BILL NUMBER: AB 792 AMENDED
BILL TEXT
AMENDED IN SENATE AUGUST 24, 2012
AMENDED IN SENATE AUGUST 21, 2012
AMENDED IN SENATE AUGUST 17, 2011
AMENDED IN SENATE JUNE 30, 2011
AMENDED IN ASSEMBLY MAY 27, 2011
AMENDED IN ASSEMBLY MAY 10, 2011
AMENDED IN ASSEMBLY APRIL 14, 2011
INTRODUCED BY Assembly Member Bonilla
(Coauthor: Assembly Member Huffman)
FEBRUARY 17, 2011
An act to add Sections 2024.7 and 8613.7 to the Family Code, to
add Sections Section 1366.50
and 1366.51 to the Health and Safety Code, and to add
Sections Section 10786 and
10787 to the Insurance Code, relating to health care
coverage.
LEGISLATIVE COUNSEL'S DIGEST
AB 792, as amended, Bonilla. Health care coverage: California
Health Benefit Exchange.
Existing law, the federal Patient Protection and Affordable Care
Act, requires each state to, by January 1, 2014, establish an
American Health Benefit Exchange that makes available qualified
health plans to qualified individuals and small employers. Existing
state law establishes the California Health Benefit Exchange within
state government, specifies the powers and duties of the board
governing the Exchange relative to determining eligibility for
enrollment in the Exchange and arranging for coverage under qualified
health plans, and requires the board to facilitate the purchase of
qualified health plans through the Exchange by qualified individuals
and small employers by January 1, 2014.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975,
provides for the regulation of health care service plans by the
Department of Managed Health Care and makes a willful violation of
the act a crime. Existing law provides for the regulation of health
insurers by the Department of Insurance. Existing law
imposes specified requirements on health care service plans and
health insurers that provide medical and hospital coverage under an
employer-sponsored group plan for an employer, employee association,
or other entity subject to requirements under COBRA or Cal-COBRA, as
defined. Existing law sets forth procedures related to a
petition for dissolution of marriage, nullity of marriage, or legal
separation, or a petition for adoption.
This bill would require a court, upon the filing of a petition for
dissolution of marriage, nullity of marriage, or legal separation on
and after January 1, 2014, to provide a specified notice informing
the petitioner and respondent that they may be eligible for
reduced-cost coverage through the Exchange or no-cost coverage
through Medi-Cal. The bill would also require a court to provide such
a notice to a petition for adoption. The bill would require the
notice to include information regarding obtaining coverage through
those programs and would require the notice to be developed by the
Exchange.
Commencing January 1, 2014, this bill would require specified
health care service plans and health insurers to provide to
individuals who cease to be enrolled in individual or group
coverage and to individuals who lose coverage under an
employer-sponsored group plan a notice informing those
individuals that they may be eligible for reduced-cost coverage
through the Exchange or no-cost coverage through Medi-Cal. The bill
would require the notice to include information regarding obtaining
coverage through those programs and would require that the notice be
developed no later than July 1, 2013, by the Department of
Managed Health Care and the Department of Insurance , as
specified .
Because a willful violation of the bill's provisions relative to
health care service plans would be a crime, the bill would impose a
state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 2024.7 is added to the Family Code, to read:
2024.7. On and after January 1, 2014, upon the filing of a
petition for dissolution of marriage, nullity of marriage, or legal
separation, the court shall provide to the petitioner and the
respondent a notice informing him or her that he or she may be
eligible for reduced-cost coverage through the California Health
Benefit Exchange established under Title 22 (commencing with Section
100500) of the Government Code or no-cost coverage through Medi-Cal.
The notice shall include information on obtaining coverage pursuant
to those programs, and shall be developed by the California Health
Benefit Exchange.
SEC. 2. Section 8613.7 is added to the Family Code, to read:
8613.7. On and after January 1, 2014, the court shall provide to
any petitioner for adoption pursuant to this part a notice informing
him or her that he or she may be eligible for reduced-cost coverage
through the California Health Benefit Exchange established under
Title 22 (commencing with Section 100500) of the Government Code or
no-cost coverage through Medi-Cal. The notice shall include
information on obtaining coverage pursuant to those programs, and
shall be developed by the California Health Benefit Exchange.
SEC. 3. Section 1366.50 is added to the Health
and Safety Code, to read:
1366.50. (a) On and after January 1, 2014, a health care service
plan that provides medical and hospital coverage under an
employer-sponsored group plan for an employer subject to COBRA, as
defined in subdivision (e) of Section 1373.621, or an employer group
for which the plan is required to offer Cal-COBRA coverage, as
defined in subdivision (f) of Section 1373.621, shall, consistent
with this section and to the extent permitted under the federal
Patient Protection and Affordable Care Act (Public Law 111-148),
provide a notice to qualified beneficiaries upon a qualifying event
informing them that they may be eligible for reduced-cost coverage
through the California Health Benefit Exchange established under
Title 22 (commencing with Section 100500) of the Government Code or
no-cost coverage through Medi-Cal. The notice shall include
information on obtaining coverage pursuant to those programs, shall
be in no less than 12-point type, and shall be developed by the
department, in consultation with the Department of Insurance.
(b) The notice described in subdivision (a) may be incorporated
into existing COBRA or Cal-COBRA notices or other existing notices.
(c) For purposes of this section:
(1) "Qualified beneficiary" means any individual who, on the day
before the qualifying event, is an enrollee in a group benefit plan
offered by a health care service plan and who has a qualifying event.
