BILL NUMBER: AB 98	AMENDED
	BILL TEXT

	AMENDED IN SENATE  SEPTEMBER 4, 2009
	AMENDED IN ASSEMBLY  APRIL 13, 2009

INTRODUCED BY   Assembly Member De La Torre
   (Coauthors: Assembly Members Ammiano, Brownley, Caballero, Carter,
Chesbro, Eng, Galgiani, Jones, Krekorian, Bonnie Lowenthal, Ma,
Monning, Ruskin, Salas, Skinner, Torlakson, Torres, and Yamada)
   (Coauthors: Senators DeSaulnier, Hancock, Negrete McLeod, and
Wolk)

                        JANUARY 6, 2009

   An act to add Section 10123.865 to the Insurance Code, relating to
health care coverage.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 98, as amended, De La Torre. Maternity services.
   Existing law provides for the regulation of health insurers by the
Department of Insurance. Under existing law, a health insurer that
provides maternity coverage may not restrict inpatient hospital
benefits, as specified, and is required to provide notice of the
maternity services coverage. 
   This bill would require specified health insurance policies to
provide coverage for maternity services, as defined.  
   This bill would require new forms for health insurance policies
submitted to the department after January 1, 2010, to provide
coverage for maternity services, as defined. With respect to policy
forms on file with the department as of January 1, 2010, the bill
would require health insurers to submit to the department, on or
before March 1, 2010, revised policy forms that provide coverage for
maternity services and would require insurers to include that
coverage in the corresponding policies that are issued, amended, or
renewed following the department's approval of the revised forms, as
specified. 
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  The Legislature finds and declares the following:
   (a) In actual practice, health care service plans have been
required by the Knox-Keene Health Care Service Plan Act of 1975
(Chapter 2.2 (commencing with Section 1340) of Division 2 of the
Health and Safety Code) to provide maternity services as a basic
health care benefit.
   (b) At the same time, existing law does not require health
insurers to provide designated basic health care services and,
therefore, health insurers are not required to provide coverage for
maternity services.
   (c) Therefore, it is essential to clarify that all health coverage
made available to California consumers, whether issued by health
care service plans regulated by the Department of Managed Health Care
or by health insurers regulated by the Department of Insurance, must
include maternity services.
  SEC. 2.  Section 10123.865 is added to the Insurance Code, to read:

   10123.865.  (a) Every individual or group policy of health
insurance that covers hospital, medical, or surgical expenses and
that is issued, amended, renewed, or delivered on or after January 1,
2010, shall provide coverage for maternity services. For the

    10123.865.   (a) With respect to a pending or
approved individual or group health insurance policy form on file
with the department as of January 1, 2010, a health insurer shall
submit to the department, on or before March 1, 2010, a revised
policy form that provides coverage for maternity services. The
corresponding policy issued, amended, or renewed on or after 30 days
following the department's approval of the revised form shall include
coverage for maternity services.  
   (b) New forms for individual or group policies of health insurance
submitted to the department after January 1, 2010, shall provide
coverage for maternity services. 
    (c)    For  purposes of this section,
"maternity services" include prenatal care, ambulatory care maternity
services, involuntary complications of pregnancy, neonatal care, and
inpatient hospital maternity care, including labor and delivery and
postpartum care. 
   (b) 
    (d)  This section shall not apply to specialized health
insurance, Medicare supplement  insurance  , short-term
limited duration health insurance, CHAMPUS-supplement insurance,
 TRI-CARE supplement   or TRI-CARE supplement
insurance  , or to hospital indemnity, accident-only, or
specified disease insurance.