full Text

Texas 28 TAC 1.3.FF.2.3.5110	Repeals rule regarding credit life, accident and health policies applications and policies.
Report Date: 06/13/05 Adopted: 5/18/05 Effective: 6/7/05 Full Text

Texas 28 TAC 1.3.FF.6.3.5603	Repeals rule regarding credit life, accident and health policies deviation procedures.
Report Date: 06/13/05 Adopted: 5/18/05 Effective: 6/7/05 Full Text

DOI Examination - Market Conduct

Texas SB 14

Revises provisions governing property and casualty rates. Also, enacts the Insurance Market Conduct Surveillance Act. Provides that an insurer may not be compelled to disclose a self-audit document or waive any statutory or common law privilege. An insurer may, however, voluntarily disclose a document described by this subsection to the commissioner in response to any market conduct action or examination.

Report Date: 06/27/05 Enacted: 6/17/05 Effective: 9/1/05 Full Text

Department of Insurance

Texas HB 2017

This 600 page bill makes nonsubstantive revisions of statutes relating to the Texas Department of Insurance, the business of insurance, and certain related businesses, including conforming amendments, repeals, and penalties. This bill is not reported under all subjects to which it pertains, so READ CAREFULLY TO ASSESS IMPACT. The substantive changes include creating a class of insurance insuring against the loss of employment and allowing the group purchase of workers' compensation insurance.

Report Date: 06/27/05 Enacted: 6/17/05 Effective: 4/1/07 Full Text

Texas SB 781	Revises provisions of the Insurance Code that govern the prosecution of certain acts that constitute the unauthorized business of insurance.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: Immediately Full Text

Texas HB 2614	Relates to the applicability of certain insurance laws to Lloyd's plans and reciprocal and interinsurance exchanges.
Report Date: 06/27/05 Enacted: 6/18/05 Effective: 9/1/05 Full Text

Employment Law

Texas SB 1408	Revises law governing the review of wage claim disputes by the Texas Workforce Commission.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: 9/1/05 Full Text

Fraud

Texas HB 2388	Revises fraud notification requirements. Requires notification within 30 days of discovery.
Report Date: 06/27/05 Enacted: 6/18/05 Effective: 9/1/05 Full Text

Texas HB 3376	Relates to criminal offenses involving theft and fraud, to the statutes of limitation for those offenses, and to the effect of the commission of those offenses on certain license holders and applicants.
Report Date: 06/27/05 Enacted: 6/18/05 Effective: 9/1/05 Full Text

Group Insurance

Texas SB 805	Revises laws governing small and large employer health cooperatives.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: 9/1/05 Full Text

Texas 28 TAC 1.3.FF.10.3.6002	Amends rules regarding the responsibilities and obligations of insurance companies and their representatives. Updates citation with regard to refunds of unearned premiums.
Report Date: 06/13/05 Adopted: 5/18/05 Effective: 6/7/05 Full Text

Texas HB 765	Revises the notices that must be provided to all employees or members of the insured group.
Report Date: 06/27/05 Enacted: 6/18/05 Effective: 9/1/05 Full Text

Guaranty Associations

Texas HB 2883	Revises laws governing coverage under the Texas Life, Accident, and Hospital Service Insurance Guaranty Association.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: 9/1/05 Full Text

Health Insurance Plans

Texas SB 809	Revises laws governing the Texas Health Insurance Risk Pool.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: 1/1/06 Full Text

Holding Companies

Texas SB 1283	Repeals an exemption under the holding company laws for each affiliate in a system if it is privately owned by not more than five security holders, each of whom is an individual.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: 9/1/05 Full Text

Insolvency

Texas HB 2157	Enacts the Insurer Receivership Act. Governs the receivership of insurers in this state; provides penalties.
Report Date: 06/27/05 Enacted: 6/18/05 Effective: 9/1/05 Full Text

Investments

Texas SB 1592	Provides that the commissioner, in the commissioner's sole discretion, may require an insurer to make a deposit under this article if the commissioner determines that one of the following conditions, if not rectified, may potentially be hazardous to the insurer's policyholders, enrollees, or creditors, or to the public.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: Immediately Full Text

Managed Care

Texas HB 1030	States that the insured's coinsurance applicable to payment to nonpreferred providers may not exceed 50 percent of the total covered amount applicable to the medical or health care services.
Report Date: 06/27/05 Enacted: 6/18/05 Effective: 9/1/05 Full Text

Texas SB 50

Provides that if requested by a participating physician or provider, a managed care organization shall include a provision in the physician's or provider's contract providing that the health maintenance organization or the health maintenance organization's clearinghouse may not refuse to process or pay an electronically submitted clean claim because the claim is submitted together with or in a batch submission with a claim that is not a clean claim.

