BILL ANALYSIS �
AB 402
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ASSEMBLY THIRD READING
AB 402 (Ammiano)
As Introduced February 15, 2013
Majority vote
INSURANCE 12-1
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|Ayes:|Perea, Hagman, Bonilla, | | |
| |Bradford, Ian Calderon, | | |
| |Cooley, Frazier, | | |
| |Mitchell, Nestande, | | |
| |Olsen, Torres, Wieckowski | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Beth Gaines | | |
| | | | |
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SUMMARY : Requires disability income insurance policies to cover
disability caused by severe mental illness. Specifically, this
bill :
1)Defines severe mental illness as:
a) Schizophrenia;
b) Schizoaffective disorder;
c) Bipolar disorder;
d) Major depressive disorders;
e) Panic disorder;
f) Obsessive-compulsive disorder;
g) Pervasive developmental disorder or autism;
h) Anorexia nervosa;
i) Bulimia nervosa.
2)Requires every disability income insurance policy issued,
amended, or renewed on or after January 1, 2014, to provide
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coverage for disability resulting from severe mental illness.
EXISTING LAW :
1)Provides disability benefits to participants in the State
Disability Insurance (SDI) program when they are disabled by
mental illness.
2)Requires health insurers and health care service plans to
provide coverage for the diagnosis and treatment of severe
mental illness and the severe emotional disturbance of a child
on the same terms as a physical illness.
3)Defines severe mental illness for the health insurers and
health care service plans to include:
a) Schizophrenia;
b) Schizoaffective disorder;
c) Bipolar disorder;
d) Major depressive disorders;
e) Panic disorder;
f) Obsessive-compulsive disorder;
g) Pervasive developmental disorder or autism;
h) Anorexia nervosa;
i) Bulimia nervosa.
FISCAL EFFECT : Unknown. This bill is keyed non-fiscal by the
Legislative Counsel.
COMMENTS :
1)Purpose . According to the author, approximately 1.2 million
adults live with serious mental illness. Most of these adults
continue to work right through their mental illness utilizing
sick days on occasion when symptoms are severe. Occasionally,
employees may need a longer period of time to adequately
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recover from a severe mental illness or transition onto a new
medication. California SDI can pay for a portion of an
employee's salary but many rely on short term disability
income insurance to make up the remaining lost wages and allow
an injured person to continue paying their bills. When these
policies exclude coverage for mental illness or injury,
families are left with choosing to work against their doctor's
orders or bearing unmanageable financial burdens.
2)Disability Income Insurance . Disability income insurance pays
supplemental income benefits for a short period of time when
the insured is injured or sick. These policies may be
purchased by individuals or can be offered as an employee
benefit. Many employees or individuals have the option to
purchase a short term disability income plan, some employers
offer short term disability insurance as an employment
benefit. Policies vary in regards to exclusions for severe
mental illness.
3)Mental Health Parity . Since 2000, California law has required
health care service plans and health insurers to provide
coverage for the diagnosis and treatment of severe mental
illnesses and the serious emotional disturbances of a child
under the same terms and conditions applied to other medical
conditions. For covered conditions, health plans may not
limit benefits and or impose share-of-cost requirements that
render mental health benefits less comprehensive than physical
health benefits.
4)Policy Approval Delay . The bill has the effect of requiring
every insurer offering disability income insurance to revise
their policy and submit it to the Department of Insurance
(department) for review and approval prior to offering that
policy in the market. It is common for the department to take
years to review and approve revised policies. Accordingly,
the author may wish to consider delaying implementation of
this bill to allow insurers time to have their revised
policies reviewed and approved by the department.
Analysis Prepared by : Paul Riches / INS. / (916) 319-2086
FN: 0000288
AB 402
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