Amended in Senate April 20, 2015

Senate BillNo. 514


Introduced by Senator Anderson

February 26, 2015


begin deleteAn act to amend Section 11344.1 of the Government Code, relating to administrative procedures. end deletebegin insertAn act to amend Section 100503 of the Government Code, relating to health care coverage, and declaring the urgency thereof, to take effect immediately.end insert

LEGISLATIVE COUNSEL’S DIGEST

SB 514, as amended, Anderson. begin deleteCalifornia Regulatory Notice Register. end deletebegin insertCalifornia Health Benefit Exchange.end insert

begin insert

Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA), enacts various health care coverage market reforms that took effect January 1, 2014. Among other things, PPACA requires each health insurance issuer that offers health insurance coverage in the individual or group market in a state to accept every employer and individual in the state that applies for that coverage and to renew that coverage at the option of the plan sponsor or the individual. PPACA also requires each state to establish an American Health Benefit Exchange that facilitates the purchase of qualified health plans by qualified individuals and qualified small employers, as specified.

end insert
begin insert

Existing 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. Existing law requires the board, among other things, to determine the criteria and process for eligibility, enrollment, and disenrollment of enrollees and potential enrollees in the Exchange and coordinate that process with state and local government entities administering other specified health care coverage programs, as specified.

end insert
begin insert

This bill would additionally require the board, without unreasonable delay, to allow an applicant to indicate in an application for health care coverage whether or not the applicant would like assistance with completing the application from an Exchange certified insurance agent or certified enrollment counselor. The bill would prohibit the Exchange from disclosing any personal information, as defined, that was obtained from the application for health care coverage to a certified insurance agent or certified enrollment counselor until the Exchange has complied with the provision described above. The bill would also prohibit the Exchange from disclosing personal information that was obtained from the application for health care coverage to a certified insurance agent or certified enrollment counselor if the applicant indicates that the applicant does not want assistance from an Exchange certified insurance agent or certified enrollment counselor. The bill would provide that these provisions do not preclude the Exchange from sharing the information of current enrollees or applicants with the same certified enrollment counselor or certified insurance agent of record that provided the applicant assistance with an existing application, or their successor or authorized staff, as specified.

end insert
begin insert

This bill would declare that it is to take effect immediately as an urgency statute.

end insert
begin delete

Existing law governs the procedure for the adoption, amendment, or repeal of regulations by state agencies and for the review of those regulatory actions by the Office of Administrative Law. Existing law requires the office to provide for the publication of the California Regulatory Notice Register and to include specified information in the register, including notices of proposed action prepared by regulatory agencies, a summary of regulations filed with the Secretary of State, and a summary of regulation decisions issued, as specified.

end delete
begin delete

This bill would make technical, nonsubstantive changes to that law.

end delete

Vote: begin deletemajority end deletebegin insert23end insert. Appropriation: no. Fiscal committee: begin deleteno end deletebegin insertyesend insert. State-mandated local program: no.

The people of the State of California do enact as follows:

P3    1begin insert

begin insertSECTION 1.end insert  

end insert

begin insertSection 100503 of the end insertbegin insertGovernment Codeend insertbegin insert, as
2amended by Section 1 of Chapter 572 of the Statutes of 2014, is
3amended to read:end insert

4

100503.  

In addition to meeting the minimum requirements of
5Section 1311 of the federal act, the board shall do all of the
6following:

7(a) begin insert(1)end insertbegin insertend insert Determine the criteria and process for eligibility,
8enrollment, and disenrollment of enrollees and potential enrollees
9in the Exchange and coordinate that process with the state and
10local government entities administering other health care coverage
11programs, including the State Department of Health Care Services,
12the Managed Risk Medical Insurance Board, and California
13counties, in order to ensure consistent eligibility and enrollment
14processes and seamless transitions between coverage.

begin insert

15(2) (A) Without unreasonable delay, allow an applicant to
16indicate in an application for health care coverage whether or not
17the applicant would like assistance with completing the application
18from an Exchange certified insurance agent or certified enrollment
19counselor.

end insert
begin insert

20(B) Until the Exchange has complied with subparagraph (A),
21the Exchange shall not disclose any personal information, as
22defined in Section 1798.3 of the Civil Code, that was obtained
23from the application for health care coverage to a certified
24insurance agent or certified enrollment counselor.

