BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 119
                                                                  Page  1

          CONCURRENCE IN SENATE AMENDMENTS
          AB 119 (Jones)
          As Amended August 25, 2009
          Majority vote
           
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          |ASSEMBLY:  |51-29|(May 11, 2009)  |SENATE: |24-13|(September 1,  |
          |           |     |                |        |     |2009)          |
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           Original Committee Reference:    HEALTH  

           SUMMARY  :  Prohibits health plans and health insurers from  
          charging a premium, price, or charge differential for health  
          care coverage because of the sex of the prospective subscriber,  
          enrollee, policyholder, or insured.  

           The Senate amendments  :  

           1)Make this bill effective January 1, 2011.

          2)Make technical, clarifying changes and add co-authors.

           EXISTING LAW  :

          1)Provides for the regulation of health plans by the Department  
            of Managed Health Care (DMHC) under Knox-Keene and regulation  
            of disability insurers selling health insurance (health  
            insurers) by the California Department of Insurance (CDI)  
            under the Insurance Code.

          2)Prohibits, under Knox-Keene, a health plan from refusing to  
            contract, canceling, or declining to renew or reinstate any  
            health plan contract because of the race, color, national  
            origin, ancestry, religion, sex, marital status, sexual  
            orientation, or age of any contracting party, prospective  
            contracting party, subscriber, enrollee, member, or otherwise.

          3)Prohibits, in Knox-Keene, modification of benefits, coverage,  
            or the inclusion of any limitations, exceptions, exclusions,  
            reductions, copayments, coinsurance, deductibles,  
            reservations, or premium, price, or charge differentials  
            because of the race, color, national origin, ancestry,  
            religion, sex, marital status, sexual orientation, or age of  
            any contracting party, prospective contracting party,  








                                                                  AB 119
                                                                  Page  2

            subscriber, enrollee, member, or otherwise.

          4)Establishes in Knox-Keene, for individual coverage, an  
            exception to 3) above for premium, price or charge  
            differentials because of the sex or age of any individual,  
            when based on objective, valid, and up-to-date statistical and  
            actuarial data.

          5)Prohibits life and disability insurers, including health  
            insurers, from using race, color, religion, sex, national  
            origin, ancestry, or sexual orientation in determining whether  
            to offer insurance.

          6)Prohibits life and disability insurers, including health  
            insurers, from using race, color, religion, national origin,  
            ancestry, or sexual orientation as a condition or risk for  
            which a higher rate, premium, or charge may be required to be  
            paid by an insured, but does not include sex in the prohibited  
            list of conditions or risks.

          7)Authorizes in the Insurance Code, for life and disability  
            policies, including health insurance, premium, price, or  
            charge differentials because of the sex of the individual when  
            based on objective, valid, and up-to-date statistical and  
            actuarial date or sound underwriting practices. 

           AS PASSED BY THE ASSEMBLY  , this bill was substantially similar  
          to the version approved by the Senate.

           FISCAL EFFECT  :  According to the Senate Appropriations  
          Committee, pursuant to Senate Rule 28.8, negligible state costs.


           Analysis Prepared by  :    Deborah Kelch / HEALTH / (916) 319-2097


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