BILL NUMBER: SB 890	AMENDED
	BILL TEXT

	AMENDED IN SENATE  APRIL 6, 2010

INTRODUCED BY   Senator Alquist

                        JANUARY 21, 2010

   An act  to add Section 10112.56 to the Insurance Code, 
relating to health care coverage.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 890, as amended, Alquist. Health care  coverage.
  coverage: basic health care services. 
   Existing law  , the Knox-Keene Health Care Service Plan Act of
1975,  provides for  licensing   the
licensure  and regulation of health care service plans by the
Department of Managed Health Care. Existing law provides for 
licensing and   the  regulation of health insurers
by the Department of Insurance. Existing law  creates
various programs to provide health care services to persons of
limited incomes, including the Medi-Cal program and the Healthy
Families Program   requires health care service plan
contracts and health insurance policies to provide coverage for
certain benefits. Under existing law, health care service plan
contracts are required, subject to certain exemptions, to provide
basic health care services, as defined, among other benefits  .

   This bill would state the intent of the Legislature to implement
federal health care reforms by enacting specified legislation in that
regard. 
   This bill would require health insurance policies issued, amended,
or renewed on or after January 1, 2011, to provide coverage for
medically necessary basic health care services, as defined, and would
prohibit those policies from imposing annual or lifetime limits on
basic health care services. 
   Vote: majority. Appropriation: no. Fiscal committee:  no
  yes  . State-mandated local program: no.


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

   SECTION 1.    Section 10112.56 is added to the 
 Insurance Code  , to read:  
   10112.56.  (a) For purposes of this section, "basic health care
services" has the same meaning as set forth in Section 1345 of the
Health and Safety Code and in Section 1300.67 of Title 28 of the
California Code of Regulations.
   (b) A health insurance policy issued, amended, or renewed on or
after January 1, 2011, shall provide coverage for medically necessary
basic health care services.
   (c) A health insurance policy issued, amended, or renewed on or
after January 1, 2011, shall have no annual or lifetime limits on
basic health care services.
   (d) Nothing in this section shall prohibit a health insurer from
charging policyholders or insureds a copayment or a deductible for a
basic health care service or from setting forth, by contract,
limitations on maximum coverage of basic health care services,
provided that the copayments, deductibles, or limitations are
reported to, and held unobjectionable by, the commissioner and set
forth to the policyholder or insured pursuant to the disclosure
provisions of Section 10604.
   (e) This section shall not apply to specialized health insurance
policies, Medicare supplement policies, CHAMPUS-supplement insurance
policies, TRICARE supplement insurance policies, accident-only
insurance policies, or insurance policies excluded from the
definition of "health insurance" under subdivision (b) of Section
106.  
  SECTION 1.    (a) It is the intent of the
Legislature to implement federal health care reform legislation.
   (b) In order to accomplish this goal, the Legislature proposes to
take, at a minimum, all of the following steps by enacting
legislation in that regard:
   (1) Enacting and enforcing health insurance market reforms,
including, but not limited to, increasing the limiting age for
dependent coverage, and addressing rescission, preexisting condition
exclusions, rating rules, medical loss ratios, waiting periods,
annual and lifetime limits, and guaranteed issue.
   (2) Expanding Medi-Cal coverage to medically indigent adults.
   (3) Modifying the provisions relating to the Major Risk Medical
Insurance Program in order to make the state eligible for federal
funding.