end insert
begin insert

25(C) The Exchange shall not disclose personal information, as
26defined in Section 1798.3 of the Civil Code, that was obtained
27from the application for health care coverage to a certified
28insurance agent or certified enrollment counselor if the applicant
29indicates that the applicant does not want assistance from an
30Exchange certified insurance agent or certified enrollment
31counselor.

end insert
begin insert

32(D) Nothing in this section shall preclude the Exchange from
33sharing the information of current enrollees or applicants with
34the same certified enrollment counselor or certified insurance
35agent of record that provided the applicant assistance with an
36existing application, or their successor or authorized staff, as
37otherwise permitted by federal and state laws and regulations.

end insert

P4    1(b) Develop processes to coordinate with the county entities
2that administer eligibility for the Medi-Cal program and the entity
3that determines eligibility for the Healthy Families Program,
4including, but not limited to, processes for case transfer, referral,
5and enrollment in the Exchange of individuals applying for
6assistance to those entities, if allowed or required by federal law.

7(c) Determine the minimum requirements a carrier must meet
8to be considered for participation in the Exchange, and the
9standards and criteria for selecting qualified health plans to be
10offered through the Exchange that are in the best interests of
11qualified individuals and qualified small employers. The board
12shall consistently and uniformly apply these requirements,
13standards, and criteria to all carriers. In the course of selectively
14contracting for health care coverage offered to qualified individuals
15and qualified small employers through the Exchange, the board
16shall seek to contract with carriers so as to provide health care
17coverage choices that offer the optimal combination of choice,
18value, quality, and service.

19(d) Provide, in each region of the state, a choice of qualified
20health plans at each of the five levels of coverage contained in
21subsections (d) and (e) of Section 1302 of the federal act, subject
22to subdivision (e) of this section, paragraph (2) of subdivision (d)
23of Section 1366.6 of the Health and Safety Code, and paragraph
24(2) of subdivision (d) of Section 10112.3 of the Insurance Code.

25(e) Require, as a condition of participation in the individual
26market of the Exchange, carriers to fairly and affirmatively offer,
27market, and sell in the individual market of the Exchange at least
28one product within each of the five levels of coverage contained
29in subsections (d) and (e) of Section 1302 of the federal act and
30require, as a condition of participation in the SHOP Program,
31carriers to fairly and affirmatively offer, market, and sell in the
32SHOP Program at least one product within each of the four levels
33of coverage contained in subsection (d) of Section 1302 of the
34federal act. The board may require carriers to offer additional
35products within each of those levels of coverage. This subdivision
36shall not apply to a carrier that solely offers supplemental coverage
37in the Exchange under paragraph (10) of subdivision (a) of Section
38100504.

39(f) (1) Except as otherwise provided in this section and Section
40100504.5, require, as a condition of participation in the Exchange,
P5    1carriers that sell any products outside the Exchange to do both of
2the following:

3(A) Fairly and affirmatively offer, market, and sell all products
4made available to individuals in the Exchange to individuals
5purchasing coverage outside the Exchange.

6(B) Fairly and affirmatively offer, market, and sell all products
7made available to small employers in the Exchange to small
8employers purchasing coverage outside the Exchange.

9(2) For purposes of this subdivision, “product” does not include
10contracts entered into pursuant to Part 6.2 (commencing with
11Section 12693) of Division 2 of the Insurance Code between the
12Managed Risk Medical Insurance Board and carriers for enrolled
13Healthy Families beneficiaries or contracts entered into pursuant
14to Chapter 7 (commencing with Section 14000) of, or Chapter 8
15(commencing with Section 14200) of, Part 3 of Division 9 of the
16Welfare and Institutions Code between the State Department of
17Health Care Services and carriers for enrolled Medi-Cal
18beneficiaries. “Product” also does not include a bridge plan product
19offered pursuant to Section 100504.5.

20(3) Except as required by Section 1301(a)(1)(C)(ii) of the federal
21act, a carrier offering a bridge plan product in the Exchange may
22limit the products it offers in the Exchange solely to a bridge plan
23product contract.

24(g) Determine when an enrollee’s coverage commences and the
25extent and scope of coverage.

26(h) Provide for the processing of applications and the enrollment
27and disenrollment of enrollees.

28(i) Determine and approve cost-sharing provisions for qualified
29health plans.

30(j) Establish uniform billing and payment policies for qualified
31health plans offered in the Exchange to ensure consistent
32enrollment and disenrollment activities for individuals enrolled in
33the Exchange.

