AB 2066 — Triggering event: pregnancy.
Last action — Vetoed by Governor.
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✓Introduced
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✓In Committee
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✓Passed Assembly
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✓Passed Senate
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5To Executive
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6Enacted
This bill has been sent to the executive. Introduced February 18, 2026. It awaits signature.
Vetoed by Governor Gavin Newsom (Democratic) on September 30, 2026.
Next likely step: the executive signs it into law or issues a veto.
Odds of enactment
Low chanceBased on the sponsor, cosponsors, and committee posture, this bill has a low chance of becoming law.
Upgrade to see the exact probability and what's driving it.
A statistical estimate from our own model of past outcomes — an insight, not a guarantee. Policymaking is volatile.
Prognosis
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To Executive
Current position in the legislative process.
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9 sponsors
1 primary, 8 co-sponsors signed on.
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Single-party support
Sponsorship is currently within one party (8 D).
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Cleared a recorded vote
Passed 7 recorded votes so far.
Based on stage, sponsorship breadth, committee status, recorded votes, and cross-state momentum — a description of the observable signals, not a prediction.
In plain language
The bill makes pregnancy a reason to enroll or change health benefit plans.
This legislation allows individuals to enroll in or change their health benefit plans due to pregnancy. It specifies that health care service plans must accommodate this triggering event.
What this means for you
- Families: For families, this means easier access to necessary health care options during pregnancy.
Summary
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law provides for the regulation of disability insurers by the Department of Insurance. Existing law requires a health care service plan or disability insurer to allow an individual to enroll in or change their health benefit plan as a result of a specified triggering event. This bill would make pregnancy a triggering event for purposes of enrollment or changing a health benefit plan. Because a willful violation of this provision by a health care service plan would be a crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
Bill Text
What changed in the latest version
1 added · 1 removedPlain-language change summary
The new version of Bill AB 2066 includes some additional text that clarifies certain provisions, while removing some previously included text that may have been redundant. These changes are essential because they help make the bill's intentions clearer and more accessible to those affected by it. Simplifying the language also helps ensure that all stakeholders understand the bill's impact.
Bill20250AB__206698AMD Text98 -INTRODUCED AB-20662026-02-18 TriggeringAMENDED_SENATE event:2026-08-21 2025 0 AB 2066 AMD Introduced by Assembly Member Celeste Rodriguez (Principal coauthor:
Senator Wahab) (Coauthors:
Assembly Members Addis, Aguiar-Curry, Bains, Bonta, Calderon, Caloza, Castillo, Davies, Elhawary, Hadwick, Irwin, Krell, Ortega, Pacheco, Papan, Patel, Pellerin, Quirk-Silva, Michelle Rodriguez, Rogers, Blanca Rubio, Sanchez, Solache, Stefani, Wallis, and Wilson) (Coauthors:
Senators Blakespear, Caballero, Durazo, Grayson, Menjivar, Reyes, Valladares, and Weber Pierson) LEAD_AUTHOR ASSEMBLY Celeste Rodriguez PRINCIPAL_COAUTHOR SENATE Wahab COAUTHOR ASSEMBLY Addis COAUTHOR ASSEMBLY Aguiar-Curry COAUTHOR ASSEMBLY Bains COAUTHOR ASSEMBLY Bonta COAUTHOR ASSEMBLY Calderon COAUTHOR ASSEMBLY Caloza COAUTHOR ASSEMBLY Castillo COAUTHOR ASSEMBLY Davies COAUTHOR ASSEMBLY Elhawary COAUTHOR ASSEMBLY Hadwick COAUTHOR ASSEMBLY Irwin COAUTHOR ASSEMBLY Krell COAUTHOR ASSEMBLY Ortega COAUTHOR ASSEMBLY Pacheco COAUTHOR ASSEMBLY Papan COAUTHOR ASSEMBLY Patel COAUTHOR ASSEMBLY Pellerin COAUTHOR ASSEMBLY Quirk-Silva COAUTHOR ASSEMBLY Michelle Rodriguez COAUTHOR ASSEMBLY Rogers <caml:Contribution>COAUTHOR</caml:Contribution><caml:House>ASSEMBLY</caml:House><caml:Name>Stefani</caml:Name></caml:Legislator>"?> COAUTHOR ASSEMBLY Blanca Rubio COAUTHOR ASSEMBLY Sanchez COAUTHOR ASSEMBLY Solache COAUTHOR ASSEMBLY Stefani COAUTHOR ASSEMBLY Wallis COAUTHOR ASSEMBLY Wilson COAUTHOR SENATE Blakespear COAUTHOR SENATE Caballero COAUTHOR SENATE Durazo COAUTHOR SENATE Grayson COAUTHOR SENATE Menjivar COAUTHOR SENATE Reyes COAUTHOR SENATE Valladares COAUTHOR SENATE Weber Pierson An act to amend Section 1399.849 of the Health and Safety Code, and to amend Section 10965.3 of the Insurance Code, relating to health care coverage.
health care coverage Triggering event:
skipExisting tolaw, contentthe homeKnox-Keene accessibilityHealth FAQCare feedbackService sitemapPlan loginAct xof Quick1975, Search:provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime.
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08/22/2026 04:00 AM AB2066:v98#DOCUMENTBill Start Amended IN Senate August 21, 2026 CALIFORNIA LEGISLATURE— 2025–2026 REGULAR SESSION Assembly Bill No.
2066Introduced by Assembly Member Celeste Rodriguez(Principal coauthor:
Senator Wahab)(Coauthors:
Assembly Members Addis, Aguiar-Curry, Bains, Bonta, Calderon, Caloza, Castillo, Davies, Elhawary, Hadwick, Irwin, Krell, Ortega, Pacheco, Papan, Patel, Pellerin, Quirk-Silva, Michelle Rodriguez, Rogers, and Stefani) Blanca Rubio, Sanchez, Solache, Stefani, Wallis, and Wilson)(Coauthors:
Senators Blakespear, Caballero, Durazo, Grayson, Menjivar, Reyes, Valladares, and Weber Pierson)February 18, 2026 An act to amend Section 1399.849 of the Health and Safety Code, and to amend Section 10965.3 of the Insurance Code, relating to health care coverage.
LEGISLATIVE COUNSEL'S DIGESTAB 2066, as amended, Celeste Rodriguez.
Triggering event:
pregnancy.Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime.
Because a willful violation of this provision by a health care service plan would be a crime, the bill would impose a state-mandated local program.Theprogram. California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state.
StatutoryThe provisionsCalifornia establishConstitution proceduresrequires forthe makingstate thatto reimbursement.Thisreimburse billlocal wouldagencies provideand thatschool nodistricts reimbursement is required by this act for acertain specifiedcosts reason.Digestmandated Keyby Vote:the state.
MAJORITY Statutory Appropriation:provisions establish procedures for making that reimbursement.
NO This Fiscalbill Committee:would provide that no reimbursement is required by this act for a specified reason.
YES MAJORITY LocalNO Program:YES YES NO NO NO NO NO NO NO The people of the State of California do enact as follows:
YES BillSECTION TextThe1. people of the State of California do enact as follows:SECTION 1. Section 1399.849 of the Health and Safety Code is amended to read:1399.849. (a) (1) On and after October 1, 2013, a plan shall fairly and affirmatively offer, market, and sell all of the plan’s health benefit plans that are sold in the individual market for policy years on or after January 1, 2014, to all individuals and dependents in each service area in which the plan provides or arranges for the provision of health care services.
ASection plan1399.849 shall limit enrollment in individual health benefit plans to open enrollment periods, annual enrollment periods, and special enrollment periods as provided in subdivisions (c) and (d).(2) A plan shall allow the subscriber of an individual health benefit plan to add a dependent to the subscriber’sHealth plan at the option of the subscriber, consistent with the open enrollment, annual enrollment, and specialSafety enrollmentCode periodis requirementsamended in this section.(b) An individual health benefit plan issued, amended, or renewed on or after January 1, 2014, shall not impose any preexisting condition provision upon any individual.(c) (1) With respect to individualread: health benefit plans offered outside of the Exchange, a plan shall provide an initial open enrollment period from October 1, 2013, to March 31, 2014, inclusive, an annual enrollment period for the policy year beginning on January 1, 2015, from November 15, 2014, to February 15, 2015, inclusive, annual enrollment periods for policy years beginning on or after January 1, 2016, to December 31, 2018, inclusive, from November 1, of the preceding calendar year, to January 31 of the benefit year, inclusive, and annual enrollment periods for policy years beginning on or after January 1, 2019, from October 15, of the preceding calendar year, to January 15 of the benefit year, inclusive.(2) With respect to individual health benefit plans offered through the Exchange, a plan shall provide an annual enrollment period for the policy years beginning on January 1, 2016, to December 31, 2018, inclusive, from November 1, of the preceding calendar year, to January 31 of the benefit year, inclusive, and annual enrollment periods for policy years beginning on or after January 1, 2019, from November 1 to December 15 of the preceding calendar year, inclusive.(3) With respect to individual health benefit plans offered through the Exchange, for policy years beginning on or after January 1, 2019, a plan shall provide a special enrollment period for all individuals selecting an individual health benefit plan through the Exchange from October 15 to October 31 of the preceding calendar year, inclusive, and from December 16, of the preceding calendar year, to January 15 of the benefit year, inclusive.
