AB 710, as introduced, Pan. Review of rate increases: California Health Benefit Exchange.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Under the federal Patient Protection and Affordable Care Act (PPACA), each state is required, by January 1, 2014, to establish an American Health Benefit Exchange that makes available qualified health plans to qualified individuals and small employers. Existing state law establishes the California Health Benefit Exchange (Exchange) within state government, specifies the powers and duties of the board governing the Exchange, and requires the board to facilitate the purchase of qualified health plans through the Exchange by qualified individuals and small employers by January 1, 2014. Existing law provides that, for the purposes of provisions relating to review of rate increases by health care service plan contracts and health insurance policies, specified definitions shall apply.
This bill would add the definition of “Exchange” to those provisions.
Vote: majority. Appropriation: no. Fiscal committee: no. State-mandated local program: no.
The people of the State of California do enact as follows:
Section 1385.01 of the Health and Safety Code
2 is amended to read:
For purposes of this article, the following definitions
4shall apply:
5(a) “Exchange” means the California Health Benefit Exchange
6created by Section 100500 of the Government Code.
7(a)
end delete
8begin insert(b)end insert “Large group health care service plan contract” means a
9group health care service
plan contract other than a contract issued
10to a small employer, as defined in Section 1357, 1357.500, or
111357.600.
12(b)
end delete
13begin insert(c)end insert “Small group health care service plan contract” means a
14group health care service plan contract issued to a small employer,
15as defined in Section 1357, 1357.500, or 1357.600.
16(c)
end delete
17begin insert(d)end insert “PPACA” means Section 2794 of the
federal Public Health
18Service Act (42 U.S.C. Sec. 300gg-94), as amended by the federal
19Patient Protection and Affordable Care Act (Public Law
20(111-148)), and any subsequent rules, regulations, or guidance
21issued under that section.
22(d)
end delete
23begin insert(e)end insert “Unreasonable rate increase” has the same meaning as that
24term is defined in PPACA.
Section 10181 of the Insurance Code is amended to
26read:
For purposes of this article, the following definitions
28shall apply:
29(a) “Exchange” means the California Health Benefit Exchange
30created by Section 100500 of the Government Code.
31(a)
end delete
32begin insert(b)end insert “Large group health insurance policy” means a group health
33insurance policy other than
a policy issued to a small employer,
34as defined in Section 10700, 10753, or 10755.
35(b)
end delete
P3 1begin insert(c)end insert “Small group health insurance policy” means a group health
2insurance policy issued to a small employer, as defined in Section
310700, 10753, or 10755.
4(c)
end delete
5begin insert(d)end insert “PPACA” means Section 2794 of the federal Public Health
6Service Act (42 U.S.C. Sec. 300gg-94),
as amended by the federal
7Patient Protection and Affordable Care Act (Public Law 111-148),
8and any subsequent rules, regulations, or guidance issued pursuant
9to that law.
10(d)
end delete
11begin insert(e)end insert “Unreasonable rate increase” has the same meaning as that
12term is defined in PPACA.
O
99