HBA-JRA H.B. 141 76(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 141 By: Reyna, Arthur Insurance 2/3/1999 Introduced BACKGROUND AND PURPOSE Currently a health benefit plan is not required to provide vision or medical eye care services or procedures. H.B. 141 provides that certain health benefit plans must cover the diagnosis and treatment of deficient vision including consultation, examination, corrective lenses, and corrective surgery. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the commissioner of insurance in SECTION 1 (Sections 3 and 7, Article 21.53X, Insurance Code) of this bill. SECTION BY SECTION ANALYSIS SECTION 1. Amends Subchapter E, Chapter 21, Insurance Code, by adding Article 21.53X, as follows: Article. 21.53X. COVERAGE FOR SIGHT-CORRECTIVE PROCEDURES Sec. 1. DEFINITIONS. Defines "enrollee" and "health benefit plan." Sec. 2. SCOPE OF ARTICLE. (a) Specifies that this article applies only to a health benefit plan that provides benefits for medical or surgical expenses incurred as a result of a health condition, accident, or sickness (lists examples of such plans), or one that is offered by an approved nonprofit health corporation certified under Section 5.01(a), Medical Practice Act (Article 4495b, V.T.C.S. (Certification of Certain Organizations)), that holds a certificate of authority from the commissioner of insurance (commissioner). (b) Specifies that this article does not apply to: a plan that provides only certain limited coverages, a small employer health benefit plan, a Medicare supplemental policy, workers' compensation insurance coverage, medical payment insurance issued as part of a motor vehicle insurance policy, or a long-term care policy. Sec. 3. COVERAGE REQUIRED. Provides that a health benefit plan must provide coverage for the diagnosis and treatment of deficient vision including consultation, examination, corrective lenses, corrective surgery, and other measures determined by the commissioner, by rule. Sec. 4. DEDUCTIBLE, COINSURANCE, AND COPAYMENT REQUIREMENTS. Prohibits requiring a deductible, coinsurance, or copayment for these benefits in excess of the requirements applicable to similar benefits provided under the health benefit plan. Sec. 5. LIMITATIONS. Provides that a health benefit plan must provide coverage for at least one pair of corrective lenses each year. Prohibits any limitation adopted by the health benefit plan from restricting the number of visits to an eye care provider. Sec. 6. NOTICE. Provides that each health benefit plan must provide each enrollee with written notice regarding the coverage required by this article. Sec. 7. RULES. Requires the commissioner to adopt rules as necessary to administer this article. SECTION 2. Effective date: September 1, 1999. Makes application of this Act prospective. SECTION 3. Emergency clause.