Carol Liu
- Democratic
Author
Under existing law, the Department of Insurance, headed by the Insurance Commissioner, licenses and regulates insurers. Existing law divides insurance into various classes, including long-term care insurance, which includes an insurance policy, certificate, or rider advertised, marketed, offered, solicited, or designed to provide coverage for diagnostic, preventive, therapeutic, rehabilitative, maintenance, or personal care services that are provided in a setting other than an acute care unit of a hospital. Existing law defines "policy" for these purposes. This bill would, among other things, define "alternate plan of care" as a plan of care developed by a licensed health care practitioner that includes a specification of long-term care services required by an insured that are not specifically defined as a covered service under the policy. The bill would also define "alternate-plan-of-care provision" to mean a provision in a policy, rider, endorsement, or amendment that allows benefits for services specified in an alternate plan of care. The bill would authorize, for policies issued on or after January 1, 2017, the insured or an insurer to propose an alternate plan of care. The bill would also prohibit the maximum benefit available under the contract from being changed based on an insured utilizing an alternate plan of care but would authorize the maximum benefit to be reduced by the amount of any benefits paid under an alternate plan of care. The bill would also require coverage for services under an alternate plan of care to be in addition to, not in lieu of, coverage for services specifically defined as covered services under the policy. The bill would also require an insurer, within 60 days, to provide a written explanation to the policyholder or certificate holder as to the specific reason an agreement cannot be reached for policies or certificates that contain an alternate plan of care provision, as specified.
Chaptered by Secretary of State. Chapter 589, Statutes of 2016.
Approved by the Governor.
Enrolled and presented to the Governor at 5 p.m.
Assembly amendments concurred in. (Ayes 39. Noes 0. Page 5448.) Ordered to engrossing and enrolling.
In Senate. Concurrence in Assembly amendments pending.
Read third time. Passed. (Ayes 80. Noes 0. Page 6227.) Ordered to the Senate.
Ordered to third reading.
Read third time and amended.
Ordered to third reading.
From consent calendar on motion of Assembly Member Calderon.
Read second time. Ordered to consent calendar.
From committee: Do pass. Ordered to consent calendar. (Ayes 13. Noes 0.) (June 22).
From committee with author's amendments. Read second time and amended. Re-referred to Com. on INS.
In Assembly. Read first time. Held at Desk.
Read third time. Passed. (Ayes 37. Noes 0. Page 3873.) Ordered to the Assembly.
Read second time. Ordered to third reading.
From committee: Be ordered to second reading pursuant to Senate Rule 28.8.
Set for hearing May 9.
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 8. Noes 0. Page 3560.) (April 13).
From committee with author's amendments. Read second time and amended. Re-referred to Com. on INS.
Set for hearing April 13.
From printer. May be acted upon on or after March 19.
Introduced. Read first time. To Com. on RLS. for assignment. To print.
| Bill Text Versions | Format |
|---|---|
| SB1091 | HTML |
| 02/17/16 - Introduced | |
| 04/04/16 - Amended Senate | |
| 04/19/16 - Amended Senate | |
| 06/15/16 - Amended Assembly | |
| 08/18/16 - Amended Assembly | |
| 08/30/16 - Enrolled | |
| 09/24/16 - Chaptered |
| Document | Format |
|---|---|
| No related documents. |
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