BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 803
                                                                  Page  1

          Date of Hearing:   April 22, 2009

            ASSEMBLY COMMITTEE ON PUBLIC EMPLOYEES, RETIREMENT AND SOCIAL  
                                      SECURITY
                                 Ed Hernandez, Chair
                    AB 803 (Duvall) - As Amended:  April 13, 2009
           
          SUBJECT  :   Health care coverage: state employees and legislative  
          employees: cash payments.

           SUMMARY  :   Requires the state, as of July 1, 2010, to provide a  
          state or legislative employee the option of receiving a cash  
          payment in lieu of coverage in a health benefit plan.   
          Specifically,  this bill  :  

          1)States that it is the intent of the Legislature, in an effort  
            to increase flexibility and adaptability of the employment  
            benefits of state and legislative employees, to provide those  
            employees with the option of receiving cash in lieu of health  
            care coverage from the state.

          2)Specifies that, upon appropriation by the Legislature of the  
            necessary funds, the state will provide state and legislative  
            employees who are currently able to elect coverage in a health  
            plan, the option of taking a cash payment in lieu of that  
            coverage.

          3)Specifies that the amount of the cash payment will be equal to  
            67% of the average benefit for which the employee is eligible.

          4)Specifies that these provisions become effective July 1, 2010.

           EXISTING LAW  establishes the Public Employees' Medical and  
          Hospital Care Act (PEMHCA) under the administration of the  
          California Public Employees' Retirement System (CalPERS).  Under  
          PEMHCA, health coverage is available to state employees,  
          including legislative employees, as well as local public agency  
          and school employees if their employer contracts with CalPERS to  
          provide these benefits.  The CalPERS Board of Administration  
          reviews health plan contracts annually to determine the specific  
          health plans available, as well as covered benefits, monthly  
          health premiums, and co-payments.

          Under existing law, state employees who have medical or dental  
          insurance through their spouses have the option to receive cash  








                                                                  AB 803
                                                                  Page  2

          in lieu of their state-sponsored benefits.  This option, the  
          FlexElect Cash Option Program, allows an employee to receive  
          $128 per month in lieu of health benefits.  This money is  
          treated as taxable income, reported on the W-2, and is not  
          considered compensation for retirement purposes.  This program  
          is administered by the Department of Personnel Administration.

           FISCAL EFFECT  :   Unknown.

           COMMENTS  :  CalPERS is the third largest purchaser of health care  
          in the nation, providing benefits to more than 1.3 million  
          public employees, retirees, and their families.  The size of the  
          underwriting pool allows CalPERS to average the risk throughout  
          the membership, which provides an overall lower average cost  
          than the individual plans currently available.  In addition, the  
          volume of the purchase provides some reduction in market costs,  
          and helps reduce administrative costs for the plans. 

          According to the author, "The cash benefit for health insurance  
          coverage is insufficient in its ability to purchase coverage  
          remotely similar in quality to what is provided to state and  
          legislative employees through CalPERS.  This is a disincentive  
          to employees who would like to obtain their own coverage on the  
          private market so that they can maintain coverage should they  
          leave or lose their state/legislative job, and have developed  
          some type of health condition in the interim that would prevent  
          them from securing their own coverage at that time."

          The author concludes, "This legislation will liberate those  
          employees concerned about their future health who want to make  
          sure they will always have coverage, since once a private  
          company takes on an insured, they cannot drop them.  AB 803 will  
          also save the state money through administrative cost savings,  
          as well as principal cost saving, since the CoBen (FlexElect)  
          allowance will remain only a fraction - though now a more  
          sizable one - of the cost of these employees' group premiums."

          Opponents state, "By allowing individual employees to opt out of  
          the employer-based coverage and take cash, AB 803 virtually  
          assures adverse selection that will increase the health care  
          costs for all those who choose to remain covered under the state  
          plans.  Healthier, younger employees will likely opt out leaving  
          only the older, less healthy employees, with coverage at rapidly  
          increasing premiums to the state and individuals contrary to the  
          stated intent of the bill.








                                                                  AB 803
                                                                  Page  3


          "Also, AB 803 does not require the cash payments be spent on an  
          alternative health care plan.  Employees would be allowed to  
          spend that money as they saw fit and then reenroll in the state  
          coverage when necessary.  The only incentive to participate in  
          the current state offered plan would be the guaranteed coverage  
          for all those who might already be ill or expecting costly  
          medical treatment."

          Opponents conclude, "In the long run, AB 803 may very well end  
          up costing the state more money by creating these adverse  
          selection incentives in addition to having the state, local  
          agencies and health providers pick up the cost for a newly  
          created uninsured population."

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          None on file

           Opposition 
           
          California Association of Professional Scientists
          California Association of Psychiatric Technicians
          California Professional Firefighters
          California School Employees Association
          California State Employees Association
          CDF Firefighters Local 2881
          Glendale City Employees Association
          Organization of SMUD Employees
          Peace Officer's Research Association of California
          Professional Engineers in California Government
          San Bernardino Public Employees Association
          San Luis Obispo County Employees Association
          Santa Rosa City Employees Association
          Service Employees International Union
           
          Analysis Prepared by  :    Karon Green / P.E., R. & S.S. / (916)  
          319-3957