34(k) Undertake activities necessary to market and publicize the
35availability of health care coverage and federal subsidies through
36the Exchange. The board shall also undertake outreach and
37enrollment activities that seek to assist enrollees and potential
38enrollees with enrolling and reenrolling in the Exchange in the
39least burdensome manner, including populations that may
P6    1experience barriers to enrollment, such as the disabled and those
2with limited English language proficiency.

3(l) Select and set performance standards and compensation for
4navigators selected under subdivision (l) of Section 100502.

5(m) Employ necessary staff.

6(1) The board shall hire a chief fiscal officer, a chief operations
7officer, a director for the SHOP Exchange, a director of Health
8Plan Contracting, a chief technology and information officer, a
9general counsel, and other key executive positions, as determined
10by the board, who shall be exempt from civil service.

11(2) (A) The board shall set the salaries for the exempt positions
12described in paragraph (1) and subdivision (i) of Section 100500
13in amounts that are reasonably necessary to attract and retain
14individuals of superior qualifications. The salaries shall be
15published by the board in the board’s annual budget. The board’s
16annual budget shall be posted on the Internet Web site of the
17Exchange. To determine the compensation for these positions, the
18board shall cause to be conducted, through the use of independent
19outside advisors, salary surveys of both of the following:

20(i) Other state and federal health insurance exchanges that are
21most comparable to the Exchange.

22(ii) Other relevant labor pools.

23(B) The salaries established by the board under subparagraph
24(A) shall not exceed the highest comparable salary for a position
25of that type, as determined by the surveys conducted pursuant to
26subparagraph (A).

27(C) The Department of Human Resources shall review the
28methodology used in the surveys conducted pursuant to
29subparagraph (A).

30(3) The positions described in paragraph (1) and subdivision (i)
31of Section 100500 shall not be subject to otherwise applicable
32provisions of the Government Code or the Public Contract Code
33and, for those purposes, the Exchange shall not be considered a
34state agency or public entity.

35(n) Assess a charge on the qualified health plans offered by
36carriers that is reasonable and necessary to support the
37development, operations, and prudent cash management of the
38Exchange. This charge shall not affect the requirement under
39Section 1301 of the federal act that carriers charge the same
P7    1premium rate for each qualified health plan whether offered inside
2or outside the Exchange.

3(o) Authorize expenditures, as necessary, from the California
4Health Trust Fund to pay program expenses to administer the
5Exchange.

6(p) Keep an accurate accounting of all activities, receipts, and
7expenditures, and annually submit to the United States Secretary
8of Health and Human Services a report concerning that accounting.
9Commencing January 1, 2016, the board shall conduct an annual
10audit.

11(q) (1) Annually prepare a written report on the implementation
12and performance of the Exchange functions during the preceding
13fiscal year, including, at a minimum, the manner in which funds
14were expended and the progress toward, and the achievement of,
15the requirements of this title. The report shall also include data
16provided by health care service plans and health insurers offering
17bridge plan products regarding the extent of health care provider
18and health facility overlap in their Medi-Cal networks as compared
19to the health care provider and health facility networks contracting
20with the plan or insurer in their bridge plan contracts. This report
21shall be transmitted to the Legislature and the Governor and shall
22be made available to the public on the Internet Web site of the
23Exchange. A report made to the Legislature pursuant to this
24subdivision shall be submitted pursuant to Section 9795.

25(2) The Exchange shall prepare, or contract for the preparation
26of, an evaluation of the bridge plan program using the first three
27years of experience with the program. The evaluation shall be
28provided to the health policy and fiscal committees of the
29Legislature in the fourth year following federal approval of the
30bridge plan option. The evaluation shall include, but not be limited
31to, all of the following:

32(A) The number of individuals eligible to participate in the
33bridge plan program each year by category of eligibility.

34(B) The number of eligible individuals who elect a bridge plan
35option each year by category of eligibility.

36(C) The average length of time, by region and statewide, that
37individuals remain in the bridge plan option each year by category
38of eligibility.

39(D) The regions of the state with a bridge plan option, and the
40carriers in each region that offer a bridge plan, by year.

P8    1(E) The premium difference each year, by region, between the
2bridge plan and the first and second lowest cost plan for individuals
3in the Exchange who are not eligible for the bridge plan.