Report Date: 06/27/05 Enacted: 6/17/05 Effective: 9/1/05 Full Text

Texas SB 51

Revises requirements for managed care contracts. Provides that such contracts must provide that in addition to any other premiums for which the group policyholder is liable, the group policyholder is liable for an individual insured's premiums from the time the individual is no longer part of the group eligible for coverage under the policy until the end of the month in which the policyholder notifies the insurer that the individual is no longer part of the group eligible for coverage under the policy; and the individual remains covered under the policy until the end of that period. Also, provides certain exemptions for plans limited to routine vision coverage.

Report Date: 06/27/05 Enacted: 6/17/05 Effective: 9/1/05 Full Text

Texas HB 2999	An insurer that contracts with hospitals to provide services to insureds under a preferred provider benefit plan may not deny a hospital the opportunity to participate in providing health care services as a preferred provider solely because the hospital is not accredited by the Joint Commission on Accreditation of Healthcare Organizations or another specified national accrediting body.
Report Date: 06/27/05 Enacted: 6/18/05 Effective: Immediately Full Text

Texas SB 1284	State the circumstances under which a health maintenance organization is subject to certain requirements of the insurance code.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: 9/1/05 Full Text

Medicaid

Texas SB 1188	Revises laws governing the medical assistance and children's health insurance programs.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: 9/1/05 Full Text

Texas SB 1340	Relates to the regulation and reimbursement of health care services provided through telemedicine or telepsychiatry under the state Medicaid program.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: 9/1/05 Full Text

Texas HB 1771	Requires the he executive commissioner, by rule, to develop an integrated care management model of Medicaid managed care. The "integrated care management model" is a noncapitated primary care case management model of Medicaid managed care with enhanced components.
Report Date: 06/27/05 Enacted: 6/18/05 Effective: Immediately Full Text

Texas SB 563	Relates to the prevention of Medicaid fraud; provides penalties.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: 9/1/05 Full Text

Texas SB 826	Considers providing mental health services for women with postpartum depression.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: 9/1/05 Full Text

Premium Finance Contracts

Texas HB 2965	Revises requirements for insurance premium finance agreements.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: Immediately Full Text

Privacy

Texas SB 122	Enacts the Identity Theft Enforcement and Protection Act. Assists certain victims of identity theft; provides penalties.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: 9/1/05 Full Text

Texas HB 1130	Provides that a person may not require an individual to disclose the individual's social security number to obtain goods or services from or enter into a business transaction with the person, with certain exceptions.
Report Date: 06/06/05 Enacted: 5/27/05 Effective: 9/1/05 Full Text

Producers

Texas HB 1201	Increases the number of temporary license holder an insurer may appoint from 250 to 500.
Report Date: 06/06/05 Enacted: 5/27/05 Effective: Immediately Full Text

United States 28 CFR Part 904	The Compact Council, established pursuant to the National Crime Prevention and Privacy Compact, is publishing a rule to establish criminal history record screening standards for criminal history record information received from the Interstate Identification Index (III) for authorized noncriminal justice purposes.
Report Date: 06/27/05 Adopted: 6/22/05 Effective: 7/22/05 Full Text

Producers - Continuing Education

Texas SB 265	Allows the commissioner to authorize the department to grant not more than four hours of continuing education credit to an agent who is an active member of a state or national insurance association.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: 9/1/05 Full Text

Rates, Forms & Filings

Texas HB 2613	Adopts the Interstate Insurance Product Regulation Compact.
Report Date: 06/27/05 Enacted: 6/18/05 Effective: Immediately Appears under "Advertising" and "Rates, Forms & Filings" Full Text

Sales and Marketing

Texas HB 2565	Expands the list of items that are not considered rebates under the category of promotional and educational activities.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: 9/1/05 Full Text

Texas HB 2941	Provides that if an agent, or any affiliate of an agent, receives compensation from a customer for the placement or renewal of an insurance product, other than a service fee, an application fee, or an inspection fee, the agent or the affiliate may not accept or receive any compensation from an insurer or other third party for that placement or renewal unless certain conditions are met.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: 9/1/05 Full Text

State and Federal Programs

Texas SB 261	Creates a program to educate the public on the value of health coverage and to increase public awareness of health coverage options.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: Immediately Full Text

Tax

United States Rev. Rul. 2005-40 Tax on Insurance Companies other than Life Insurance Companies

The Treasury Department and the IRS issued guidance on the qualification of arrangements as "insurance" for federal income tax purposes.  Today's ruling does not call into question the vast majority of insurance contracts, which are issued by commercial insurance companies in the ordinary course of business.  Instead, it reminds taxpayers who are parties to smaller one-on-one arrangements that the requirement of risk distribution must be met for the arrangements to qualify as insurance.  The ruling was accompanied by a notice soliciting comments from the public on other insurance-related topics.

Report Date: 06/27/05 Issued: 6/17/05 Effective: Immediately Full Text

Underwriting

Texas SB 53	Expands scope of law governing use of genetic testing information to cover individual as well as group health benefit plans.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: 9/1/05 Full Text

Texas HB 2810	Prohibits certain questions of an applicant for health benefit plan coverage.
Report Date: 06/27/05 Enacted: 6/17/05 Effective: 9/1/05 Full Text