BILL NUMBER: AB 1102	AMENDED
	BILL TEXT

	AMENDED IN SENATE  JULY 9, 2015
	AMENDED IN ASSEMBLY  JUNE 3, 2015
	AMENDED IN ASSEMBLY  MAY 5, 2015
	AMENDED IN ASSEMBLY  MARCH 26, 2015

INTRODUCED BY   Assembly Member Santiago

                        FEBRUARY 27, 2015

   An act to  amend Section 1399.849 of the Health and Safety
Code, and to amend Section 10965.3 of the Insurance Code, 
  add Section 15849 to the Welfare and Institutions Code, 
relating to health care coverage.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1102, as amended, Santiago. Health care coverage: 
special enrollment periods: triggering event.   Medi-Cal
Access Program: disclosures.  
   Existing federal law, the Patient Protection and Affordable Care
Act (PPACA), enacts various health care coverage market reforms as of
January 1, 2014. Among other things, PPACA requires each state to
establish an American Health Benefits Exchange and allows qualified
individuals to obtain premium assistance for coverage purchased
through the Exchange. PPACA specifies that this premium assistance is
not available if the individual is eligible for affordable
employer-sponsored coverage that provides minimum value, as
specified.  
   Existing law establishes the Medi-Cal Access Program, administered
by the State Department of Health Care Services. Existing law
creates the California Major Risk Medical Insurance Program (MRMIP),
which is administered by the Managed Risk Medical Insurance Board, to
arrange for major risk medical coverage for eligible residents of
the state who are unable to secure adequate private health care
coverage.  
   This bill would require the State Department of Health Care
Services to inform applicants who are rejected for Medi-Cal Access
Program coverage of other coverage options through MRMIP and Covered
California, and direct applicants how to receive more information on
Covered California and MRMIP, as specified.  
   Existing federal law, the Patient Protection and Affordable Care
Act (PPACA), enacts various health care coverage market reforms as of
January 1, 2014. Among other things, PPACA requires each state, by
January 1, 2014, to establish an American Health Benefit Exchange
that facilitates the purchase of qualified health plans by qualified
individuals and qualified small employers, and requires each exchange
to provide for an initial open enrollment period, annual open
enrollment periods, and special enrollment periods. 

   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.
Existing law requires a health care service plan or health insurer,
on and after October 1, 2013, to offer, market, and sell all of the
plan's or insurer's health benefit plans that are sold in the
individual market for policy years on or after January 1, 2014, to
all individuals and dependents in each service area in which the plan
or insurer provides or arranges for the provision of health care
services, as specified, but requires plans and insurers to limit
enrollment in individual health benefit plans to specified open
enrollment and special enrollment periods. Existing law requires a
health care service plan and health insurer to allow an individual to
enroll in or change individual health benefit plans as a result of
specified triggering events, including that he or she gains a
dependent.  
   This bill would require, on and after January 1, 2017, and until
October 1, 2020, a health care service plan or health insurer to
allow an individual who does not have minimum essential coverage to
enroll in an individual health benefit plan if the individual becomes
pregnant. Because a willful violation of this requirement by a
health care service plan would be a crime, this bill would impose a
state-mandated local program.  
   The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.  
   This bill would provide that no reimbursement is required by this
act for a specified reason. 
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program:  yes   no  .


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

   SECTION 1.    Section 15849 is added to the 
 Welfare and Institutions Code   , to read:  
   15849.  If an applicant is rejected for coverage, the department
shall inform the applicant about the California Major Risk Medical
Insurance Program (MRMIP) (Part 6.5 (commencing with Section 12700)
of Division 2 of the Insurance Code) and about the coverage options
and the potential for subsidized coverage through Covered California.
The department shall direct persons seeking more information to
MRMIP, Covered California, plan or policy representatives, insurance
agents, or an entity paid by Covered California to assist with health
coverage enrollment, such as a navigator or an assister.  All
matter omitted in this version of the bill appears in the bill as
amended in the Assembly, June 3, 2015. (JR11)