4(F) The effect of the bridge plan on the premium subsidy amount
5for bridge plan eligible individuals each year by each region.

6(G) Based on a survey of individuals enrolled in the bridge plan:

7(i) Whether individuals enrolling in the bridge plan product are
8able to keep their existing health care providers.

9(ii) Whether individuals would want to retain their bridge plan
10product, buy a different Exchange product, or decline to purchase
11health insurance if there was no bridge plan product available. The
12Exchange may include questions designed to elicit the information
13in this subparagraph as part of an existing survey of individuals
14receiving coverage in the Exchange.

15(3) In addition to the evaluation required by paragraph (2), the
16Exchange shall post the items in subparagraphs (A) to (F),
17inclusive, on its Internet Web site each year.

18(4) In addition to the report described in paragraph (1), the board
19shall be responsive to requests for additional information from the
20Legislature, including providing testimony and commenting on
21proposed state legislation or policy issues. The Legislature finds
22and declares that activities including, but not limited to, responding
23to legislative or executive inquiries, tracking and commenting on
24legislation and regulatory activities, and preparing reports on the
25implementation of this title and the performance of the Exchange,
26are necessary state requirements and are distinct from the
27promotion of legislative or regulatory modifications referred to in
28subdivision (d) of Section 100520.

29(r) Maintain enrollment and expenditures to ensure that
30expenditures do not exceed the amount of revenue in the fund, and
31if sufficient revenue is not available to pay estimated expenditures,
32institute appropriate measures to ensure fiscal solvency.

33(s) Exercise all powers reasonably necessary to carry out and
34comply with the duties, responsibilities, and requirements of this
35act and the federal act.

36(t) Consult with stakeholders relevant to carrying out the
37 activities under this title, including, but not limited to, all of the
38following:

39(1) Health care consumers who are enrolled in health plans.

P9    1(2) Individuals and entities with experience in facilitating
2enrollment in health plans.

3(3) Representatives of small businesses and self-employed
4individuals.

5(4) The State Medi-Cal Director.

6(5) Advocates for enrolling hard-to-reach populations.

7(u) Facilitate the purchase of qualified health plans in the
8Exchange by qualified individuals and qualified small employers
9no later than January 1, 2014.

10(v) Report, or contract with an independent entity to report, to
11the Legislature by December 1, 2018, on whether to adopt the
12option in Section 1312(c)(3) of the federal act to merge the
13individual and small employer markets. In its report, the board
14shall provide information, based on at least two years of data from
15the Exchange, on the potential impact on rates paid by individuals
16and by small employers in a merged individual and small employer
17market, as compared to the rates paid by individuals and small
18employers if a separate individual and small employer market is
19maintained. A report made pursuant to this subdivision shall be
20submitted pursuant to Section 9795.

21(w) With respect to the SHOP Program, collect premiums and
22administer all other necessary and related tasks, including, but not
23limited to, enrollment and plan payment, in order to make the
24offering of employee plan choice as simple as possible for qualified
25small employers.

26(x) Require carriers participating in the Exchange to immediately
27notify the Exchange, under the terms and conditions established
28by the board when an individual is or will be enrolled in or
29disenrolled from any qualified health plan offered by the carrier.

30(y) Ensure that the Exchange provides oral interpretation
31services in any language for individuals seeking coverage through
32the Exchange and makes available a toll-free telephone number
33for the hearing and speech impaired. The board shall ensure that
34written information made available by the Exchange is presented
35in a plainly worded, easily understandable format and made
36available in prevalent languages.

37(z) This section shall become inoperative on the October 1 that
38is five years after the date that federal approval of the bridge plan
39option occurs, and, as of the second January 1 thereafter, is
40repealed, unless a later enacted statute that is enacted before that
P10   1date deletes or extends the dates on which it becomes inoperative
2and is repealed.

3begin insert

begin insertSEC. 2.end insert  

end insert

begin insertSection 100503 of the end insertbegin insertGovernment Codeend insertbegin insert, as amended
4by Section 2 of Chapter 572 of the Statutes of 2014, is amended
5to read:end insert

6

100503.  

