BILL NUMBER: AB 1461	INTRODUCED
	BILL TEXT


INTRODUCED BY   Assembly Member Monning
   (Principal coauthor: Senator Hernandez)

                        JANUARY 9, 2012

   An act to add Section 10961 to the Insurance Code, relating to
health insurance.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1461, as introduced, Monning. Health insurance.
   Existing law provides for the licensing and regulation of health
insurers by the Insurance Commissioner. Existing law provides for
licensing and regulation of health care service plans by the
Department of Managed Health Care. The California Health Benefit
Exchange is governed by a board and the board is required to
facilitate enrollment of qualified individuals in qualified health
plans.
   Existing federal law, the federal Patient Protection and
Affordable Care Act, commencing on and after January 1, 2014,
requires each health insurance issuer that offers health insurance
coverage in the individual or group market in a state to accept every
employer and individual in the state that applies for that coverage
and requires the issuer to renew that coverage. Existing federal law,
commencing on and after January 1, 2014, prohibits discriminatory
premium rates charged by a health insurance issuer for health
insurance coverage offered in the individual or small group market,
as specified, and also prohibits discrimination against individuals
based on health status. Existing federal law, commencing on and after
January 1, 2014, except as otherwise specified, prohibits a group
health plan and a health insurance issuer offering group or
individual health insurance coverage from imposing any preexisting
condition exclusion with respect to that plan or coverage.
   This bill would, consistent with federal law, commencing on and
after January 1, 2014, require a health insurer to comply with these
federal requirements. The bill would require the commissioner to
consult and coordinate with the department and the Exchange in
carrying out these provisions. The bill would also authorize the
commissioner, in consultation with the department, to adopt
regulations to carry out these provisions.
   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.  Section 10961 is added to the Insurance Code, to read:
   10961.  (a) To the extent required by federal law, commencing on
and after January 1, 2014, every health insurer shall comply with the
following provisions related to the offer, sale, issuance, and
renewal of individual health benefit plans, consistent with federal
law and implementing rules, regulations, and federal guidance:
   (1) Guaranteed availability of coverage pursuant to Section 2702
of the Public Health Service Act (42 U.S.C. Sec. 300gg-1).
   (2) Guaranteed renewability of coverage pursuant to Section 2703
of the Public Health Service Act (42 U.S.C. Sec. 300gg-2).
   (3) The portability and nondiscrimination provisions in Sections
2701, 2704, and 2705 of the Public Health Service Act (42 U.S.C.
Secs. 300gg, 300gg-3, and 300gg-4).
   (b) The commissioner shall consult and coordinate with the
Department of Managed Health Care in the implementation and
enforcement of this section to ensure uniform and consistent rules,
regulations, guidance, and enforcement for health benefit plans sold
to individuals in this state.
   (c) In implementing this section, the commissioner shall, in
addition to the requirements in subdivision (b), consult and
coordinate with the California Health Benefit Exchange established
pursuant to Section 100500 of the Government Code.
   (d) The commissioner may, in consultation with the Department of
Managed Health Care, adopt regulations implementing this section,
pursuant to the Administrative Procedure Act (Chapter 3.5 (commencing
with Section 11340) of Part 1 of Division 3 of Title 2 of the
Government Code).