BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 757
                                                                  Page  1

          Date of Hearing:   August 17, 2011

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                    SB 757 (Lieu) - As Amended:  August 15, 2011 

          Policy Committee:                             JudiciaryVote:6-3
                       Health                           Vote: 13-5

          Urgency:     No                   State Mandated Local Program: 
          Yes    Reimbursable:              No

           SUMMARY  

          This bill requires that out-of-state health insurance or health 
          plan issuers (carriers) comply with requirements to provide 
          coverage to domestic partners.  These requirements currently 
          only apply to in-state carriers.  Specifically, this bill:

          1)Subjects, notwithstanding any other provision of law, every 
            group health care service plan contract or health insurance 
            policy marketed, issued, or delivered to a California 
            resident, to the requirements to provide the same coverage to 
            domestic partners that is provided to spouses, regardless of 
            the situs of the contract or the subscriber. 

          2)States that group policies and plan contracts may not 
            discriminate in coverage between spouses or domestic partners 
            based on whether they are same-sex or opposite-sex.

           FISCAL EFFECT  

          1)Potential minor, absorbable costs to the Department of Managed 
            Health Care (DMHC) and California Department Insurance (CDI) 
            related to ensuring carrier compliance with the provisions of 
            this bill that states that policies and plan contracts may not 
            discriminate on the basis of the sex of spouses or domestic 
            partners.  

          2)As it is unclear how the provisions of this bill that apply to 
            out-of-state carriers can be enforced by state regulators, 
            there is no anticipated direct state fiscal impact for 
            enforcement.  









                                                                  SB 757
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           COMMENTS  

           1)Rationale  .  The author states that although California has 
            strong laws prohibiting discrimination in the issuance of 
            insurance policies in the state, including a requirement that 
            all California licensed and regulated insurers and health 
            plans provide equal coverage to domestic partners, some 
            out-of-state insurance companies are attempting to evade the 
            California law that prohibits the sale or issuance of 
            discriminatory insurance policies.  The author states that 
            multi-state companies that do business in California often 
            contract with out-of-state insurance companies to provide 
            coverage for their employees, and that because some of these 
            out-of-state insurance companies believe there is a loophole 
            in the law, they are discriminating against employees who live 
            in California and who are in a domestic partnership by 
            refusing to provide equal coverage to domestic partners.  This 
            bill intends to provide a legal basis for individuals seeking 
            to ensure equal coverage for same-sex spouses or domestic 
            partners.

           2)Background  .  Some California residents are employed by an 
            employer whose headquarters is located in another state.  
            These out-of-state employers may contract with one insurance 
            company for all of their employees, regardless of the 
            employee's state of residence.  If an insurance company is not 
            licensed by a California regulator, either DMHC or CDI, they 
            do not have to comply with antidiscrimination requirements in 
            state law, regardless of whether they are providing coverage 
            to a California resident.  The sponsors suggest that this bill 
            would be applicable to a small number of people, perhaps 
            numbering in the low thousands, who work for out-of-state 
            companies and may seek coverage for same-sex spouses or 
            domestic partners.

           3)Jurisdiction and Enforcement  . There are currently 12 states 
            that exercise extraterritorial jurisdiction over health 
            insurance policies for their residents.  In these states, 
            health insurers are required to provide benefits consistent 
            with the state law in which an employee resides.  This bill 
            would make California one of these extraterritorial states.  
            However, it is unclear how this bill would be enforced, as 
            state regulators do not have authority over out-of-state 
            carriers.
                








                                                                 SB 757
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            4)Related Legislation  . 

             a)   AB 205 (Goldberg) Chapter 421, Statutes of 2003 provided 
               that registered domestic partners should have the same 
               rights, protections, and benefits as are granted to 
               spouses.  

             b)   AB 2208 (Kehoe) Chapter 488, Statutes of 2004 
               established the California Insurance Equality Act which 
               required all insurance plans to provide equal coverage to 
               registered domestic partners as to spouses. 

           Analysis Prepared by  :    Lisa Murawski / APPR. / (916) 319-2081