In addition to meeting the minimum requirements of
7Section 1311 of the federal act, the board shall do all of the
8following:

9(a) begin insert(1)end insertbegin insertend insert Determine the criteria and process for eligibility,
10enrollment, and disenrollment of enrollees and potential enrollees
11in the Exchange and coordinate that process with the state and
12local government entities administering other health care coverage
13programs, including the State Department of Health Care Services,
14the Managed Risk Medical Insurance Board, and California
15counties, in order to ensure consistent eligibility and enrollment
16processes and seamless transitions between coverage.

begin insert

17(2) (A) Without unreasonable delay, allow an applicant to
18indicate in an application for health care coverage whether or not
19the applicant would like assistance with completing that application
20from an Exchange certified insurance agent or certified enrollment
21counselor.

end insert
begin insert

22(B) Until the Exchange has complied with subparagraph (A),
23the Exchange shall not disclose any personal information, as
24defined in Section 1798.3 of the Civil Code, that was obtained
25from the application for health care coverage to a certified
26insurance agent or certified enrollment counselor.

end insert
begin insert

27(C) The Exchange shall not disclose personal information, as
28defined in Section 1798.3 of the Civil Code, that was obtained
29from the application for health care coverage to a certified
30insurance agent or certified enrollment counselor if the applicant
31indicates that the applicant does not want assistance from an
32Exchange certified insurance agent or certified enrollment
33counselor.

end insert
begin insert

34(D) Nothing in this section shall preclude the Exchange from
35sharing the information of current enrollees or applicants with
36the same certified enrollment counselor or certified insurance
37agent of record that provided the applicant assistance with an
38existing application, or their successor or authorized staff, as
39otherwise permitted by federal and state laws and regulations.

end insert

P11   1(b) Develop processes to coordinate with the county entities
2that administer eligibility for the Medi-Cal program and the entity
3that determines eligibility for the Healthy Families Program,
4including, but not limited to, processes for case transfer, referral,
5and enrollment in the Exchange of individuals applying for
6assistance to those entities, if allowed or required by federal law.

7(c) Determine the minimum requirements a carrier must meet
8to be considered for participation in the Exchange, and the
9standards and criteria for selecting qualified health plans to be
10offered through the Exchange that are in the best interests of
11qualified individuals and qualified small employers. The board
12shall consistently and uniformly apply these requirements,
13standards, and criteria to all carriers. In the course of selectively
14contracting for health care coverage offered to qualified individuals
15and qualified small employers through the Exchange, the board
16shall seek to contract with carriers so as to provide health care
17coverage choices that offer the optimal combination of choice,
18value, quality, and service.

19(d) Provide, in each region of the state, a choice of qualified
20health plans at each of the five levels of coverage contained in
21subsections (d) and (e) of Section 1302 of the federal act, subject
22to subdivision (e) of this section, paragraph (2) of subdivision (d)
23of Section 1366.6 of the Health and Safety Code and paragraph
24(2) of subdivision (d) of Section 10112.3 of the Insurance Code.

25(e) Require, as a condition of participation in the Exchange,
26carriers to fairly and affirmatively offer, market, and sell in the
27Exchange at least one product within each of the five levels of
28coverage contained in subsections (d) and (e) of Section 1302 of
29the federal act and require, as a condition of participation in the
30SHOP Program, carriers to fairly and affirmatively offer, market,
31and sell in the SHOP Program at least one product within each of
32the four levels of coverage contained in subsection (d) of Section
331302 of the federal act. The board may require carriers to offer
34additional products within each of those levels of coverage. This
35subdivision shall not apply to a carrier that solely offers
36supplemental coverage in the Exchange under paragraph (10) of
37subdivision (a) of Section 100504.

38(f) (1) Require, as a condition of participation in the Exchange,
39carriers that sell any products outside the Exchange to do both of
40the following:

P12   1(A) Fairly and affirmatively offer, market, and sell all products
2made available to individuals in the Exchange to individuals
3purchasing coverage outside the Exchange.

4(B) Fairly and affirmatively offer, market, and sell all products
5made available to small employers in the Exchange to small
6employers purchasing coverage outside the Exchange.

7(2) For purposes of this subdivision, “product” does not include
8contracts entered into pursuant to Part 6.2 (commencing with
9Section 12693) of Division 2 of the Insurance Code between the
10Managed Risk Medical Insurance Board and carriers for enrolled
11Healthy Families beneficiaries or contracts entered into pursuant
12to Chapter 7 (commencing with Section 14000) of, or Chapter 8
13(commencing with Section 14200) of, Part 3 of Division 9 of the
14Welfare and Institutions Code between the State Department of
15Health Care Services and carriers for enrolled Medi-Cal
16beneficiaries.

