BILL NUMBER: SB 222	ENROLLED
	BILL TEXT

	PASSED THE SENATE  SEPTEMBER 8, 2011
	PASSED THE ASSEMBLY  SEPTEMBER 7, 2011
	AMENDED IN ASSEMBLY  SEPTEMBER 2, 2011

INTRODUCED BY   Senators Evans and Alquist
   (Coauthor: Senator De León)
   (Coauthors: Assembly Members Alejo, Ammiano, Blumenfield, Huffman,
and Bonnie Lowenthal)

                        FEBRUARY 9, 2011

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


	LEGISLATIVE COUNSEL'S DIGEST


   SB 222, Evans. 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, commencing July 1, 2012, would require every individual
health insurance policy to provide coverage for maternity services
for all insureds covered under the policy.
   This bill would become operative only if AB 210 of the 2011-12
Regular Session is also enacted.


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 care
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) Commencing no later than July 1, 2012, every
individual health insurance policy shall provide coverage for
maternity services for all insureds covered under the policy.
   (b) 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.
This definition of "maternity services" shall remain in effect until
such time as federal regulations and guidance issued pursuant to the
federal Patient Protection and Affordable Care Act (Public Law
111-148) define the scope of benefits to be provided under the
maternity benefit requirement of that act, after which time the
definition of that term under the federal act and associated
regulations and guidance shall apply for purposes of this section.
   (c) 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.
  SEC. 3.  This act shall become operative only if Assembly Bill 210
of the 2011-12 Regular Session is also enacted and takes effect.