HB2290 - Relating to health benefits offered by postsecondary educational institutions to students and their families.

  89R21096 SCF-F     By: Johnson, Lambert, Lalani H.B. No. 2290     Substitute the following for H.B. No. 2290:     By:  Wilson C.S.H.B. No. 2290       A BILL TO BE ENTITLED   AN ACT   relating to health benefits offered by postsecondary educational   institutions to students and their families.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 1275.002, Insurance Code, is amended to   read as follows:          Sec. 1275.002.  APPLICABILITY OF CHAPTER.  This chapter   applies only to:                (1)  a health benefit plan offered by a nonprofit   agricultural organization under Chapter 1682; [ and ]                (2)  a health benefit plan:                      (A)  that is a self-insured or self-funded plan   established by an employer for the benefit of the employer's   employees in accordance with the Employee Retirement Income   Security Act of 1974 (29 U.S.C. Section 1001 et seq.); and                      (B)  for which the plan sponsor has made an   election, submitted to the commissioner in the form and manner   prescribed by the commissioner, to apply this chapter to the plan   for the relevant plan year ; and                 (3)     a health benefit plan offered by a postsecondary   educational institution under Chapter 1683 .          SECTION 2.  Subtitle K, Title 8, Insurance Code, is amended   by adding Chapter 1683 to read as follows:   CHAPTER 1683. HEALTH BENEFITS PROVIDED BY CERTAIN POSTSECONDARY   EDUCATIONAL INSTITUTIONS           Sec. 1683.001.  DEFINITIONS. In this chapter:                 (1)     "Higher education health benefits" means health   benefits:                       (A)     sponsored by a postsecondary educational   institution;                       (B)  offered only to:                             (i)     students enrolled at the postsecondary   educational institution; and                             (ii)     family members of students enrolled at   the postsecondary educational institution;                       (C)     that are not provided through an insurance   policy or other product the offering or issuance of which is   regulated as the business of insurance in this state; and                       (D)     that are deemed by the postsecondary   educational institution to be important in assisting its students   and their families to live long and productive lives.                 (2)     "Postsecondary educational institution" means an   institution of higher education or a private or independent   institution of higher education, as those terms are defined by   Section 61.003, Education Code.                 (3)     "Preexisting condition" means a condition present   before the effective date of an individual's enrollment in higher   education health benefits.           Sec.   1683.002.     HIGHER EDUCATION HEALTH BENEFITS   AUTHORIZED. A postsecondary educational institution may offer in   this state higher education health benefits.   A postsecondary   educational institution that offers higher education health   benefits under this chapter may not require a student to enroll in   the benefits.           Sec.   1683.003.     WAITING PERIOD FOR PREEXISTING CONDITION.   Notwithstanding any other provision of this chapter, a   postsecondary educational institution that offers higher education   health benefits may not require a waiting period of more than six   months for treatment of a preexisting condition otherwise included   in higher education health benefits.           Sec.   1683.004.     REQUIRED DISCLOSURE FOR HIGHER EDUCATION   HEALTH BENEFITS. (a) A postsecondary educational institution that   offers higher education health benefits must provide to an   individual applying for higher education health benefits written   notice that the benefits are not provided through an insurance   policy or other product the offering or issuance of which is   regulated as the business of insurance in this state.           (b)     An individual must sign and return to the postsecondary   educational institution the notice described by Subsection (a)   before the individual may enroll in higher education health   benefits. The postsecondary educational institution must:                 (1)     maintain a copy of the signed written notice for   the duration of the term during which the higher education health   benefits are provided to the individual; and                 (2)     at the request of the individual, provide a copy of   the written notice to the individual.           Sec.   1683.005.     POSTSECONDARY EDUCATIONAL INSTITUTION NOT   ENGAGED IN BUSINESS OF HEALTH INSURANCE; REGISTRATION REQUIRED.   (a)   Notwithstanding any other provision of this code, for the   purposes of offering higher education health benefits, a   postsecondary educational institution that acts in accordance with   this chapter is not a health insurer and is not engaging in the   business of health insurance in this state.           (b)     A postsecondary educational institution that offers   higher education health benefits must register with the department   and provide information as needed to facilitate compliance with   Chapter 1467, as applicable to those benefits under Section   1275.004.           Sec.   1683.006.     RISK TRANSFER OR COVERAGE. A postsecondary   educational institution that offers higher education health   benefits under this chapter may contract with a company authorized   to engage in the business of insurance in this state that is not   under common control with the postsecondary educational   institution to:                 (1)     transfer to that company all or a portion of the   organization's risks arising from higher education health benefits   offered under this chapter; or                 (2)     obtain insurance coverage from the company   guarantying the postsecondary educational institution's   obligations arising from higher education health benefits offered   under this chapter.           Sec.   1683.007.     ACTUARIAL SOUNDNESS. (a) A postsecondary   educational institution that offers higher education health   benefits under this chapter shall administer the benefits in a   manner that is actuarially sound.             (b)     The postsecondary educational institution shall ensure   the higher education health benefits offered by the postsecondary   educational institution are actuarially sound by:                 (1)     obtaining an actuarial opinion from an actuary who   is a fellow of the Society of Actuaries or a member of the American   Academy of Actuaries that recommends the amount of cash reserves   and the level of specific and aggregate stop-loss insurance the   postsecondary educational institution should maintain for purposes   of administering the benefits; and                   (2)     maintaining the levels of cash reserves and   stop-loss insurance recommended by the actuarial opinion obtained   under Subdivision (1).          SECTION 3.  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.