1399.849.
(a) (1) On and after October 1, 2013, a plan shall fairly and affirmatively offer, market, and sell all of the plan’s health benefit plans that are sold in the individual market for policy years on or after January 1, 2014, to all individuals and dependents in each service area in which the plan provides or arranges for the provision of health care services.
A plan shall limit enrollment in individual health benefit plans to open enrollment periods, annual enrollment periods, and special enrollment periods as provided in subdivisions (c) and (d).
(2) A plan shall allow the subscriber of an individual health benefit plan to add a dependent to the subscriber’s plan at the option of the subscriber, consistent with the open enrollment, annual enrollment, and special enrollment period requirements in this section.
(b) An individual health benefit plan issued, amended, or renewed on or after January 1, 2014, shall not impose any preexisting condition provision upon any individual.
(c) (1) With respect to individual health benefit plans offered outside of the Exchange, a plan shall provide an initial open enrollment period from October 1, 2013, to March 31, 2014, inclusive, an annual enrollment period for the policy year beginning on January 1, 2015, from November 15, 2014, to February 15, 2015, inclusive, annual enrollment periods for policy years beginning on or after January 1, 2016, to December 31, 2018, inclusive, from November 1, of the preceding calendar year, to January 31 of the benefit year, inclusive, and annual enrollment periods for policy years beginning on or after January 1, 2019, from October 15, of the preceding calendar year, to January 15 of the benefit year, inclusive.
(2) With respect to individual health benefit plans offered through the Exchange, a plan shall provide an annual enrollment period for the policy years beginning on January 1, 2016, to December 31, 2018, inclusive, from November 1, of the preceding calendar year, to January 31 of the benefit year, inclusive, and annual enrollment periods for policy years beginning on or after January 1, 2019, from November 1 to December 15 of the preceding calendar year, inclusive.
(3) With respect to individual health benefit plans offered through the Exchange, for policy years beginning on or after January 1, 2019, a plan shall provide a special enrollment period for all individuals selecting an individual health benefit plan through the Exchange from October 15 to October 31 of the preceding calendar year, inclusive, and from December 16, of the preceding calendar year, to January 15 of the benefit year, inclusive.
The effective date of coverage for plan selections made between October 15 and October 31, inclusive, shall be January 1 of the benefit year, and for plan selections made from December 16 to January 15, inclusive, shall be no later than February 1 of the benefit year.(4) Pursuantyear. to Section 147.104(b)(2) of Title 45 of the Code of Federal Regulations, for individuals enrolled in noncalendar year individual health plan contracts, a plan shall also provide a limited open enrollment period beginning on the date that is 30 calendar days prior to before the date the policy year ends in 2014.(d) (1) Subject to paragraph (2), commencing January 1, 2014, a plan shall allow an individual to enroll in or change individual health benefit plans as a result of the following triggering events:(A) The individual or the individual’s dependent loses minimum essential coverage.
For(4) purposesPursuant to Section 147.104(b)(2) of thisTitle paragraph,45 of the followingCode definitionsof shallFederal apply:(i) “MinimumRegulations, essentialfor coverage”individuals hasenrolled thein samenoncalendar meaningyear asindividual thathealth termplan iscontracts, defineda inplan Sectionshall 1345.5also orprovide subsectiona (f)limited ofopen Sectionenrollment 5000Aperiod ofbeginning on the Internaldate Revenuethat Codeis (2630 U.S.C.calendar days before the date the policy year ends in 2014.
(d) (1) Subject to paragraph (2), commencing January 1, 2014, a plan shall allow an individual to enroll in or change individual health benefit plans as a result of the following triggering events:
(A) The individual or the individual’s dependent loses minimum essential coverage.
For purposes of this paragraph, the following definitions shall apply:
(i) “Minimum essential coverage” has the same meaning as that term is defined in Section 1345.5 or subsection (f) of Section 5000A of the Internal Revenue Code (26 U.S.C.
5000A).(ii) “Loss5000A). of minimum essential coverage” includes, but is not limited to, loss of that coverage due to the circumstances described in Section 54.9801-6(a)(3)(i) to (iii), inclusive, of Title 26 of the Code of Federal Regulations and the circumstances described in Section 1163 of Title 29 of the United States Code.
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(ii) “Loss of minimum essential coverage” alsoincludes, includesbut loss of that coverage for a reason that is not duelimited toto, the fault of the individual.(iii) “Loss of minimum essential coverage” does not include loss of that coverage due to the individual’scircumstances failuredescribed to pay premiums on a timely basis or situations allowing for a rescission, subject to clause (ii) and Sections 1389.7 and 1389.21.(B) The individual gains a dependent or becomes a dependent.(C) The individual is mandated to be covered as a dependent pursuant to a valid state or federal court order.(D) The individual has been released from incarceration.(E) The individual’s health coverage issuer substantially violated a material provision of the health coverage contract.(F) The individual gains access to new health benefit plans as a result of a permanent move.(G) The individual was receiving services from a contracting provider under another health benefit plan, as defined in Section 1399.84554.9801-6(a)(3)(i) ofto this(iii), codeinclusive, or Section 10965 of theTitle Insurance26 Code, for one of the conditionsCode described in subdivision (c) of SectionFederal 1373.96Regulations of this code and that provider is no longer participating in the healthcircumstances benefitdescribed plan.(H) The individual demonstrates to the Exchange, with respect to health benefit plans offered through the Exchange, or to the department, with respect to health benefit plans offered outside the Exchange, that the individual did not enroll in aSection health1163 benefit plan during the immediately preceding enrollment period available to the individual because the individual was misinformed that the individual was covered under minimum essential coverage.(I) The individual is a member of the reserve forces of the United States military returning from active duty or a member of the California National Guard returning from active duty service under Title 3229 of the United States Code.(J) TheCode. individual is pregnant.
(K) With“Loss respectof tominimum individualessential healthcoverage” benefitalso plansincludes offeredloss through the Exchange, in addition to the triggering events listed in this paragraph, any other events listed in Section 155.420(d) of Titlethat 45coverage offor thea Codereason ofthat Federalis Regulations.(2) Withnot respectdue to individual health benefit plans offered outside the Exchange,fault anof individual shall have 60 days from the dateindividual. of a triggering event identified in paragraph (1) to apply for coverage from a health care service plan subject to this section.
With(iii) respect“Loss toof individualminimum healthessential benefitcoverage” plansdoes offerednot throughinclude theloss Exchange, an individual shall have 60 days from the date of athat triggeringcoverage eventdue identified in paragraph (1) to select a plan offered through the Exchange,individual’s unlessfailure a longer period is provided in Part 155 (commencing with Section 155.10) of Subchapter B of Subtitle A of Title 45 of the Code of Federal Regulations.(e) With respect to individualpay healthpremiums benefiton plansa offeredtimely throughbasis theor Exchange,situations theallowing effectivefor datea ofrescission, coveragesubject required pursuant to thisclause section(ii) shalland beSections consistent1389.7 withand the1389.21. dates specified in Section 155.410 or 155.420 of Title 45 of the Code of Federal Regulations, as applicable.
A(B) dependentThe who is a registered domestic partner pursuant to Section 297 of the Family Code shall have the same effective date of coverage as a spouse.(f) With respect to individual healthgains benefit plans offered outside the Exchange, the following provisions shall apply:(1) After an individual submits a completeddependent applicationor formbecomes for a plandependent. contract, the health care service plan shall, within 30 days, notify the individual of the individual’s actual premium charges for that plan established in accordance with Section 1399.855.
(C) The individual shallis havemandated 30 days in which to exercisebe thecovered rightas toa buydependent coveragepursuant at the quoted premium charges.(2) With respect to an individual health benefit plan for which an individual applies during the initial open enrollment period described in paragraph (1) of subdivision (c), when the subscriber submits a premiumvalid payment,state based on the quoted premium charges, and that payment is delivered or postmarked,federal whichevercourt occursorder. earlier, by December 15, 2013, coverage under the individual health benefit plan shall become effective no later than January 1, 2014.