(2) "Qualifying event" means any of the following events that
would result in a loss of coverage under the group benefit plan to a
qualified beneficiary:
(A) The death of the covered employee.
(B) The termination of employment or reduction in hours of the
covered employee's employment.
(C) The divorce or legal separation of the covered employee from
the covered employee's spouse.
(D) The loss of dependent status by a dependent enrolled in the
group benefit plan.
(E) With respect to a covered dependent only, the covered employee'
s entitlement to benefits under Title XVIII of the federal Social
Security Act.
(d) This section shall not apply with respect to a specialized
health care service plan contract or a plan contract consisting
solely of coverage of excepted benefits as described in Section 2722
of the federal Public Health Service Act (42 U.S.C. Sec. 300gg-21).
SEC. 4. SEC. 3. Section
1366.51 1366.50 is added to the Health and
Safety Code, to read:
1366.51. 1366.50. (a) On and after
January 1, 2014, a health care service plan providing individual
or group health care coverage shall provide to
individuals, dependents, or former dependents
enrollees or subscribers who cease to be enrolled in
individual coverage a notice informing them that they may
be eligible for reduced-cost coverage through the California Health
Benefit Exchange established under Title 22 (commencing with Section
100500) of the Government Code or no-cost coverage through Medi-Cal.
The notice shall include information on obtaining coverage pursuant
to those programs, shall be in no less than 12-point type, and shall
be developed by the department, no later than July 1, 2013,
in consultation with the Department of Insurance and the
California Health Benefit Exchange .
(b) The notice described in subdivision (a) may be incorporated
into or sent simultaneously with and in the same manner as
existing any other notices sent by the
health care service plan .
(c) This section shall not apply with respect to a specialized
health care service plan contract or a Medicare supplemental
plan contract consisting solely of coverage of
excepted benefits as described in Section 2722 of the federal Public
Health Service Act (42 U.S.C. Sec. 300gg-21) .
SEC. 5. Section 10786 is added to the Insurance
Code, to read:
10786. (a) On and after January 1, 2014, a health insurer that
provides medical and hospital coverage under an employer-sponsored
group plan for an employer subject to COBRA, as defined in
subdivision (e) of Section 10116.5, or an employer group for which
the insurer is required to offer Cal-COBRA coverage, as defined in
subdivision (f) of Section 10116.5, shall, consistent with this
section and to the extent permitted under the federal Patient
Protection and Affordable Care Act (Public Law 111-148), provide a
notice to qualified beneficiaries upon a qualifying event informing
them that they may be eligible for reduced-cost coverage through the
California Health Benefit Exchange established under Title 22
(commencing with Section 100500) of the Government Code or no-cost
coverage through Medi-Cal. The notice shall include information on
obtaining coverage pursuant to those programs, shall be in no less
than 12-point type, and shall be developed by the department, in
consultation with the Department of Managed Health Care.
(b) The notice described in subdivision (a) may be incorporated
into existing COBRA or Cal-COBRA notices or other existing notices.
(c) For purposes of this section:
(1) "Qualified beneficiary" means any individual who, on the day
before the qualifying event, is an enrollee in a group benefit plan
offered by a health insurer and who has a qualifying event.
(2) "Qualifying event" means any of the following events that
would result in a loss of coverage under the group benefit plan to a
qualified beneficiary:
(A) The death of the covered employee.
(B) The termination of employment or reduction in hours of the
covered employee's employment.
(C) The divorce or legal separation of the covered employee from
the covered employee's spouse.
(D) The loss of dependent status by a dependent enrolled in the
group benefit plan.
(E) With respect to a covered dependent only, the covered employee'
s entitlement to benefits under Title XVIII of the federal Social
Security Act.
(d) This section shall not apply with respect to a specialized
health insurance policy or a health insurance policy consisting
solely of coverage of excepted benefits as described in Section 2722
of the federal Public Health Service Act (42 U.S.C. Sec. 300gg-21).
SEC. 6. SEC. 4. Section
10787 10786 is added to the Insurance Code, to
read:
10787. 10786. (a) On and after
January 1, 2014, a health insurer providing individual
health care insurance
coverage shall provide to individuals, dependents, or former
dependents policyholders in individual policies or
certificate holders in group policies who cease to be enrolled
in individual coverage a notice informing them
that they may be eligible for reduced-cost coverage through the
California Health Benefit Exchange established under Title 22
(commencing with Section 100500) of the Government Code or no-cost
coverage through Medi-Cal. The notice shall include information on
obtaining coverage pursuant to those programs, shall be in no less
than 12-point type, and shall be developed by the department, no
later than July 1, 2013, in consultation with the Department
of Managed Health Care and the California Health
Benefit Exchange .
(b) The notice described in subdivision (a) may be incorporated
into or sent simultaneously with and in the same manner as
existing notices any other notices sent by the health
insurer .
(c) This section shall not apply with respect to a specialized
health insurance policy or a health insurance policy consisting
solely of coverage of excepted benefits as described in Section 2722
of the federal Public Health Service Act (42 U.S.C. Sec. 300gg-21).
SEC. 7. SEC. 5. No reimbursement is
required by this act pursuant to Section 6 of Article XIII B of the
California Constitution because the only costs that may be incurred
by a local agency or school district will be incurred because this
act creates a new crime or infraction, eliminates a crime or
infraction, or changes the penalty for a crime or infraction, within
the meaning of Section 17556 of the Government Code, or changes the
definition of a crime within the meaning of Section 6 of Article XIII
B of the California Constitution.