Elaine Alquist
- Democratic
Author
Existing law, the federal Patient Protection and Affordable Care Act, on and after January 1, 2014, requires a health insurance issuer offering health insurance coverage in the individual or group market to accept every employer and individual in the state that applies for that coverage, as specified, and requires issuers in the individual and small group markets to ensure that the coverage includes a specified essential benefits package. The act requires an essential health benefits package to provide coverage in one of 5 levels based on actuarial 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 Department of Insurance. Existing law imposes various requirements with respect to individual contracts and policies issued by health care service plans and health insurers. Existing law requires a health care service plan to permit, at least once each year, an individual who has been covered for at least 18 months under an individual plan contract issued by the health care service plan to transfer, without medical underwriting, as defined, to another individual plan contract offered by the health care service plan having equal or lesser benefits, as specified. Existing law imposes a parallel requirement with respect to individual policies issued by health insurers. This bill would eliminate the 18-month requirement and would require plans and insurers to allow an individual to transfer to another individual contract or policy without medical underwriting on the annual renewal date of his or her contract or policy. Commencing July 1, 2011, the bill would require plans and insurers to categorize all products offered in the individual market into 5 tiers according to actuarial value, as specified, and would require plans and insurers to disclose this value and other information in certain disclosure forms. Existing law prohibits a health care service plan from expending for administrative costs, as defined, an excessive amount of the payments the plan receives for providing health care services to its subscribers and enrollees. The Insurance Commissioner is required to withdraw approval of an individual or mass-marketed policy of disability insurance if the commissioner finds that the benefits provided under the policy are unreasonable in relation to the premium charged, as specified. The federal Patient Protection and Affordable Care Act prohibits a health insurance issuer issuing health insurance coverage from establishing lifetime limits or unreasonable annual limits on the dollar value of benefits for any participant or beneficiary, as specified. The act also requires a health insurance issuer issuing health insurance coverage to provide an annual rebate to each enrollee if the ratio of the amount of the revenue expended by the issuer on costs to the total amount of premium revenue is less than a certain percentage, as specified. This bill would require health care service plans and health insurers to comply with the requirements imposed under those provisions to the extent required under federal law. Because a willful violation of the bill's requirements with respect to health care service plans 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.
Died on file.
In Senate. To unfinished business. (Veto)
Vetoed by Governor.
Enrolled. To Governor at 3:30 p.m.
From committee: Be re-referred to Com. on HEALTH pursuant to Senate Rule 29.10. (Ayes 3. Noes 0. Page 5056.) Re-referred to Com. on HEALTH.
Senate concurs in Assembly amendments. (Ayes 22. Noes 11. Page 5077.) To enrollment.
From committee: That the Assembly amendments be concurred in. (Ayes 6. Noes 2. Page 5131.)
Read third time. Passed. (Ayes 51. Noes 27. Page 6833.) To Senate.
Re-referred to Com. on RLS. pursuant to Senate Rule 29.10.
In Senate.
Read second time. To third reading.
Joint Rule 62(a) file notice suspended. (Page 6706.)
(Heard in committee on August 26.)
From committee: Do pass. (Ayes 12. Noes 4.)
From committee with author's amendments. Read second time. Amended. Re-referred to Com. on HEALTH.
(August 24 amended measure version corrected August 25.)
From committee with author's amendments. Read second time. Amended. Re-referred to Com. on HEALTH.
Re-referred to Com. On HEALTH pursuant to Assembly Rule 77.2.
Assembly Rule 69(d) suspended. (Ayes 49. Noes 27. Page 6463.)
(August 20 amended measure version corrected August 25.)
Read third time. Amended. (Page 6425.) To third reading.
Read second time. To third reading.
Read second time. Amended. To second reading.
From committee: Do pass as amended. (Ayes 12. Noes 5.)
(Heard in committe August 12.)
Set, first hearing. Referred to APPR. suspense file.
Read second time. Amended. Re-referred to Com. on APPR.
Joint Rule 62(a) file notice suspended. (Page 5989.)
From committee: Do pass as amended, but first amend, and re-refer to Com. on APPR. (Ayes 13. Noes 6.)
(Heard in committee on June 29.)
Set, first hearing. Hearing canceled at the request of author.
From committee with author's amendments. Read second time. Amended. Re-referred to Com. on HEALTH.
To Com. on HEALTH.
Read third time. Passed. (Ayes 23. Noes 11. Page 3699.) To Assembly.
In Assembly. Read first time. Held at Desk.
Read second time. To third reading.
From committee: Do pass. (Ayes 7. Noes 2. Page 3669.)
(Suspense - for vote only).
Set for hearing May 27.
Placed on APPR suspense file.
From committee with author's amendments. Read second time. Amended. Re-referred to Com. on APPR.
Set for hearing May 24.
Hearing postponed by committee.
Set for hearing May 17.
Hearing postponed by committee.
Set for hearing May 10.
Read second time. Amended. Re-referred to Com. on APPR.
From committee: Do pass as amended, but first amend, and re-refer to Com. on APPR. (Ayes 5. Noes 0. Page 3302.)
Set for hearing April 21.
From committee with author's amendments. Read second time. Amended. Re-referred to Com. on HEALTH.
From committee with author's amendments. Read second time. Amended. Re-referred to Com. on RLS.
To Com. on RLS.
From print. May be acted upon on or after February 21.
Introduced. Read first time. To Com. on RLS. for assignment. To print.
| Bill Text Versions | Format |
|---|---|
| SB890 | HTML |
| 01/21/10 - Introduced | |
| 04/06/10 - Amended Senate | |
| 04/13/10 - Amended Senate | |
| 04/27/10 - Amended Senate | |
| 05/20/10 - Amended Senate | |
| 06/15/10 - Amended Assembly | |
| 08/02/10 - Amended Assembly | |
| 08/16/10 - Amended Assembly | |
| 08/20/10 - Amended Assembly | |
| 08/24/10 - Amended Assembly | |
| 08/25/10 - Amended Assembly | |
| 09/02/10 - Enrolled |
| Document | Format |
|---|---|
| No related documents. |
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