(D) The individual has been released from incarceration.
(E) The individual’s health coverage issuer substantially violated a material provision of the health coverage contract.
(F) The individual gains access to new health benefit plans as a result of a permanent move.
(G) The individual was receiving services from a contracting provider under another health benefit plan, as defined in Section 1399.845 of this code or Section 10965 of the Insurance Code, for one of the conditions described in subdivision (c) of Section 1373.96 of this code and that provider is no longer participating in the health benefit plan.
(H) The individual demonstrates to the Exchange, with respect to health benefit plans offered through the Exchange, or to the department, with respect to health benefit plans offered outside the Exchange, that the individual did not enroll in a health benefit plan during the immediately preceding enrollment period available to the individual because the individual was misinformed that the individual was covered under minimum essential coverage.
(I) The individual is a member of the reserve forces of the United States military returning from active duty or a member of the California National Guard returning from active duty service under Title 32 of the United States Code.
(J) The individual is pregnant.
(K) With respect to individual health benefit plans offered through the Exchange, in addition to the triggering events listed in this paragraph, any other events listed in Section 155.420(d) of Title 45 of the Code of Federal Regulations.
(2) With respect to individual health benefit plans offered outside the Exchange, an individual shall have 60 days from the date of a triggering event identified in paragraph (1) to apply for coverage from a health care service plan subject to this section.
With respect to individual health benefit plans offered through the Exchange, an individual shall have 60 days from the date of a triggering event identified in paragraph (1) to select a plan offered through the Exchange, unless a longer period is provided in Part 155 (commencing with Section 155.10) of Subchapter B of Subtitle A of Title 45 of the Code of Federal Regulations.
(e) With respect to individual health benefit plans offered through the Exchange, the effective date of coverage required pursuant to this section shall be consistent with the dates specified in Section 155.410 or 155.420 of Title 45 of the Code of Federal Regulations, as applicable.
A dependent who is a registered domestic partner pursuant to Section 297 of the Family Code shall have the same effective date of coverage as a spouse.
(f) With respect to individual health benefit plans offered outside the Exchange, the following provisions shall apply:
(1) After an individual submits a completed application form for a plan contract, the health care service plan shall, within 30 days, notify the individual of the individual’s actual premium charges for that plan established in accordance with Section 1399.855.
The individual shall have 30 days in which to exercise the right to buy coverage at the quoted premium charges.
(2) With respect to an individual health benefit plan for which an individual applies during the initial open enrollment period described in paragraph (1) of subdivision (c), when the subscriber submits a premium payment, based on the quoted premium charges, and that payment is delivered or postmarked, whichever occurs earlier, by December 15, 2013, coverage under the individual health benefit plan shall become effective no later than January 1, 2014.
When that payment is delivered or postmarked between December 16, 2013, to December 31, 2013, inclusive, or after the 15th day of any subsequent month, coverage shall become effective no later than the first day of the second month following delivery or postmark of the payment.(3) Withpayment. respect to an individual health benefit plan for which an individual applies during the annual open enrollment period described in paragraph (1) of subdivision (c), when the individual submits a premium payment, based on the quoted premium charges, and that payment is delivered or postmarked, whichever occurs later, by December 15 of the preceding calendar year, coverage shall become effective on January 1 of the benefit year.
(3) With respect to an individual health benefit plan for which an individual applies during the annual open enrollment period described in paragraph (1) of subdivision (c), when the individual submits a premium payment, based on the quoted premium charges, and that payment is delivered or postmarked, whichever occurs later, by December 15 of the preceding calendar year, coverage shall become effective on January 1 of the benefit year.
When that payment is delivered or postmarked between December 16 to December 31, inclusive, or after the 15th day of any subsequent month, coverage shall become effective no later than the first day of the second month following delivery or postmark of the payment.(4) Withpayment. respect to an individual health benefit plan for which an individual applies during a special enrollment period described in subdivision (d), the following provisions shall apply:(A) When the individual submits a premium payment, based on the quoted premium charges, and that payment is delivered or postmarked, whichever occurs earlier, within the first 15 days of the month, coverage under the plan shall become effective no later than the first day of the following month.
When(4) theWith premiumrespect payment is neither delivered nor postmarked until after the 15th day of the month, coverage shall become effective no later than the first day of the second month following delivery or postmark of the payment.(B) Notwithstanding subparagraph (A), in the case of a birth, adoption, or placement for adoption, the coverage shall be effective on the date of birth, adoption, or placement for adoption.(C) Notwithstanding subparagraph (A), in the case of marriage or becoming a registered domestic partner or in the case where a qualified individual loses minimum essential coverage, the coverage effective date shall be the first day of the month following the date the plan receives the request for special enrollment.(g) (1) A health care service plan shall not establish rules for eligibility, including continued eligibility, of any individual to enroll under the terms of an individual health benefit plan basedfor onwhich any of the following factors:(A) Health status.(B) Medical condition, including physical and mental illnesses.(C) Claims experience.(D) Receipt of health care.(E) Medical history.(F) Genetic information.(G) Evidence of insurability, including conditions arising out of acts of domestic violence.(H) Disability.(I) Any other health status-related factor as determined by any federal regulations, rules, or guidance issued pursuant to Section 2705 of the federal Public Health Service Act (Public Law 78-410).(2) Notwithstanding Section 1389.1, a health care service plan shall not require an individual applicantapplies orduring the applicant’s dependent to fill out a healthspecial assessmentenrollment orperiod medicaldescribed questionnairein priorsubdivision to(d), enrollmentthe underfollowing anprovisions individualshall healthapply: benefit plan.
A(A) healthWhen care service plan shall not acquire or request information that relates to a health status-related factor from the applicantindividual orsubmits the applicant’s dependent or any other source prior to enrollment of the individual.(h) (1) A health care service plan shall consider as a singlepremium riskpayment, poolbased foron rating purposes in the individualquoted marketpremium thecharges, claims experience of all insureds and all enrollees in all nongrandfathered individual health benefit plans offered by that healthpayment careis servicedelivered plan in this state, whether offered as health care service plan contracts or individualpostmarked, healthwhichever insuranceoccurs policies,earlier, includingwithin thosethe insuredsfirst and15 enrolleesdays whoof enrollthe inmonth, individual coverage throughunder the Exchangeplan andshall insuredsbecome andeffective enrolleesno wholater enrollthan inthe individualfirst coverageday outside of the Exchange.following month.
StudentWhen healththe insurancepremium coverage,payment asis thatneither coveragedelivered isnor definedpostmarked inuntil Sectionafter 147.145(a)the of15th Titleday 45 of the Codemonth, ofcoverage Federal Regulations, shall notbecome beeffective includedno inlater athan health care service plan’s single risk pool for individual coverage.(2) Each calendar year, a health care service plan shall establish an index rate for the individualfirst marketday inof the statesecond basedmonth onfollowing thedelivery totalor combinedpostmark claims costs for providing essential health benefits, as defined pursuant to Section 1302 of PPACA, within the singlepayment. risk pool required under paragraph (1).
(B) Notwithstanding subparagraph (A), in the case of a birth, adoption, or placement for adoption, the coverage shall be effective on the date of birth, adoption, or placement for adoption.
(C) Notwithstanding subparagraph (A), in the case of marriage or becoming a registered domestic partner or in the case where a qualified individual loses minimum essential coverage, the coverage effective date shall be the first day of the month following the date the plan receives the request for special enrollment.
(g) (1) A health care service plan shall not establish rules for eligibility, including continued eligibility, of any individual to enroll under the terms of an individual health benefit plan based on any of the following factors:
(A) Health status.
(B) Medical condition, including physical and mental illnesses.
(C) Claims experience.
(D) Receipt of health care.
(E) Medical history.
(F) Genetic information.
(G) Evidence of insurability, including conditions arising out of acts of domestic violence.
(H) Disability.
(I) Any other health status-related factor as determined by any federal regulations, rules, or guidance issued pursuant to Section 2705 of the federal Public Health Service Act (Public Law 78-410).
(2) Notwithstanding Section 1389.1, a health care service plan shall not require an individual applicant or the applicant’s dependent to fill out a health assessment or medical questionnaire prior to enrollment under an individual health benefit plan.
A health care service plan shall not acquire or request information that relates to a health status-related factor from the applicant or the applicant’s dependent or any other source prior to enrollment of the individual.
