BILL NUMBER: AB 1018	INTRODUCED
	BILL TEXT


INTRODUCED BY   Assembly Member Conway

                        FEBRUARY 22, 2013

   An act to amend Section 1389.5 of the Health and Safety Code,
relating to health care service plans.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1018, as introduced, Conway. Health care service plans:
transfers to different individual plans.
   Existing law, the Knox-Keene Health Care Service Plan Act of 1975
(the Knox-Keene Act), 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
requires a health care service plan to permit an individual who has
been covered for at least 18 months under an individual plan contract
to transfer, without medical underwriting, as defined, to another
individual plan contract offered by the same health care service
plan, that provides equal or lesser benefits.
   This bill would make technical, nonsubstantive changes to these
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 1.  Section 1389.5 of the Health and Safety Code is amended
to read:
   1389.5.  (a) This section shall apply to a health care service
plan that provides coverage under an individual plan contract that is
issued, amended, delivered, or renewed on or after January 1, 2007.
   (b) At least once each year, the health care service plan shall
permit an individual who has been covered for at least 18 months
under an individual plan contract to transfer, without medical
underwriting, to any other individual plan contract offered by that
same health care service plan that provides equal or lesser benefits,
as determined by the plan.
   "Without medical underwriting" means that the health care service
plan shall not decline to offer coverage to, or deny enrollment of,
the individual or impose  any   a 
preexisting condition exclusion on the individual who transfers to
another individual plan contract pursuant to this section.
   (c) The plan shall establish, for the purposes of subdivision (b),
a ranking of the individual plan contracts it offers to individual
purchasers and  either  post the ranking on its Internet Web
site or make the ranking available upon request. The plan shall
update the ranking whenever a new benefit design for individual
purchasers is approved.
   (d) The plan shall notify in writing all enrollees of the right to
transfer to another individual plan contract pursuant to this
section, at a minimum, when the plan changes the enrollee's premium
rate. Posting this information on the plan's Internet Web site shall
not constitute notice for purposes of this subdivision. The notice
shall adequately inform enrollees of the transfer rights provided
under this section, including information on the process to obtain
details about the individual plan contracts available to that
enrollee and advising that the enrollee may be unable to return to
his or her current individual plan contract if the enrollee transfers
to another individual plan contract.
   (e) The requirements of this section shall not apply to the
following:
   (1) A federally eligible defined individual, as defined in
subdivision (c) of Section 1399.801, who is enrolled in an individual
health benefit plan contract offered pursuant to Section 1366.35.
   (2) An individual offered conversion coverage pursuant to Section
1373.6.
   (3) Individual coverage under a specialized health care service
plan contract.
   (4) An individual enrolled in the Medi-Cal program pursuant to
Chapter 7 (commencing with Section 14000) of Division 9 of Part 3 of
the Welfare and Institutions Code.
   (5) An individual enrolled in the Access for Infants and Mothers
Program pursuant to Part 6.3 (commencing with Section 12695) of
Division 2 of the Insurance Code.
   (6) An individual enrolled in the Healthy Families Program
pursuant to Part 6.2 (commencing with Section 12693) of Division 2 of
the Insurance Code.
   (f) It is the intent of the Legislature that individuals 
shall  have more choice in their health coverage when health
care service plans guarantee the right of an individual to transfer
to another product based on the plan's own ranking system. The
Legislature does not intend for the department to review or verify
the plan's ranking for actuarial or other purposes.