17(g) Determine when an enrollee’s coverage commences and the
18extent and scope of coverage.

19(h) Provide for the processing of applications and the enrollment
20and disenrollment of enrollees.

21(i) Determine and approve cost-sharing provisions for qualified
22health plans.

23(j) Establish uniform billing and payment policies for qualified
24health plans offered in the Exchange to ensure consistent
25enrollment and disenrollment activities for individuals enrolled in
26the Exchange.

27(k) Undertake activities necessary to market and publicize the
28availability of health care coverage and federal subsidies through
29the Exchange. The board shall also undertake outreach and
30enrollment activities that seek to assist enrollees and potential
31enrollees with enrolling and reenrolling in the Exchange in the
32least burdensome manner, including populations that may
33experience barriers to enrollment, such as the disabled and those
34with limited English language proficiency.

35(l) Select and set performance standards and compensation for
36navigators selected under subdivision (l) of Section 100502.

37(m) Employ necessary staff.

38(1) The board shall hire a chief fiscal officer, a chief operations
39officer, a director for the SHOP Exchange, a director of Health
40Plan Contracting, a chief technology and information officer, a
P13   1general counsel, and other key executive positions, as determined
2by the board, who shall be exempt from civil service.

3(2) (A) The board shall set the salaries for the exempt positions
4described in paragraph (1) and subdivision (i) of Section 100500
5in amounts that are reasonably necessary to attract and retain
6individuals of superior qualifications. The salaries shall be
7published by the board in the board’s annual budget. The board’s
8annual budget shall be posted on the Internet Web site of the
9Exchange. To determine the compensation for these positions, the
10board shall cause to be conducted, through the use of independent
11outside advisors, salary surveys of both of the following:

12(i) Other state and federal health insurance exchanges that are
13most comparable to the Exchange.

14(ii) Other relevant labor pools.

15(B) The salaries established by the board under subparagraph
16(A) shall not exceed the highest comparable salary for a position
17of that type, as determined by the surveys conducted pursuant to
18subparagraph (A).

19(C) The Department of Human Resources shall review the
20methodology used in the surveys conducted pursuant to
21subparagraph (A).

22(3) The positions described in paragraph (1) and subdivision (i)
23of Section 100500 shall not be subject to otherwise applicable
24provisions of the Government Code or the Public Contract Code
25and, for those purposes, the Exchange shall not be considered a
26state agency or public entity.

27(n) Assess a charge on the qualified health plans offered by
28carriers that is reasonable and necessary to support the
29development, operations, and prudent cash management of the
30Exchange. This charge shall not affect the requirement under
31Section 1301 of the federal act that carriers charge the same
32premium rate for each qualified health plan whether offered inside
33or outside the Exchange.

34(o) Authorize expenditures, as necessary, from the California
35Health Trust Fund to pay program expenses to administer the
36Exchange.

37(p) Keep an accurate accounting of all activities, receipts, and
38expenditures, and annually submit to the United States Secretary
39of Health and Human Services a report concerning that accounting.
P14   1Commencing January 1, 2016, the board shall conduct an annual
2audit.

3(q) (1) Annually prepare a written report on the implementation
4and performance of the Exchange functions during the preceding
5fiscal year, including, at a minimum, the manner in which funds
6were expended and the progress toward, and the achievement of,
7the requirements of this title. This report shall be transmitted to
8the Legislature and the Governor and shall be made available to
9the public on the Internet Web site of the Exchange. A report made
10to the Legislature pursuant to this subdivision shall be submitted
11pursuant to Section 9795.

12(2) In addition to the report described in paragraph (1), the board
13shall be responsive to requests for additional information from the
14Legislature, including providing testimony and commenting on
15proposed state legislation or policy issues. The Legislature finds
16and declares that activities including, but not limited to, responding
17to legislative or executive inquiries, tracking and commenting on
18legislation and regulatory activities, and preparing reports on the
19implementation of this title and the performance of the Exchange,
20are necessary state requirements and are distinct from the
21promotion of legislative or regulatory modifications referred to in
22subdivision (d) of Section 100520.

23(r) Maintain enrollment and expenditures to ensure that
24expenditures do not exceed the amount of revenue in the fund, and
25if sufficient revenue is not available to pay estimated expenditures,
26institute appropriate measures to ensure fiscal solvency.