(h) (1) A health care service plan shall consider as a single risk pool for rating purposes in the individual market the claims experience of all insureds and all enrollees in all nongrandfathered individual health benefit plans offered by that health care service plan in this state, whether offered as health care service plan contracts or individual health insurance policies, including those insureds and enrollees who enroll in individual coverage through the Exchange and insureds and enrollees who enroll in individual coverage outside of the Exchange.
Student health insurance coverage, as that coverage is defined in Section 147.145(a) of Title 45 of the Code of Federal Regulations, shall not be included in a health care service plan’s single risk pool for individual coverage.
(2) Each calendar year, a health care service plan shall establish an index rate for the individual market in the state based on the total combined claims costs for providing essential health benefits, as defined pursuant to Section 1302 of PPACA, within the single risk pool required under paragraph (1).
The premium rate for all of the health benefit plans in the individual market within the single risk pool required under paragraph (1) shall use the applicable marketwide adjusted index rate, subject only to the adjustments permitted under paragraph (3).(3) A(3). health care service plan may vary premium rates for a particular health benefit plan from its index rate based only on the following actuarially justified plan-specific factors:(A) The actuarial value and cost-sharing design of the health benefit plan.(B) The health benefit plan’s provider network, delivery system characteristics, and utilization management practices.(C) The benefits provided under the health benefit plan that are in addition to the essential health benefits, as defined pursuant to Section 1302 of PPACA and Section 1367.005.
These(3) additionalA benefitshealth shallcare beservice pooledplan withmay similarvary benefitspremium withinrates thefor singlea riskparticular poolhealth requiredbenefit underplan paragraph (1) and the claims experience from thoseits benefitsindex shall be utilized to determine rate variationsbased for plans that offer those benefits in addition to essential health benefits.(D) With respect to catastrophic plans, as described in subsection (e) of Section 1302 of PPACA, the expected impact of the specific eligibility categories for those plans.(E) Administrative costs, excluding user fees required by the Exchange.(i) This section shall only apply with respect to individual health benefit plans for policy years on orthe afterfollowing Januaryactuarially 1,justified 2014.(j) Thisplan-specific sectionfactors: shall not apply to a grandfathered health plan.SEC.
2. Section(A) 10965.3The ofactuarial thevalue Insurance Code is amended to read:10965.3. (a) (1) On and aftercost-sharing Octoberdesign 1, 2013, a health insurer shall fairly and affirmatively offer, market, and sell all of the insurer’s health benefit plansplan. that are sold in the individual market for policy years on or after January 1, 2014, to all individuals and dependents in each service area in which the insurer provides or arranges for the provision of health care services.
A(B) healthThe insurer shall limit enrollment in individual health benefit plansplan’s toprovider opennetwork, enrollmentdelivery periods,system annualcharacteristics, enrollment periods, and specialutilization enrollmentmanagement periodspractices. as provided in subdivisions (c) and (d).(2) A health insurer shall allow the policyholder of an individual health benefit plan to add a dependent to the policyholder’s health benefit plan at the option of the policyholder, consistent with the open enrollment, annual enrollment, and special enrollment period requirements in this section.(b) An individual health benefit plan issued, amended, or renewed on or after January 1, 2014, shall not impose any preexisting condition provision upon any individual.(c) (1) With respect to individual health benefit plans offered outside of the Exchange, a health insurer shall provide an initial open enrollment period from October 1, 2013, to March 31, 2014, inclusive, an annual enrollment period for the policy year beginning on January 1, 2015, from November 15, 2014, to February 15, 2015, inclusive, annual enrollment periods for policy years beginning on or after January 1, 2016, to December 31, 2018, inclusive, from November 1, of the preceding calendar year, to January 31 of the benefit year, inclusive, and annual enrollment periods for policy years beginning on or after January 1, 2019, from October 15 of the preceding calendar year, to January 15 of the benefit year, inclusive.(2) With respect to individual health benefit plans offered through the Exchange, a health insurer shall provide an annual enrollment period for the policy years beginning on January 1, 2016, to December 31, 2018, inclusive, from November 1, of the preceding calendar year, to January 31 of the benefit year, inclusive, and annual enrollment periods for policy years beginning on or after January 1, 2019, from November 1 to December 15 of the preceding calendar year, inclusive.(3) With respect to individual health benefit plans offered through the Exchange, for policy years beginning on or after January 1, 2019, a health insurer shall provide a special enrollment period for all individuals selecting an individual health benefit plan through the Exchange from October 15 to October 31 of the preceding calendar year, inclusive, and from December 16, of the preceding calendar year, to January 15 of the benefit year, inclusive.
(C) The benefits provided under the health benefit plan that are in addition to the essential health benefits, as defined pursuant to Section 1302 of PPACA and Section 1367.005.
These additional benefits shall be pooled with similar benefits within the single risk pool required under paragraph (1) and the claims experience from those benefits shall be utilized to determine rate variations for plans that offer those benefits in addition to essential health benefits.
(D) With respect to catastrophic plans, as described in subsection (e) of Section 1302 of PPACA, the expected impact of the specific eligibility categories for those plans.
(E) Administrative costs, excluding user fees required by the Exchange.
(i) This section shall only apply with respect to individual health benefit plans for policy years on or after January 1, 2014.
(j) This section shall not apply to a grandfathered health plan.
SEC.
2.
Section 10965.3 of the Insurance Code is amended to read:
10965.3.
(a) (1) On and after October 1, 2013, a health insurer shall fairly and affirmatively offer, market, and sell all of the insurer’s health benefit plans that are sold in the individual market for policy years on or after January 1, 2014, to all individuals and dependents in each service area in which the insurer provides or arranges for the provision of health care services.
A health insurer shall limit enrollment in individual health benefit plans to open enrollment periods, annual enrollment periods, and special enrollment periods as provided in subdivisions (c) and (d).
(2) A health insurer shall allow the policyholder of an individual health benefit plan to add a dependent to the policyholder’s health benefit plan at the option of the policyholder, consistent with the open enrollment, annual enrollment, and special enrollment period requirements in this section.
(b) An individual health benefit plan issued, amended, or renewed on or after January 1, 2014, shall not impose any preexisting condition provision upon any individual.
(c) (1) With respect to individual health benefit plans offered outside of the Exchange, a health insurer shall provide an initial open enrollment period from October 1, 2013, to March 31, 2014, inclusive, an annual enrollment period for the policy year beginning on January 1, 2015, from November 15, 2014, to February 15, 2015, inclusive, annual enrollment periods for policy years beginning on or after January 1, 2016, to December 31, 2018, inclusive, from November 1, of the preceding calendar year, to January 31 of the benefit year, inclusive, and annual enrollment periods for policy years beginning on or after January 1, 2019, from October 15 of the preceding calendar year, to January 15 of the benefit year, inclusive.
(2) With respect to individual health benefit plans offered through the Exchange, a health insurer shall provide an annual enrollment period for the policy years beginning on January 1, 2016, to December 31, 2018, inclusive, from November 1, of the preceding calendar year, to January 31 of the benefit year, inclusive, and annual enrollment periods for policy years beginning on or after January 1, 2019, from November 1 to December 15 of the preceding calendar year, inclusive.
(3) With respect to individual health benefit plans offered through the Exchange, for policy years beginning on or after January 1, 2019, a health insurer shall provide a special enrollment period for all individuals selecting an individual health benefit plan through the Exchange from October 15 to October 31 of the preceding calendar year, inclusive, and from December 16, of the preceding calendar year, to January 15 of the benefit year, inclusive.
The effective date of coverage for plan selections made between October 15 and October 31, inclusive, shall be January 1 of the benefit year, and for plan selections made from December 16 to January 15, inclusive, shall be no later than February 1 of the benefit year.(4) Pursuantyear. to Section 147.104(b)(2) of Title 45 of the Code of Federal Regulations, for individuals enrolled in noncalendar year individual health plan contracts, a health insurer shall also provide a limited open enrollment period beginning on the date that is 30 calendar days prior to before the date the policy year ends in 2014.(d) (1) Subject to paragraph (2), commencing January 1, 2014, a health insurer shall allow an individual to enroll in or change individual health benefit plans as a result of the following triggering events:(A) The individual or the individual’s dependent loses minimum essential coverage.
For(4) purposesPursuant ofto thisSection paragraph,147.104(b)(2) bothof Title 45 of the followingCode definitionsof shallFederal apply:(i) “MinimumRegulations, essentialfor coverage”individuals hasenrolled thein samenoncalendar meaningyear asindividual thathealth termplan iscontracts, defineda inhealth Sectioninsurer 1345.5shall ofalso theprovide Healtha andlimited Safetyopen Codeenrollment orperiod subsectionbeginning (f)on ofthe Sectiondate 5000Athat ofis 30 calendar days before the Internaldate Revenuethe Codepolicy (26year U.S.C.ends in 2014.
