BILL ANALYSIS                                                                                                                                                                                                    �




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                          SB 757 (Lieu)
          
          Hearing Date: 5/16/2011         Amended: 4/28/2011
          Consultant: Katie Johnson       Policy Vote: Health 6-3 
          Judiciary 3-2
          _________________________________________________________________
          ____
          BILL SUMMARY: SB 757 would require every group health care 
          service plan contract and every group health insurance 
          certificate marketed, issued, or delivered to a resident of 
          California to provide coverage to the subscriber's registered 
          domestic partner, regardless of the situs of the contract, 
          subscriber, or master group policyholder.
          _________________________________________________________________
          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2011-12      2012-13       2013-14     Fund
           
          DMHC enforcement       unknown, potentially minor to 
          significant*           Special**
                                                                      
          *See Staff Comments
          **Managed Care Fund
          _________________________________________________________________
          ____

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

          This bill would require that every group health care service 
          plan contract and every group health insurance certificate 
          marketed, issued, or delivered to a resident of California that 
          provides hospital, medical, or surgical expense benefits provide 
          equal coverage to employers or guaranteed associations for the 
          registered domestic partner of an employee or subscriber to the 
          same extent, and subject to the same terms and conditions, as 
          provided to a spouse of the employee, subscriber, or 
          policyholder, regardless of the situs of the contract, 
          subscriber, or master group policyholder.

          Health care coverage and insurance is regulated by two entities: 
          the Department of Managed Health Care (DMHC) and the California 








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          Department of Insurance (CDI). Any costs to oversee the 
          provisions of this bill would be minor and absorbable for CDI.

          However, DMHC and CDI only have jurisdiction over those entities 
          licensed or certificated by the state; it is unclear how either 
          department would be able to exercise any authority over 
          out-of-state contract or policyholders. CDI estimates that this 
          would happen rarely and that it could bring an injunction 
          against the insurer.

          Staff notes that to the extent that DMHC and CDI receive 
          complaints from California citizens covered by out-of-state 
          insurers that are not subject to California law, there could be 
          enforcement costs. Although the likely number of complaints is 
          small, the cost of enforcing this type of provision is unknown 
          and could be either minor, if the enforcement was within their 
          normal course of business, or potentially significant if the 
          departments had no other recourse than legal action. The type of 
          enforcement action would depend on the individual situation.

          Existing law, AB 2208 (Kehoe), Chapter 488, Statutes of 2004, 
          establishes the California Insurance Equality Act, which 
          requires all types of insurance, including health insurance, to 
          provide coverage to registered domestic partners equal to that 
          provided to a spouse.

          This bill, with the words "regardless of the situs of the 
          contract or master policyholder," seeks to clarify that this 
          parity requirement extends to insurance provided to California 
          residents by employers located out-of-state with out-of-state 
          insurance contracts or policies. 

          In the majority of states, the laws of the state where the 
          insurance company is licensed apply. However, a state may 
          exercise extraterritorial jurisdiction in that the health plans 
          and insurers must provide benefits consistent with the state law 
          in which an employee resides. 12 states currently exercise such 
          authority: Alaska, Arkansas, Connecticut, Delaware, Indiana, 
          Kansas, Mississippi, Montana, North Carolina, Oklahoma, Utah, 
          and Washington. This bill would add California to the list.












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