AB 248 — Health insurance: minimum value: large group market policies.

Summary

Existing law, the federal Patient Protection and Affordable Care Act (PPACA) , enacts various health care coverage market reforms that take effect January 1, 2014, and exempts health insurance coverage that provides excepted benefits from those reforms. PPACA requires each state to establish an American Health Benefits Exchange and allows qualified individuals to obtain premium assistance for coverage purchased through the Exchange. PPACA specifies that this premium assistance is not available if the individual is eligible for affordable employer-sponsored coverage that provides minimum value, as specified. 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 health insurers by the Insurance Commissioner. Existing law requires that health benefit plans issued by health insurers and health care service plans in the small group market and the individual market comply with specified requirements. Existing law defines a health benefit plan for the purpose of health benefit plans issued by health insurers to exclude a policy or certificate of specified disease or hospital confinement indemnity if the insurer certifies to the commissioner that the policy is being offered as supplemental health insurance and not as a substitute for essential health benefits. Existing law requires an insurer issuing these policies in the small group market or the individual market to require that the persons to be covered are covered by coverage that is not designed to serve as supplemental coverage. This bill would extend that requirement to a nongrandfathered health care service plan that offers, amends, or renews a group health plan contract and an insurer issuing a policy, except a health care service plan or insurer issuing a specialized health care service plan or policy, that provides less than 60% minimum value in the large group market and would require that the persons to be covered are also covered by a contract or plan that provides at least 60% minimum value. The bill would not apply to limited wraparound coverage, as described in a specified federal regulation, or a policy that provides coverage for Medicare services pursuant to federal government contracts. This bill would exempt an insurer that is subject to specified disclosure requirements from these provisions. The bill also would not apply to certain grandfathered health insurance policies that provide basic health care services without annual or lifetime limits, as specified. By expanding the scope of an existing crime, with respect to the regulation of health care service plans, this 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

• Chaptered 10/08/15 - Chaptered Current pdf October 08, 2015
• Enrolled 08/31/15 - Enrolled pdf August 31, 2015
• Amended 06/29/15 - Amended Senate pdf June 29, 2015
• Amended 06/10/15 - Amended Senate pdf June 10, 2015
• Amended 04/14/15 - Amended Assembly pdf April 14, 2015
• Introduced 02/09/15 - Introduced pdf February 09, 2015
• AB248 View text html

Action History

1. October 08, 2015

   Chaptered by Secretary of State - Chapter 617, Statutes of 2015.

2. October 08, 2015

   Approved by the Governor.

3. September 03, 2015

   Enrolled and presented to the Governor at 4 p.m.

4. August 27, 2015

   Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 52. Noes 27. Page 2605.).

5. August 25, 2015

   In Assembly. Concurrence in Senate amendments pending. May be considered on or after August 27 pursuant to Assembly Rule 77.

6. August 24, 2015

   Read third time. Passed. Ordered to the Assembly. (Ayes 24. Noes 15. Page 2145.).

7. July 14, 2015

   Read second time. Ordered to third reading.

8. July 13, 2015

   From committee: Be placed on second reading file pursuant to Senate Rule 28.8.

9. June 29, 2015

   Read second time and amended. Re-referred to Com. on APPR.

10. June 25, 2015

    From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 6. Noes 2.) (June 24).

11. June 18, 2015

    In committee: Hearing postponed by committee.

12. June 10, 2015

    From committee chair, with author's amendments: Amend, and re-refer to committee. Read second time, amended, and re-referred to Com. on HEALTH.

13. May 14, 2015

    Referred to Com. on HEALTH.

14. April 30, 2015

    In Senate. Read first time. To Com. on RLS. for assignment.

15. April 30, 2015

    Read third time. Passed. Ordered to the Senate. (Ayes 51. Noes 27. Page 1217.)

16. April 23, 2015

    Read second time. Ordered to third reading.

17. April 22, 2015

    From committee: Do pass. (Ayes 12. Noes 5.) (April 22).

18. April 15, 2015

    Re-referred to Com. on APPR.

19. April 14, 2015

    Read second time and amended.

20. April 13, 2015

    From committee: Amend, and do pass as amended and re-refer to Com. on APPR. (Ayes 12. Noes 3.) (April 7).

21. February 17, 2015

    Referred to Com. on HEALTH.

22. February 10, 2015

    From printer. May be heard in committee March 12.

23. February 09, 2015

    Read first time. To print.

Sponsors

• Jeff Gonzalez · Cosponsor
• Roger Hernández · Primary

Votes

Subjects