(d) (1) Subject to paragraph (2), commencing January 1, 2014, a health insurer shall allow an individual to enroll in or change individual health benefit plans as a result of the following triggering events:
(A) The individual or the individual’s dependent loses minimum essential coverage.
For purposes of this paragraph, both of the following definitions shall apply:
(i) “Minimum essential coverage” has the same meaning as that term is defined in Section 1345.5 of the Health and Safety Code or subsection (f) of Section 5000A of the Internal Revenue Code (26 U.S.C.
5000A).(ii) “Loss5000A). of minimum essential coverage” includes, but is not limited to, loss of that coverage due to the circumstances described in Section 54.9801-6(a)(3)(i) to (iii), inclusive, of Title 26 of the Code of Federal Regulations and the circumstances described in Section 1163 of Title 29 of the United States Code.
(ii) “Loss of minimum essential coverage” alsoincludes, includesbut loss of that coverage for a reason that is not duelimited toto, the fault of the individual.(iii) “Loss of minimum essential coverage” does not include loss of that coverage due to the individual’scircumstances failuredescribed toin paySection premiums54.9801-6(a)(3)(i) on a timely basis or situations allowing for a rescission, subject to clause(iii), (ii)inclusive, andof SectionsTitle 10119.226 and 10384.17.(B) The individual gains a dependent or becomes a dependent.(C) The individual is mandated to be covered as a dependent pursuant to a valid state or federal court order.(D) The individual has been released from incarceration.(E) The individual’s health coverage issuer substantially violated a material provision of the healthCode coverage contract.(F) The individual gains access to new health benefit plans as a result of aFederal permanentRegulations move.(G) The individual was receiving services from a contracting provider under another health benefit plan, as defined in Section 10965 of this code or Section 1399.845 of the Health and Safety Code, for one of the conditionscircumstances described in subdivision (a) of Section 10133.561163 of this code and that provider is no longer participating in the health benefit plan.(H) The individual demonstrates to the Exchange, with respect to health benefit plans offered through the Exchange, or to the department, with respect to health benefit plans offered outside the Exchange, that the individual did not enroll in a health benefit plan during the immediately preceding enrollment period available to the individual because the individual was misinformed that the individual was covered under minimum essential coverage.(I) The individual is a member of the reserve forces of the United States military returning from active duty or a member of the California National Guard returning from active duty service under Title 3229 of the United States Code.(J) TheCode. individual is pregnant.
(K) With“Loss respectof tominimum individualessential healthcoverage” benefitalso plansincludes offeredloss through the Exchange, in addition to the triggering events listed in this paragraph, any other events listed in Section 155.420(d) of Titlethat 45coverage offor thea Codereason ofthat Federalis Regulations.(2) Withnot respectdue to individual health benefit plans offered outside the Exchange,fault anof individual shall have 60 days from the dateindividual. of a triggering event identified in paragraph (1) to apply for coverage from a health care service plan subject to this section.
With(iii) respect“Loss toof individualminimum healthessential benefitcoverage” plansdoes offerednot throughinclude theloss Exchange, an individual shall have 60 days from the date of athat triggeringcoverage eventdue identified in paragraph (1) to select a plan offered through the Exchange,individual’s unlessfailure a longer period is provided in Part 155 (commencing with Section 155.10) of Subchapter B of Subtitle A of Title 45 of the Code of Federal Regulations.(e) With respect to individualpay healthpremiums benefiton plansa offeredtimely throughbasis theor Exchange,situations theallowing effectivefor datea ofrescission, coveragesubject required pursuant to thisclause section(ii) shalland beSections consistent10119.2 withand the10384.17. dates specified in Section 155.410 or 155.420 of Title 45 of the Code of Federal Regulations, as applicable.
A(B) dependentThe who is a registered domestic partner pursuant to Section 297 of the Family Code shall have the same effective date of coverage as a spouse.(f) With respect to an individual healthgains benefit plan offered outside the Exchange, the following provisions shall apply:(1) After an individual submits a completeddependent applicationor formbecomes for a plan,dependent. the insurer shall, within 30 days, notify the individual of the individual’s actual premium charges for that plan established in accordance with Section 10965.9.
(C) The individual shallis havemandated 30 days in which to exercisebe thecovered rightas toa buydependent coveragepursuant at the quoted premium charges.(2) With respect to an individual health benefit plan for which an individual applies during the initial open enrollment period described in paragraph (1) of subdivision (c), when the policyholder submits a premiumvalid payment,state based on the quoted premium charges, and that payment is delivered or postmarked,federal whichevercourt occursorder. earlier, by December 15, 2013, coverage under the individual health benefit plan shall become effective no later than January 1, 2014.
(D) The individual has been released from incarceration.
(E) The individual’s health coverage issuer substantially violated a material provision of the health coverage contract.
(F) The individual gains access to new health benefit plans as a result of a permanent move.
(G) The individual was receiving services from a contracting provider under another health benefit plan, as defined in Section 10965 of this code or Section 1399.845 of the Health and Safety Code, for one of the conditions described in subdivision (a) of Section 10133.56 of this code and that provider is no longer participating in the health benefit plan.
(H) The individual demonstrates to the Exchange, with respect to health benefit plans offered through the Exchange, or to the department, with respect to health benefit plans offered outside the Exchange, that the individual did not enroll in a health benefit plan during the immediately preceding enrollment period available to the individual because the individual was misinformed that the individual was covered under minimum essential coverage.
(I) The individual is a member of the reserve forces of the United States military returning from active duty or a member of the California National Guard returning from active duty service under Title 32 of the United States Code.
(J) The individual is pregnant.
(K) With respect to individual health benefit plans offered through the Exchange, in addition to the triggering events listed in this paragraph, any other events listed in Section 155.420(d) of Title 45 of the Code of Federal Regulations.
(2) With respect to individual health benefit plans offered outside the Exchange, an individual shall have 60 days from the date of a triggering event identified in paragraph (1) to apply for coverage from a health care service plan subject to this section.
With respect to individual health benefit plans offered through the Exchange, an individual shall have 60 days from the date of a triggering event identified in paragraph (1) to select a plan offered through the Exchange, unless a longer period is provided in Part 155 (commencing with Section 155.10) of Subchapter B of Subtitle A of Title 45 of the Code of Federal Regulations.
(e) With respect to individual health benefit plans offered through the Exchange, the effective date of coverage required pursuant to this section shall be consistent with the dates specified in Section 155.410 or 155.420 of Title 45 of the Code of Federal Regulations, as applicable.
A dependent who is a registered domestic partner pursuant to Section 297 of the Family Code shall have the same effective date of coverage as a spouse.
(f) With respect to an individual health benefit plan offered outside the Exchange, the following provisions shall apply:
(1) After an individual submits a completed application form for a plan, the insurer shall, within 30 days, notify the individual of the individual’s actual premium charges for that plan established in accordance with Section 10965.9.
The individual shall have 30 days in which to exercise the right to buy coverage at the quoted premium charges.
(2) With respect to an individual health benefit plan for which an individual applies during the initial open enrollment period described in paragraph (1) of subdivision (c), when the policyholder submits a premium payment, based on the quoted premium charges, and that payment is delivered or postmarked, whichever occurs earlier, by December 15, 2013, coverage under the individual health benefit plan shall become effective no later than January 1, 2014.
When that payment is delivered or postmarked between December 16, 2013, to December 31, 2013, inclusive, or after the 15th day of any subsequent month, coverage shall become effective no later than the first day of the second month following delivery or postmark of the payment.(3) Withpayment. respect to an individual health benefit plan for which an individual applies during the annual open enrollment period described in paragraph (1) of subdivision (c), when the individual submits a premium payment, based on the quoted premium charges, and that payment is delivered or postmarked, whichever occurs later, by December 15 of the preceding calendar year, coverage shall become effective on January 1 of the benefit year.
(3) With respect to an individual health benefit plan for which an individual applies during the annual open enrollment period described in paragraph (1) of subdivision (c), when the individual submits a premium payment, based on the quoted premium charges, and that payment is delivered or postmarked, whichever occurs later, by December 15 of the preceding calendar year, coverage shall become effective on January 1 of the benefit year.
When that payment is delivered or postmarked between December 16 to December 31, inclusive, or after the 15th day of any subsequent month, coverage shall become effective no later than the first day of the second month following delivery or postmark of the payment.(4) Withpayment. respect to an individual health benefit plan for which an individual applies during a special enrollment period described in subdivision (d), the following provisions shall apply:(A) When the individual submits a premium payment, based on the quoted premium charges, and that payment is delivered or postmarked, whichever occurs earlier, within the first 15 days of the month, coverage under the plan shall become effective no later than the first day of the following month.
