BILL NUMBER: SB 615	CHAPTERED
	BILL TEXT

	CHAPTER  266
	FILED WITH SECRETARY OF STATE  SEPTEMBER 7, 2012
	APPROVED BY GOVERNOR  SEPTEMBER 7, 2012
	PASSED THE SENATE  AUGUST 21, 2012
	PASSED THE ASSEMBLY  AUGUST 9, 2012
	AMENDED IN ASSEMBLY  AUGUST 6, 2012
	AMENDED IN ASSEMBLY  JUNE 18, 2012
	AMENDED IN SENATE  MAY 10, 2011
	AMENDED IN SENATE  APRIL 13, 2011

INTRODUCED BY   Senator Calderon

                        FEBRUARY 18, 2011

   An act to amend Section 742.40 of the Insurance Code, relating to
insurance.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 615, Calderon. Multiple employer welfare arrangements:
benefits.
   Commencing January 1, 2014, existing law, the federal Patient
Protection and Affordable Care Act (PPACA), requires a health
insurance issuer that offers coverage in the small group or
individual market to ensure that such coverage includes the essential
health benefits package, as defined. Under existing federal law, a
health insurance issuer, defined to include an insurance company,
insurance service, or insurance organization including a health
maintenance organization and excluding a group health plan, that
offers health insurance coverage in the individual or small group
market is required to ensure that such coverage includes the
essential health benefits package. Commencing January 1, 2014,
existing law requires specified individuals to ensure that they are
covered under minimum essential coverage and a penalty is required to
be imposed for failure to comply with that requirement.
   Existing law prohibits a self-funded or partially self-funded
multiple employer welfare arrangement (MEWA) from providing any
benefits for any resident of this state without obtaining a
certificate of compliance from the Insurance Commissioner. Existing
law imposes various eligibility requirements on a self-funded or
partially self-funded MEWA in order to obtain a certificate of
compliance, including, among other things, that it be a nonprofit
corporation, that it be established and maintained by a specified
association with at least 200 paid members, and that benefits be
offered only to association members.
    Under existing law, a self-funded or partially self-funded MEWA
is limited to providing certain benefits that include, among other
things, medical, dental, and surgical benefits. Under existing law, a
MEWA is required to offer health care coverage benefits to any newly
eligible person and his or her dependents under terms and conditions
no less favorable than those offered to the MEWA employers' existing
employees and their dependents under specified circumstances.
   This bill would, commencing January 1, 2014, prohibit a MEWA from
offering, marketing, representing, or selling any product, contract,
or discount arrangement as minimum essential coverage or as compliant
with the essential health benefits requirement under the federal
Patient Protection and Affordable Care Act, unless it meets the
applicable requirements under that act.


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

  SECTION 1.  Section 742.40 of the Insurance Code is amended to
read:
   742.40.  (a) A multiple employer welfare arrangement shall offer
health care coverage benefits to any new eligible person and his or
her dependents under terms and conditions no less favorable to those
offered to their employers' existing employees and their dependents,
if the newly eligible person had health care benefit coverage with
either the same or a different multiple employer welfare arrangement
within 31 days. The new coverage shall comply with existing
eligibility rules of the multiple employer welfare arrangement.
   (b) A multiple employer welfare arrangement shall comply with the
requirements set forth in Sections 10198.7 and 10198.9.
   (c) Notwithstanding any other provision of law, commencing January
1, 2014, a multiple employer welfare arrangement shall not offer,
market, represent, or sell any product, contract, or discount
arrangement as minimum essential coverage or as compliant with the
essential health benefits requirement under the federal Patient
Protection and Affordable Care Act, unless it meets the applicable
requirements under that act.