AB 1428, as introduced, Conway. California Health Benefit Exchange: employees and contractors.
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 requires the board to employ necessary staff and authorizes the board to enter into contracts.
This bill would require all employees, prospective employees, contractors, subcontractors, and vendors, who facilitate enrollment of persons in a qualified health plan in the Exchange and who, in the course and scope of their employment, have access to the financial or medical information of enrollees or potential enrollees, to be fingerprinted, at appropriate locations determined by the board, for the purpose of obtaining criminal history information. The bill would prohibit a person who has been convicted of felony crimes of dishonesty or breach of trust in a state or federal jurisdiction or other specified crimes from being hired by or contracting with the Exchange for the purpose of facilitating enrollment of persons in a qualified health plan in the Exchange or for any position where, in the course and scope of his or her employment, he or she will have access to the financial or medical information of enrollees or potential enrollees of the Exchange. The bill would also require an applicant to notify the Exchange of any prescribed misdemeanor or felony convictions, filing of charges, or administrative actions.
This bill would declare that it is to take effect immediately as an urgency statute.
Vote: 2⁄3. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
The Legislature finds and declares all of the
2following:
3(a) The mission of the California Health Benefit Exchange
4(Exchange) is to increase the number of insured Californians.
5(b) According to the Exchange, the Assisters Program is
6designed to target populations in California’s vast, geographically
7diverse mix of rural and urban communities, estimated at 4,000,000
8eligible individuals: one hundred thousand in northern California
9and Sierra counties, 130,000 in the Sacramento area, 390,000 in
10the greater Bay Area, 250,000 in the San Joaquin Valley, 140,000
11in the central coast, 780,000 in Los Angeles, and another 750,000
12in southern California.
13(c) According to the Exchange, the Assisters Program is
14designed to target populations within the estimated 4,000,000
15eligible individuals that are ethnically diverse: 1,880,000 estimated
16to be Hispanic, 1,340,000 Caucasian, 470,000 Asian, and 210,000
17African American.
18(d) According to the Exchange, the Assisters Program will
19conduct outreach, education, marketing, and enrollment for the
20Exchange to reach the estimated 4,000,000 eligible individuals.
P3 1(e) The Assisters Program is expected to promote maximum
2enrollment of individuals into coverage and ensure that assisters
3are knowledgeable of both subsidized and nonsubsidized health
4care coverage and qualified health plans and are equipped with
5the information and expertise needed to successfully enroll
6individuals into coverage.
7(f) The Exchange will use individual assisters, in-person
8assisters, and navigators in the Assisters Program to accomplish
9these goals.
10(g) Individual assisters, in-person assisters, and navigators will,
11necessarily, have access to eligible individuals’ personal identifying
12information, including social security numbers, personal health
13information, and state and federal tax information, to enroll over
144,000,000 Californians in health insurance programs.
15(h) Agents and brokers, health insurers, and other entities that
16currently handle applications for health care coverage and the
17applicant’s sensitive, personal information are required to be
18licensed by the Department of Insurance.
19(i) The Department of Insurance, by law, is authorized to require
20
applicants for licensure to pass background checks, including
21fingerprinting, as a condition of licensure.
22(j) It is in the public’s interest that eligible individuals
23purchasing health care coverage through the services of an
24individual assister, in-person assister, or navigator have the same
25reasonable expectation of privacy protections afforded to
26Californians purchasing health care coverage through a private
27agent or broker.
28(k) To advance the public’s interest in protecting and
29safeguarding eligible individuals from the unauthorized and illegal
30access to, or disclosure of, their personal identifying information,
31personal health information, or federal tax information when the
32Exchange begins enrolling customers into health care plans for
33coverage beginning as early as January 1, 2014.
Section 100523 is added to the Government Code, to
35read:
(a) The board shall require all employees, prospective
37employees, contractors, subcontractors, and vendors, who facilitate
38enrollment of persons in a qualified health plan in the Exchange
39and who, in the course and scope of their employment, have access
40to the financial or medical information of enrollees or potential
P4 1enrollees of the Exchange, to be fingerprinted, at appropriate
2locations determined by the board, for the purpose of obtaining
3criminal history information.
4(b) A person who has been convicted of any felony crimes of
5dishonesty or breach of trust in a state or federal jurisdiction, who
6has been convicted of any violation of Section 1033 of Title 18 of
7the United States Code, or who has been convicted of any crime
8included in
Section 2183.2 of Title 10 of the California Code of
9Regulations shall not be hired by or contract with the Exchange
10for the purpose of facilitating enrollment of persons in a qualified
11health plan in the Exchange or for any position where, in the course
12and scope of his or her employment, he or she will have access to
13the financial or medical information of enrollees or potential
14enrollees of the Exchange.
15(c) A person who has applied for employment with the Exchange
16for any position where, in the course and scope of his or her
17employment, he or she will have access to the financial or medical
18information of enrollees or potential enrollees of the Exchange
19shall immediately notify the Exchange upon any misdemeanor or
20felony conviction, any filing of felony charges in state or federal
21court, any administrative action regarding a professional or
22occupational license, or any conviction listed in subdivision (b),
23if the action occurs after an
application has been submitted.
This act is an urgency statute necessary for the
25immediate preservation of the public peace, health, or safety within
26the meaning of Article IV of the Constitution and shall go into
27immediate effect. The facts constituting the necessity are:
28In order to protect and safeguard customers from the
29unauthorized and illegal access to, or disclosure of, their personal
30identifying information, personal health information, or federal
31tax information when the California Health Benefit Exchange
32begins enrolling customers into health care plans for coverage
33beginning as early as January 1, 2014, it is necessary that this act
34take effect immediately.
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