When(4) theWith premiumrespect payment is neither delivered nor postmarked until after the 15th day of the month, coverage shall become effective no later than the first day of the second month following delivery or postmark of the payment.(B) Notwithstanding subparagraph (A), in the case of a birth, adoption, or placement for adoption, the coverage shall be effective on the date of birth, adoption, or placement for adoption.(C) Notwithstanding subparagraph (A), in the case of marriage or becoming a registered domestic partner or in the case where a qualified individual loses minimum essential coverage, the coverage effective date shall be the first day of the month following the date the insurer receives the request for special enrollment.(g) (1) A health insurer shall not establish rules for eligibility, including continued eligibility, of any individual to enroll under the terms of an individual health benefit plan basedfor onwhich any of the following factors:(A) Health status.(B) Medical condition, including physical and mental illnesses.(C) Claims experience.(D) Receipt of health care.(E) Medical history.(F) Genetic information.(G) Evidence of insurability, including conditions arising out of acts of domestic violence.(H) Disability.(I) Any other health status-related factor as determined by any federal regulations, rules, or guidance issued pursuant to Section 2705 of the federal Public Health Service Act (Public Law 78-410).(2) Notwithstanding subdivision (c) of Section 10291.5, a health insurer shall not require an individual applicantapplies orduring the applicant’s dependent to fill out a healthspecial assessmentenrollment orperiod medicaldescribed questionnairein priorsubdivision to(d), enrollmentthe underfollowing anprovisions individualshall healthapply: benefit plan.
A(A) healthWhen insurer shall not acquire or request information that relates to a health status-related factor from the applicantindividual orsubmits the applicant’s dependent or any other source prior to enrollment of the individual.(h) (1) A health insurer shall consider as a singlepremium riskpayment, poolbased foron rating purposes in the individualquoted marketpremium thecharges, claims experience of all insureds and enrollees in all nongrandfathered individual health benefit plans offered by that insurerpayment inis thisdelivered state, whether offered as health care service plan contracts or individualpostmarked, healthwhichever insuranceoccurs policies,earlier, includingwithin thosethe insuredsfirst and15 enrolleesdays whoof enrollthe inmonth, individual coverage throughunder the Exchangeplan andshall insuredsbecome andeffective enrolleesno wholater enrollthan inthe individualfirst coverageday outsideof the Exchange.following month.
StudentWhen healththe insurancepremium coverage,payment asis suchneither coveragedelivered isnor definedpostmarked inuntil Sectionafter 147.145(a)the of15th Titleday 45 of the Codemonth, ofcoverage Federal Regulations, shall notbecome beeffective includedno inlater athan health insurer’s single risk pool for individual coverage.(2) Each calendar year, a health insurer shall establish an index rate for the individualfirst marketday inof the statesecond basedmonth onfollowing thedelivery totalor combinedpostmark claims costs for providing essential health benefits, as defined pursuant to Section 1302 of PPACA, within the singlepayment. risk pool required under paragraph (1).
(B) Notwithstanding subparagraph (A), in the case of a birth, adoption, or placement for adoption, the coverage shall be effective on the date of birth, adoption, or placement for adoption.
(C) Notwithstanding subparagraph (A), in the case of marriage or becoming a registered domestic partner or in the case where a qualified individual loses minimum essential coverage, the coverage effective date shall be the first day of the month following the date the insurer receives the request for special enrollment.
(g) (1) A health insurer shall not establish rules for eligibility, including continued eligibility, of any individual to enroll under the terms of an individual health benefit plan based on any of the following factors:
(A) Health status.
(B) Medical condition, including physical and mental illnesses.
(C) Claims experience.
(D) Receipt of health care.
(E) Medical history.
(F) Genetic information.
(G) Evidence of insurability, including conditions arising out of acts of domestic violence.
(H) Disability.
(I) Any other health status-related factor as determined by any federal regulations, rules, or guidance issued pursuant to Section 2705 of the federal Public Health Service Act (Public Law 78-410).
(2) Notwithstanding subdivision (c) of Section 10291.5, a health insurer shall not require an individual applicant or the applicant’s dependent to fill out a health assessment or medical questionnaire prior to enrollment under an individual health benefit plan.
A health insurer shall not acquire or request information that relates to a health status-related factor from the applicant or the applicant’s dependent or any other source prior to enrollment of the individual.
(h) (1) A health insurer shall consider as a single risk pool for rating purposes in the individual market the claims experience of all insureds and enrollees in all nongrandfathered individual health benefit plans offered by that insurer in this state, whether offered as health care service plan contracts or individual health insurance policies, including those insureds and enrollees who enroll in individual coverage through the Exchange and insureds and enrollees who enroll in individual coverage outside the Exchange.
Student health insurance coverage, as such coverage is defined in Section 147.145(a) of Title 45 of the Code of Federal Regulations, shall not be included in a health insurer’s single risk pool for individual coverage.
(2) Each calendar year, a health insurer shall establish an index rate for the individual market in the state based on the total combined claims costs for providing essential health benefits, as defined pursuant to Section 1302 of PPACA, within the single risk pool required under paragraph (1).
The premium rate for all of the health benefit plans in the individual market within the single risk pool required under paragraph (1) shall use the applicable marketwide adjusted index rate, subject only to the adjustments permitted under paragraph (3).(3) A(3). health insurer may vary premium rates for a particular health benefit plan from its index rate based only on the following actuarially justified plan-specific factors:(A) The actuarial value and cost-sharing design of the health benefit plan.(B) The health benefit plan’s provider network, delivery system characteristics, and utilization management practices.(C) The benefits provided under the health benefit plan that are in addition to the essential health benefits, as defined pursuant to Section 1302 of PPACA and Section 10112.27.
These(3) additionalA benefitshealth shallinsurer bemay pooledvary withpremium similarrates benefitsfor withina theparticular singlehealth riskbenefit poolplan required under paragraph (1) and the claims experience from thoseits benefitsindex shall be utilized to determine rate variationsbased for plans that offer those benefits in addition to essential health benefits.(D) With respect to catastrophic plans, as described in subsection (e) of Section 1302 of PPACA, the expected impact of the specific eligibility categories for those plans.(E) Administrative costs, excluding any user fees required by the Exchange.(i) This section shall only apply with respect to individual health benefit plans for policy years on orthe afterfollowing Januaryactuarially 1,justified 2014.(j) Thisplan-specific sectionfactors: shall not apply to a grandfathered health plan.SEC.
3. No(A) reimbursementThe isactuarial requiredvalue byand thiscost-sharing actdesign pursuant to Section 6 of Article XIII B of the Californiahealth Constitutionbenefit becauseplan. the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.
(B) The health benefit plan’s provider network, delivery system characteristics, and utilization management practices.
(C) The benefits provided under the health benefit plan that are in addition to the essential health benefits, as defined pursuant to Section 1302 of PPACA and Section 10112.27.
These additional benefits shall be pooled with similar benefits within the single risk pool required under paragraph (1) and the claims experience from those benefits shall be utilized to determine rate variations for plans that offer those benefits in addition to essential health benefits.
(D) With respect to catastrophic plans, as described in subsection (e) of Section 1302 of PPACA, the expected impact of the specific eligibility categories for those plans.
(E) Administrative costs, excluding any user fees required by the Exchange.
(i) This section shall only apply with respect to individual health benefit plans for policy years on or after January 1, 2014.
(j) This section shall not apply to a grandfathered health plan.
SEC.
3.
No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.
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- Amended 08/21/26 - Amended Senate html August 21, 2026
- Introduced 02/18/26 - Introduced Current pdf February 18, 2026
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Action History
-
Vetoed by Governor.
-
Enrolled and presented to the Governor at 4 p.m.
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Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 76. Noes 0. Page 6601.).
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In Assembly. Concurrence in Senate amendments pending.
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Read third time. Passed. Ordered to the Assembly. (Ayes 39. Noes 0.).
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Read second time. Ordered to third reading.
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Read third time and amended. Ordered to second reading.
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Read second time. Ordered to third reading.
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From committee: Be ordered to second reading pursuant to Senate Rule 28.8.
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From committee: Do pass and re-refer to Com. on APPR. (Ayes 11. Noes 0.) (June 24). Re-referred to Com. on APPR.
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Referred to Com. on HEALTH.
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In Senate. Read first time. To Com. on RLS. for assignment.
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Read third time. Passed. Ordered to the Senate. (Ayes 70. Noes 0. Page 5219.)