27(s) Exercise all powers reasonably necessary to carry out and
28comply with the duties, responsibilities, and requirements of this
29act and the federal act.

30(t) Consult with stakeholders relevant to carrying out the
31activities under this title, including, but not limited to, all of the
32following:

33(1) Health care consumers who are enrolled in health plans.

34(2) Individuals and entities with experience in facilitating
35enrollment in health plans.

36(3) Representatives of small businesses and self-employed
37individuals.

38(4) The State Medi-Cal Director.

39(5) Advocates for enrolling hard-to-reach populations.

P15   1(u) Facilitate the purchase of qualified health plans in the
2Exchange by qualified individuals and qualified small employers
3no later than January 1, 2014.

4(v) Report, or contract with an independent entity to report, to
5the Legislature by December 1, 2018, on whether to adopt the
6option in Section 1312(c)(3) of the federal act to merge the
7individual and small employer markets. In its report, the board
8shall provide information, based on at least two years of data from
9the Exchange, on the potential impact on rates paid by individuals
10and by small employers in a merged individual and small employer
11market, as compared to the rates paid by individuals and small
12employers if a separate individual and small employer market is
13maintained. A report made pursuant to this subdivision shall be
14submitted pursuant to Section 9795.

15(w) With respect to the SHOP Program, collect premiums and
16administer all other necessary and related tasks, including, but not
17limited to, enrollment and plan payment, in order to make the
18offering of employee plan choice as simple as possible for qualified
19small employers.

20(x) Require carriers participating in the Exchange to immediately
21notify the Exchange, under the terms and conditions established
22by the board when an individual is or will be enrolled in or
23disenrolled from any qualified health plan offered by the carrier.

24(y) Ensure that the Exchange provides oral interpretation
25services in any language for individuals seeking coverage through
26the Exchange and makes available a toll-free telephone number
27for the hearing and speech impaired. The board shall ensure that
28written information made available by the Exchange is presented
29in a plainly worded, easily understandable format and made
30available in prevalent languages.

31(z) This section shall become operative only if Section 4 of the
32act that added this section becomes inoperative pursuant to
33subdivision (z) of that Section 4.

34begin insert

begin insertSEC. 3.end insert  

end insert
begin insert

Sections 1 and 2 of this bill shall become operative on
35October 1, 2015.

end insert
36begin insert

begin insertSEC. 4.end insert  

end insert
begin insert

This act is an urgency statute necessary for the
37immediate preservation of the public peace, health, or safety within
38the meaning of Article IV of the Constitution and shall go into
39immediate effect. The facts constituting the necessity are:

end insert
begin insert

P16   1Protecting Californians’ privacy rights is of the utmost
2importance, and in order to protect the privacy rights of individuals
3applying for health care coverage through the California Health
4Benefit Exchange at the earliest possible time, it is necessary that
5this act take effect immediately.

end insert
begin delete
6

SECTION 1.  

Section 11344.1 of the Government Code is
7amended to read:

8

11344.1.  

The office shall do all of the following:

9(a) Provide for the publication of the California Regulatory
10Notice Register, which shall be an official publication of the State
11of California and which shall contain the following:

12(1) Notices of proposed action prepared by regulatory agencies,
13subject to the notice requirements of this chapter, and which have
14been approved by the office.

15(2) A summary of all regulations filed with the Secretary of
16State in the previous week.

17(3) Summaries of all regulation decisions issued in the previous
18week detailing the reasons for disapproval of a regulation, the
19reasons for not filing an emergency regulation, and the reasons for
20repealing an emergency regulation. The California Regulatory
21Notice Register shall also include a quarterly index of regulation
22decisions.

23(4) Material that is required to be published under Sections
2411349.5, 11349.7, and 11349.9.

25(5) Determinations issued pursuant to Section 11340.5.

26(b) Establish the publication dates and manner and form in
27which the California Regulatory Notice Register shall be prepared
28and published and ensure that it is published and distributed in a
29timely manner to the presiding officer and rules committee of each
30house of the Legislature and to all subscribers.

31(c) Post on its Internet Web site, on a weekly basis:

32(1) The California Regulatory Notice Register. Each issue of
33the California Regulatory Notice Register on the office’s Internet
34Web site shall remain posted for a minimum of 18 months.

35(2) One or more Internet Web site links to assist the public to
36gain access to the text of regulations proposed by state agencies.

end delete


O

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