Ed Hernandez
- Democratic
Author
Commencing January 1, 2014, existing law, the federal Patient Protection and Affordable Care Act (PPACA) , requires a health insurance issuer that offers coverage in the small group or individual market to ensure that such coverage includes the essential health benefits package, as defined. PPACA requires each state to, by January 1, 2014, establish an American Health Benefit Exchange that facilitates the purchase of qualified health plans by qualified individuals and qualified small employers. PPACA defines a qualified health plan as a plan that, among other requirements, provides an essential health benefits package. Existing state law creates the California Health Benefit Exchange (the Exchange) to facilitate the purchase of qualified health plans by qualified individuals and qualified small employers by January 1, 2014. Existing law provides for the regulation of health insurers by the Department of Insurance and requires health insurance policies to cover various benefits. This bill would require an individual or small group health insurance policy issued, amended, or renewed on or after January 1, 2014, to cover essential health benefits, which would be defined to include the health benefits covered by particular benchmark plans. The bill would prohibit treatment limits imposed on these benefits from exceeding the corresponding limits imposed by the benchmark plans and would generally prohibit an insurer from making substitutions of the benefits required to be covered. The bill would specify that these provisions apply regardless of whether the policy is offered inside or outside the Exchange but would provide that they do not apply to grandfathered plans or plans that cover excepted benefits, as specified. The bill would prohibit a health insurer, when issuing, delivering, renewing, offering, selling, or marketing a policy, from indicating or implying that the policy covers essential health benefits unless the policy covers essential health benefits as provided in the bill. The bill would authorize the Department of Insurance to adopt emergency regulations implementing these provisions until March 1, 2016, and enact other related provisions. These provisions would only be implemented to the extent essential health benefits are required pursuant to PPACA. The bill would provide that it shall become operative only if AB 1453 is also enacted.
Chaptered by Secretary of State. Chapter 866, Statutes of 2012.
Approved by the Governor.
Enrolled and presented to the Governor at 2:30 p.m.
Assembly amendments concurred in. (Ayes 22. Noes 13. Page 4979.) Ordered to engrossing and enrolling.
Read third time. Passed. (Ayes 52. Noes 27. Page 6451.) Ordered to the Senate.
In Senate. Concurrence in Assembly amendments pending.
Read third time and amended. (Ayes 51. Noes 25. Page 6259.)
Ordered to third reading.
Read second time. Ordered to third reading.
Read second time and amended. Ordered to second reading.
From committee: Do pass as amended. (Ayes 12. Noes 5.) (August 16).
Set, first hearing. Referred to APPR. suspense file.
From committee: Do pass and re-refer to Com. on APPR. (Ayes 11. Noes 5.) (July 3). Re-referred to Com. on APPR.
Read third time. Passed. (Ayes 25. Noes 13. Page 3427.) Ordered to the Assembly.
In Assembly. Read first time. Held at Desk.
Read second time. Ordered to third reading.
From committee: Do pass. (Ayes 5. Noes 2. Page 3387.) (April 30).
Set for hearing April 30.
Read second time and amended. Re-referred to Com. on APPR.
From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 6. Noes 3. Page 3142.) (April 11).
Set for hearing April 11.
From committee with author's amendments. Read second time and amended. Re-referred to Com. on RLS.
From printer. May be acted upon on or after February 5.
Introduced. Read first time. To Com. on RLS. for assignment. To print.
| Bill Text Versions | Format |
|---|---|
| SB951 | HTML |
| 01/05/12 - Introduced | |
| 03/26/12 - Amended Senate | |
| 04/16/12 - Amended Senate | |
| 08/20/12 - Amended Assembly | |
| 08/24/12 - Amended Assembly | |
| 08/31/12 - Enrolled | |
| 09/30/12 - Chaptered |
| Document | Format |
|---|---|
| No related documents. |
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