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Read second time. Ordered to third reading.
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From committee: Do pass. (Ayes 14. Noes 0.) (May 14).
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In committee: Set, first hearing. Referred to APPR. suspense file.
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From committee: Do pass and re-refer to Com. on APPR. (Ayes 16. Noes 0.) (March 24). Re-referred to Com. on APPR.
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Coauthors revised.
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Referred to Com. on HEALTH.
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From printer. May be heard in committee March 21.
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Read first time. To print.
Sponsors
- Wahab · Cosponsor
- Catherine Stefani · Cosponsor
- Chris Rogers · Cosponsor
- Darshana R. Patel · Cosponsor
- Blanca Pacheco · Cosponsor
- Mia Bonta · Cosponsor
- Celeste Rodriguez · Primary
- Dawn Addis · Cosponsor
- Cecilia M. Aguiar-Curry · Cosponsor
Sponsorship breakdown
Export CSV (upgrade) →1 sponsors · 8 co-sponsors · 113 not signed on
Sponsors (1)
- Rodriguez, Celeste Democratic
Co-sponsors (8)
- Wahab
- Stefani, Catherine Democratic
- Rogers, Chris Democratic
- Patel, Darshana R. Democratic
- Pacheco, Blanca Democratic
- Bonta, Mia Democratic
- Addis, Dawn Democratic
- Aguiar-Curry, Cecilia M. Democratic
Not signed on (113)
113 members have not signed on to this bill.
Show all 113 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Votes
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Republican | 15 | 0 | 0 | 3 |
| Democratic | 54 | 0 | 0 | 0 |
| Unaffiliated | 7 | 0 | 0 | 0 |
| Total | 76 | 0 | 0 | 3 |
| % of votes cast | 96% | 0% | 0% | 4% |
How each member voted (79)
| Member | Party | Vote |
|---|---|---|
| Patterson | — | Yea |
| Ávila Farías | — | Yea |
| Rivas | — | Yea |
| Carrillo | — | Yea |
| Fong | — | Yea |
| Garcia | — | Yea |
| Lowenthal | — | Yea |
| Addis, Dawn | Democratic | Yea |
| Aguiar-Curry, Cecilia M. | Democratic | Yea |
| Ahrens, Patrick | Democratic | Yea |
| Alvarez, David | Democratic | Yea |
| Arambula, Joaquin | Democratic | Yea |
| Bains, Jasmeet | Democratic | Yea |
| Bauer-Kahan, Rebecca | Democratic | Yea |
| Bennett, Steve | Democratic | Yea |
| Berman, Marc | Democratic | Yea |
| Boerner, Tasha | Democratic | Yea |
| Bonta, Mia | Democratic | Yea |
| Bryan, Isaac G. | Democratic | Yea |
| Calderon, Lisa | Democratic | Yea |
| Caloza, Jessica | Democratic | Yea |
| Connolly, Damon | Democratic | Yea |
| Elhawary, Sade | Democratic | Yea |
| Gabriel, Jesse | Democratic | Yea |
| Gipson, Mike A. | Democratic | Yea |
| González, Mark | Democratic | Yea |
| Haney, Matt | Democratic | Yea |
| Harabedian, John | Democratic | Yea |
| Hart, Gregg | Democratic | Yea |
| Irwin, Jacqui | Democratic | Yea |
| Jackson, Corey A. | Democratic | Yea |
| Kalra, Ash | Democratic | Yea |
| Krell, Maggy | Democratic | Yea |
| Lee, Alex | Democratic | Yea |
| McKinnor, Tina | Democratic | Yea |
| Muratsuchi, Al | Democratic | Yea |
| Nguyen, Stephanie | Democratic | Yea |
| Ortega, Liz | Democratic | Yea |
| Pacheco, Blanca | Democratic | Yea |
| Papan, Diane | Democratic | Yea |
| Patel, Darshana R. | Democratic | Yea |
| Pellerin, Gail | Democratic | Yea |
| Petrie-Norris, Cottie | Democratic | Yea |
| Quirk-Silva, Sharon | Democratic | Yea |
| Ramos, James C. | Democratic | Yea |
| Ransom, Rhodesia | Democratic | Yea |
| Rodriguez, Celeste | Democratic | Yea |
| Rodriguez, Michelle | Democratic | Yea |
| Rogers, Chris | Democratic | Yea |
| Rubio, Blanca E. | Democratic | Yea |
| Schiavo, Pilar | Democratic | Yea |
| Schultz, Nick | Democratic | Yea |
| Sharp-Collins, LaShae | Democratic | Yea |
| Solache, Jr., José Luis | Democratic | Yea |
| Soria, Esmeralda | Democratic | Yea |
| Stefani, Catherine | Democratic | Yea |
| Valencia, Avelino | Democratic | Yea |
| Ward, Christopher M. | Democratic | Yea |
| Wicks, Buffy | Democratic | Yea |
| Wilson, Lori D. | Democratic | Yea |
| Zbur, Rick Chavez | Democratic | Yea |
| Alanis, Juan | Republican | Yea |
| Castillo, Leticia | Republican | Yea |
| Chen, Phillip | Republican | Yea |
| Davies, Laurie | Republican | Yea |
| DeMaio, Carl | Republican | Yea |
| Dixon, Diane | Republican | Yea |
| Ellis, Stan | Republican | Not Voting |
| Flora, Heath | Republican | Yea |
| Gonzalez, Jeff | Republican | Yea |
| Hadwick, Heather | Republican | Yea |
| Hoover, Josh | Republican | Yea |
| Johnson, Natasha | Republican | Yea |
| Lackey, Tom | Republican | Not Voting |
| Macedo, Alexandra | Republican | Yea |
| Sanchez, Kate | Republican | Yea |
| Ta, Tri | Republican | Yea |
| Tangipa, David J. | Republican | Not Voting |
| Wallis, Greg | Republican | Yea |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Unaffiliated | 6 | 0 | 0 | 0 |
| Republican | 9 | 0 | 0 | 0 |
| Democratic | 25 | 0 | 0 | 0 |
| Total | 40 | 0 | 0 | 0 |
| % of votes cast | 100% | 0% | 0% | 0% |
How each member voted (40)
| Member | Party | Vote |
|---|---|---|
| Allen | — | Yea |
| Gonzalez | — | Yea |
| Ochoa Bogh | — | Yea |
| Pérez | — | Yea |
| Rubio | — | Yea |
| Weber Pierson | — | Yea |
| Archuleta, Bob | Democratic | Yea |
| Arreguín, Jesse | Democratic | Yea |
| Ashby, Angelique V. | Democratic | Yea |
| Becker, Josh | Democratic | Yea |
| Blakespear, Catherine S. | Democratic | Yea |
| Cabaldon, Christopher | Democratic | Yea |
| Caballero, Anna M. | Democratic | Yea |
| Cervantes, Sabrina | Democratic | Yea |
| Cortese, Dave | Democratic | Yea |
| Durazo, Maria Elena | Democratic | Yea |
| Grayson, Timothy S. | Democratic | Yea |
| Hurtado, Melissa | Democratic | Yea |
| Laird, John | Democratic | Yea |
| Limón, Monique | Democratic | Yea |
| McGuire, Mike | Democratic | Yea |
| McNerney, Jerry | Democratic | Yea |
| Menjivar, Caroline | Democratic | Yea |
| Padilla, Stephen C. | Democratic | Yea |
| Reyes, Eloise Gómez | Democratic | Yea |
| Richardson, Laura | Democratic | Yea |
| Smallwood-Cuevas, Lola | Democratic | Yea |
| Stern, Henry I. | Democratic | Yea |
| Umberg, Thomas J. | Democratic | Yea |
| Wahab, Aisha | Democratic | Yea |
| Wiener, Scott D. | Democratic | Yea |
| Alvarado-Gil, Marie | Republican | Yea |
| Choi, Steven S. | Republican | Yea |
| Dahle, Megan | Republican | Yea |
| Grove, Shannon | Republican | Yea |
| Jones, Brian W. | Republican | Yea |
| Niello, Roger W. | Republican | Yea |
| Seyarto, Kelly | Republican | Yea |
| Strickland, Tony | Republican | Yea |
| Valladares, Suzette Martinez | Republican | Yea |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 30 | 0 | 0 | 0 |
| Republican | 10 | 0 | 0 | 0 |
| Total | 40 | 0 | 0 | 0 |
| % of votes cast | 100% | 0% | 0% | 0% |
How each member voted (40)
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 9 | 0 | 0 | 0 |
| Republican | 2 | 0 | 0 | 0 |
| Total | 11 | 0 | 0 | 0 |
