BILL ANALYSIS                                                                                                                                                                                                    




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                           838 (Strickland)
          
          Hearing Date:  4/12/2010        Amended: 4/6/2010
          Consultant: Katie Johnson       Policy Vote: Health 9-0
          _________________________________________________________________ 
          ____
          BILL SUMMARY:  SB 838, an urgency measure, would conform the  
          state Cal-COBRA health insurance law to the federal statute that  
          recently extended federal assistance for individuals choosing to  
          purchase health care coverage through Cal-COBRA after being  
          involuntarily terminated from employment.
          _________________________________________________________________ 
          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2009-10      2010-11       2011-12     Fund
           DIR oversight    $0 up to $40 - $64       $0 up to $241 - $383  
          $0 up to $241 - $383   
                                                                  Special*

          *Labor Enforcement and Compliance Fund                 
          _________________________________________________________________ 
          ____

          STAFF COMMENTS: This bill meets the criteria for referral to the  
          Suspense File.

          At this time it is unknown whether or not this bill would cause  
          a significant number of additional complaints to the Department  
          of Industrial Relations (DIR) and whether or not DIR would need  
          to take enforcement action in the event of a non-compliant  
          employer. If an investigation were necessary, however, the issue  
          of determining whether the employer complied or not would be  
          relatively uncomplicated-did the employer send the information  
          about eligible former employees to the health plan or insurer or  
          did the employer not send the information-when compared with  
          other Labor Code violations and DIR investigations such as  
          payroll violations.

          If relatively few complaints are logged, DIR enforcement costs  
          could be minor and absorbable. However, if a sufficient number  
          of complaints were registered, it is possible that DIR would  
          need up to two Deputy Labor Commissioners at $70,000 - $86,000  










          each and a staff attorney at $101,000 - $125,000 to investigate  
          the complaints for a total cost of approximately $241,000 -  
          $383,000 annually in monies from the Labor Enforcement and  
          Compliance Fund. Assuming an effective date of May 1, 2010,  
          $40,000 - $64,000 could be incurred in the last 2 months of FY  
          2009-2010, and the full annual cost could be incurred in FY  
          2010-2011 and beyond if the federal government chooses to extend  
          the COBRA premium assistance to individuals who are eligible for  
          premium assistance as a result of a loss in hours after  
          September 1, 2008, and were subsequently terminated beyond March  
          31, 2010. All costs to DIR would depend on the number of  
          complaints filed and the number and complexity of subsequent  
          investigations. 

          The language in this bill generally references the section in  
          ARRA that pertains to COBRA and mini-COBRA premium assistance  
          and does not specify the dates within which a qualifying event  
          must occur. If the federal government were to extend the premium  
          assistance beyond March 31, 2010, in that section of federal  
          law, which is 
          Page 2
          SB 838 (Strickland)

          likely, state law would not need to be updated. If there were an  
          extension beyond March 31, 2010, the fiscal impact on DIR is  
          discussed above and would depend on the length of the extension.

          As part of the state government trailer bill Chapter 12,  
          Statutes of 2009 (AB 12X4, Evans), the Director of Industrial  
          Relations would be authorized to levy a separate surcharge upon  
          all employers, as defined, for the purposes of deposit in the  
          newly created Labor Enforcement and Compliance Fund. The trailer  
          bill provides that the surcharge levied shall not exceed  
          $37,000,000 in FY 2009-2010, adjusted for as appropriate to  
          reconcile any over/under assessments from previous fiscal years,  
          and shall not be adjusted each year thereafter by more than the  
          state-local government deflator. The $37,000,000 cap represents  
          the amount expended by the Division of Labor Standards  
          Enforcement (DSLE) in 2008-2009 for the enforcement of wage and  
          hour violations. 

          With this cap, the DLSE will be forced to begin prioritizing  
          enforcement activities if enforcement duties and costs exceed  
          the cap as adjusted by the deflator. For FY 2009-2010, the  
          deflator was 0.003 percent. For FY 2010-2011, the deflator is  
          estimated to increase to 0.014 (1.4 percent) for an increase of  










          $518,000 in additional enforcement funding. For FY 2011-2012,  
          the deflator is estimated to increase to 0.016 (1.6 percent) for  
          an increase of $600,288. Thus, even if there is a minor to  
          significant increase in enforcement, the enforcement budget  
          appears to grow by an amount sufficient to cover the potential  
          annual costs of this bill. 

          Any costs to the Department of Managed Health Care (DMHC) and  
          the California Department of Insurance (CDI) to enforce these  
          provisions or to develop model notices in FY 2009-2010 and  
          ongoing would be minor and absorbable. 

