BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2608
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          Date of Hearing:   April 21, 2010

            ASSEMBLY COMMITTEE ON PUBLIC EMPLOYEES, RETIREMENT AND SOCIAL  
                                      SECURITY
                               Alberto Torrico, Chair
                AB 2608 (Chesbro) - As Introduced:  February 19, 2010
           
          SUBJECT  :   Rural Health Care Equity Program.

           SUMMARY  :   Extends, until January 1, 2012, the Rural Health Care  
          Equity Program (RHCEP) and extends the benefit provided by that  
          program to all state employees and retired annuitants living in  
          rural areas, as specified.   Specifically,  this bill  :  

          1)Extends the RHCEP until January 1, 2012.

          2)Expands the RHCEP benefits to all employees and annuitants  
            living in rural areas.

          3)Deletes the provision relating to the disposition of funds  
            remaining in the program after the date the program is  
            terminated.

           EXISTING LAW  :

          1)SB 514 (Chesbro), Chapter 743, Statutes of 1999, established  
            the RHCEP which is administered by the Department of Personnel  
            Administration (DPA) to provide subsidies and reimbursements  
            for health care costs incurred by state employees and  
            annuitants that live in rural areas of California.  A "rural  
            area" is defined as an area without a CalPERS Board-approved  
            health maintenance organization (HMO) plan.

          2)SB 1168 (Chesbro), Chapter 642, Statutes of 2006, extended the  
            operation of the RHCEP to January 1, 2012, and specified that  
            the program is only operative to the extent funding is  
            provided through the annual budget act or another statute.

          3)AB 1389 (Budget Committee), Chapter 751, Statutes of 2008,  
            eliminated the RHCEP payments to state annuitants.

          4)ABX4 12 (Evans), Chapter 12, Statutes of 2009-2010, eliminated  
            the RHCEP for all active state employees with the exception of  
            Bargaining Unit (BU) 5 (Highway Patrol) employees who were  
            allowed to continue to have access to this program, pursuant  








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            to their active bargaining agreement, until the expiration of  
            that agreement on July 2, 2010.

           FISCAL EFFECT  :   Unknown.

           COMMENTS  :   According to information provided to the Committee  
          by CalPERS, the CalPERS Health Benefits Branch, in cooperation  
          with the State Controller, provides benefit eligibility  
          information to the DPA.  RHCEP benefits are subject to funding  
          availability and require an appropriation in the annual Budget  
          Act. 
           
          For the state active employees currently eligible for the  
          program (active BU 5 employees only), the state will contribute  
          a maximum of $1,500 in subsidies and reimbursements per fiscal  
          year for each active employee eligible for RHCEP.  The subsidy  
          is equal to the difference between the lowest cost Preferred  
          Provider Organization (PPO) premium and the weighted-average HMO  
          premium.  Additionally, the state will reimburse for an employee  
          or dependent's out-of-pocket expenses, such as deductibles and  
          co-insurance costs.  

          Active employees may also be eligible for a "secondary"  
          reimbursement following the September 15th deadline each fiscal  
          year.  Each collective bargaining unit "rolls" any unused funds  
          into a pool of money at the end of the fiscal year.  Employees  
          who have received the $1,500 maximum may request additional  
          reimbursement from their bargaining unit's pool of money.

          In 2009, RHCEP subsidies were not provided because the lowest  
          cost CalPERS PPO plan (Anthem Blue Cross PERS Select) offered a  
          lower premium than the average HMO premium.  However, eligible  
          active employees were able to submit claims for deductible and  
          co-insurance expenses for that year.  

          Prior to July 1, 2008, RHCEP was available to eligible retired  
          annuitants in rural areas.  Annuitants not enrolled in Medicare  
          were eligible for up to $500 in reimbursement for health care  
          expenses paid under the PPO deductible (for self and  
          dependents).  Eligible annuitants who were enrolled in Medicare  
          automatically received reimbursement up to $75 for the actual  
          cost of Medicare Part B premiums.  No reimbursement for  
          dependents' Medicare premiums was available.

          According to the author, "The State of California offers its  








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          employees and retirees a number of health plan options including  
          at least one low-cost HMO.  Unfortunately in some rural areas of  
          California there are no HMOs available to state employees and  
          retirees requiring the use of higher cost health care options.   
          Through the collective bargaining process, the State of  
          California and its employees and retirees created the Rural  
          Health Care Equity Program to offset these area's higher health  
          care costs."

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Service Employees International Union Local 1000 (Sponsor)
          California Medical Association
          California State Employees Association
          Professional Engineers in California Government

           Opposition 
           
          None on file
           
          Analysis Prepared by  :    Karon Green / P.E., R. & S.S. / (916)  
          319-3957