| % of votes cast | 100% | 0% | 0% | 0% |
How each member voted (11)
| Member | Party | Vote |
|---|---|---|
| Caballero, Anna M. | Democratic | Yea |
| Durazo, Maria Elena | Democratic | Yea |
| Gonzalez, Lena A. | Democratic | Yea |
| Menjivar, Caroline | Democratic | Yea |
| Padilla, Stephen C. | Democratic | Yea |
| Pérez, Sasha Renée | Democratic | Yea |
| Rubio, Susan | Democratic | Yea |
| Smallwood-Cuevas, Lola | Democratic | Yea |
| Weber Pierson, M.D., Akilah | Democratic | Yea |
| Grove, Shannon | Republican | Yea |
| Valladares, Suzette Martinez | Republican | Yea |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Republican | 15 | 0 | 0 | 5 |
| Democratic | 54 | 0 | 0 | 5 |
| Unaffiliated | 1 | 0 | 0 | 0 |
| Total | 70 | 0 | 0 | 10 |
| % of votes cast | 88% | 0% | 0% | 13% |
How each member voted (80)
| Member | Party | Vote |
|---|---|---|
| Ávila Farías | — | Yea |
| Addis, Dawn | Democratic | Yea |
| Aguiar-Curry, Cecilia M. | Democratic | Yea |
| Ahrens, Patrick | Democratic | Yea |
| Alvarez, David | Democratic | Yea |
| Arambula, Joaquin | Democratic | Not Voting |
| Bains, Jasmeet | Democratic | Yea |
| Bauer-Kahan, Rebecca | Democratic | Yea |
| Bennett, Steve | Democratic | Yea |
| Berman, Marc | Democratic | Yea |
| Boerner, Tasha | Democratic | Yea |
| Bonta, Mia | Democratic | Yea |
| Bryan, Isaac G. | Democratic | Yea |
| Calderon, Lisa | Democratic | Yea |
| Caloza, Jessica | Democratic | Yea |
| Carrillo, Juan | Democratic | Yea |
| Connolly, Damon | Democratic | Yea |
| Elhawary, Sade | Democratic | Yea |
| Fong, Mike | Democratic | Yea |
| Gabriel, Jesse | Democratic | Yea |
| Garcia, Robert | Democratic | Not Voting |
| Gipson, Mike A. | Democratic | Yea |
| González, Mark | Democratic | Yea |
| Haney, Matt | Democratic | Yea |
| Harabedian, John | Democratic | Yea |
| Hart, Gregg | Democratic | Yea |
| Irwin, Jacqui | Democratic | Not Voting |
| Jackson, Corey A. | Democratic | Yea |
| Kalra, Ash | Democratic | Yea |
| Krell, Maggy | Democratic | Yea |
| Lee, Alex | Democratic | Yea |
| Lowenthal, Josh | Democratic | Yea |
| McKinnor, Tina | Democratic | Yea |
| Muratsuchi, Al | Democratic | Yea |
| Nguyen, Stephanie | Democratic | Yea |
| Ortega, Liz | Democratic | Yea |
| Pacheco, Blanca | Democratic | Yea |
| Papan, Diane | Democratic | Yea |
| Patel, Darshana R. | Democratic | Yea |
| Pellerin, Gail | Democratic | Yea |
| Petrie-Norris, Cottie | Democratic | Yea |
| Quirk-Silva, Sharon | Democratic | Yea |
| Ramos, James C. | Democratic | Not Voting |
| Ransom, Rhodesia | Democratic | Yea |
| Rivas, Robert | Democratic | Yea |
| Rodriguez, Celeste | Democratic | Not Voting |
| Rodriguez, Michelle | Democratic | Yea |
| Rogers, Chris | Democratic | Yea |
| Rubio, Blanca E. | Democratic | Yea |
| Schiavo, Pilar | Democratic | Yea |
| Schultz, Nick | Democratic | Yea |
| Sharp-Collins, LaShae | Democratic | Yea |
| Solache, Jr., José Luis | Democratic | Yea |
| Soria, Esmeralda | Democratic | Yea |
| Stefani, Catherine | Democratic | Yea |
| Valencia, Avelino | Democratic | Yea |
| Ward, Christopher M. | Democratic | Yea |
| Wicks, Buffy | Democratic | Yea |
| Wilson, Lori D. | Democratic | Yea |
| Zbur, Rick Chavez | Democratic | Yea |
| Alanis, Juan | Republican | Yea |
| Castillo, Leticia | Republican | Yea |
| Chen, Phillip | Republican | Not Voting |
| Davies, Laurie | Republican | Yea |
| DeMaio, Carl | Republican | Yea |
| Dixon, Diane | Republican | Yea |
| Ellis, Stan | Republican | Not Voting |
| Flora, Heath | Republican | Yea |
| Gallagher, James | Republican | Yea |
| Gonzalez, Jeff | Republican | Yea |
| Hadwick, Heather | Republican | Yea |
| Hoover, Josh | Republican | Not Voting |
| Johnson, Natasha | Republican | Yea |
| Lackey, Tom | Republican | Not Voting |
| Macedo, Alexandra | Republican | Yea |
| Patterson, Joe | Republican | Yea |
| Sanchez, Kate | Republican | Yea |
| Ta, Tri | Republican | Yea |
| Tangipa, David J. | Republican | Not Voting |
| Wallis, Greg | Republican | Yea |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Republican | 3 | 0 | 0 | 1 |
| Democratic | 11 | 0 | 0 | 0 |
| Total | 14 | 0 | 0 | 1 |
| % of votes cast | 93% | 0% | 0% | 7% |
How each member voted (15)
| Member | Party | Vote |
|---|---|---|
| Aguiar-Curry, Cecilia M. | Democratic | Yea |
| Calderon, Lisa | Democratic | Yea |
| Caloza, Jessica | Democratic | Yea |
| Fong, Mike | Democratic | Yea |
| González, Mark | Democratic | Yea |
| Krell, Maggy | Democratic | Yea |
| Pacheco, Blanca | Democratic | Yea |
| Pellerin, Gail | Democratic | Yea |
| Sharp-Collins, LaShae | Democratic | Yea |
| Solache, Jr., José Luis | Democratic | Yea |
| Wicks, Buffy | Democratic | Yea |
| Dixon, Diane | Republican | Yea |
| Hoover, Josh | Republican | Yea |
| Ta, Tri | Republican | Yea |
| Tangipa, David J. | Republican | Not Voting |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Democratic | 12 | 0 | 0 | 0 |
| Republican | 4 | 0 | 0 | 0 |
| Total | 16 | 0 | 0 | 0 |
| % of votes cast | 100% | 0% | 0% | 0% |
How each member voted (16)
| Member | Party | Vote |
|---|---|---|
| Addis, Dawn | Democratic | Yea |
| Aguiar-Curry, Cecilia M. | Democratic | Yea |
| Bonta, Mia | Democratic | Yea |
| Caloza, Jessica | Democratic | Yea |
| Carrillo, Juan | Democratic | Yea |
| González, Mark | Democratic | Yea |
| Pacheco, Blanca | Democratic | Yea |
| Patel, Darshana R. | Democratic | Yea |
| Rogers, Chris | Democratic | Yea |
| Schiavo, Pilar | Democratic | Yea |
| Sharp-Collins, LaShae | Democratic | Yea |
| Stefani, Catherine | Democratic | Yea |
| Chen, Phillip | Republican | Yea |
| Johnson, Natasha | Republican | Yea |
| Patterson, Joe | Republican | Yea |
| Sanchez, Kate | Republican | Yea |
Subjects
Frequently asked questions
- What does AB 2066 do?
- Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law provides for the regulation of disability insurers by the Department of Insurance. Existing law requires a health care service plan or disability insurer to allow an individual to enroll in or change their health benefit plan as a result of a specified triggering event. This bill would make pregnancy a triggering event for purposes of enrollment or changing a health benefit plan. Because a willful violation of this provision by a health care service plan would be a crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
- Who sponsors AB 2066?
- AB 2066 is sponsored by Wahab, Stefani, Catherine (Democratic), Rogers, Chris (Democratic), Patel, Darshana R. (Democratic), Pacheco, Blanca (Democratic), Bonta, Mia (Democratic), Rodriguez, Celeste (Democratic), Addis, Dawn (Democratic), and Aguiar-Curry, Cecilia M. (Democratic).
- What is the current status of AB 2066?
- This bill has been sent to the executive. Introduced February 18, 2026. It awaits signature.
- Where can I track AB 2066?
- Track AB 2066 free on One Click Politics — get push/email alerts when it moves.
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