          Existing Law

          Existing federal law creates the Consolidated Omnibus Budget  
          Reconciliation Act of 1985 (COBRA). COBRA provides certain  
          former employees the option to temporarily retain health  
          coverage at the group premium rate that they paid while  
          employed. COBRA applies to large businesses that employ 20 or  
          more employees. The eligible companies are required to inform  
          eligible former employees upon termination of employment or  
          another qualifying event. The former employees are eligible for  
          coverage for 18 months. If a former employee refuses COBRA  
          coverage upon being informed, he or she is no longer eligible. 

          Existing federal law allows and state law provides for  
          Cal-COBRA, or a "mini-COBRA" program, for small businesses with  
          2 to 19 employees. Cal-COBRA allows a former employee to  
          purchase health coverage for 36 months after a qualifying event  
          such as a reduction of hours or termination. If a former  
          employee chooses to maintain group health coverage under either  
          COBRA or Cal-COBRA, he or she pays 102 percent or up to 110  
          percent of the premium, respectively. While employed, it is  
          likely that the employer had subsidized the individual's  
          coverage.
          
          Page 3
          SB 838 (Strickland)

          Existing federal law, the American Reinvestment and Recovery Act  
          (ARRA), provides for COBRA premium assistance of 65 percent for  
          up to 9 months to employees who were involuntarily terminated  
          from their employment between September 1, 2008, and December  
          31, 2009. Beginning on or after February 17, 2009, eligible  
          individuals would pay 35 percent of the full premium for 9  
          months and then be eligible to continue on with COBRA at the  










          full premium rate. The employer or coverage provider, depending  
          on the individual situation, would pay the other 65 percent up  
          front and would be reimbursed through a tax credit. 

          AB 23 (Jones and Fletcher), Chapter 3, Statutes of 2009,  
          implemented the initial Cal-COBRA federal premium assistance.

          An analysis from Hewitt Associates found that COBRA enrollment  
          has doubled since the enactment of premium assistance. Similar  
          data is unavailable for Cal-COBRA.

          Premium Assistance Extensions
          
          Two recent federal extensions of premium assistance have been  
          enacted: 1) the federal Department of Defense Appropriations Act  
          (DOD Act) in December 2009, and 2) the Temporary Extension Act  
          of 2010 (TEA) on March 2, 2010. The DOD Act extended premium  
          assistance to individuals involuntarily terminated between  
          January 1, 2010, and February 28, 2010, and extended the  
          duration of premium assistance for an additional 6 months, for a  
          total of 15 months of subsidies. 

          TEA extended the COBRA premium assistance eligibility period for  
          one additional month-February 28, 2010, through March 31, 2010.  
          It also expanded eligibility of premium assistance to  
          individuals who had had their work hours reduced, which resulted  
          in a loss of health care coverage, between September 1, 2008,  
          and March 31, 2010, and who were then involuntarily terminated  
          on or after March 2, 2010, through March 31, 2010. Those  
          individuals who did not elect Cal-COBRA continuation coverage  
          when it was first offered, or who elected Cal-COBRA and  
          subsequently discontinued COBRA, would have a second opportunity  
          to sign up and to make use of the subsidy.

          This Bill

          The premium assistance and extensions also apply to state  
          "mini-COBRA" laws, such as Cal-COBRA, thus it is necessary to  
          update California's Cal-COBRA law.
          
          This bill would amend Cal-COBRA law to conform with the DOD and  
          TEA COBRA  provisions that, 1) extend premium assistance to  
          individuals involuntarily terminated between September 1, 2008,  
          and March 31, 2010, instead of September 1, 2008, to December  
          31, 2009, and 2) expand eligibility to employees who had had  
          their work hours reduced, which resulted in a loss of health  










          care coverage, between September 1, 2008, and March 31, 2010,  
          and were then involuntarily terminated on or after March 2,  
          2010, through March 31, 2010.


          Page 4
          SB 838 (Strickland)

          This bill would permit an eligible person's coverage to begin  
          prospectively, if permitted by federal law, meaning that a  
          person would pay premiums going forward. If federal law does not  
          permit prospective coverage, a person would pay premiums  
          retroactively back to the period of coverage beginning  
          immediately after his or her employment termination. As of this  
          date, the federal government has yet to issue any guidance on  
          this subject.

          As in federal law, this bill would require health plans and  
          insurers to send notices informing people of their eligibility  
          for the recent extension and expansion of Cal-COBRA premium  
          assistance. For health plans and insurers to identify and send  
          notices to those people who had had their hours reduced and were  
          subsequently laid off, they would need to be notified by the  
          employer that an employee was eligible. 

          Thus, this bill would also require employers to send contact  
          information to health plans and insurers for any former employee  
          who had had their work hours reduced, which resulted in a loss  
          of health care coverage, between September 1, 2008, and March  
          31, 2010, and were then involuntarily terminated on or after  
          March 2, 2010, through March 31, 2010, so that the health plans  
          and insurers may send out required notices informing these  
          individuals of their eligibility for federal premium assistance.