BILL NUMBER: AB 98	ENROLLED
	BILL TEXT

	PASSED THE SENATE  SEPTEMBER 9, 2009
	PASSED THE ASSEMBLY  SEPTEMBER 10, 2009
	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, 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 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.


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) 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.
   (d) This section shall not apply to specialized health insurance,
Medicare supplement insurance, short-term limited duration health
insurance, CHAMPUS-supplement insurance, or TRI-CARE supplement
insurance, or to hospital indemnity, accident-only, or specified
disease insurance.