BILL ANALYSIS                                                                                                                                                                                                    �



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        ASSEMBLY THIRD READING
        AB 1877 (Cooley)
        As Amended May 23, 2014
        2/3 vote.  Urgency 

         HEALTH              19-0        APPROPRIATIONS      16-0        
         
         ----------------------------------------------------------------- 
        |Ayes:|Pan, Maienschein,         |Ayes:|Gatto, Bigelow,           |
        |     |Ammiano, Holden, Bonilla, |     |Bocanegra, Bradford, Ian  |
        |     |Bonta, Ch�vez, Chesbro,   |     |Calderon, Campos, Eggman, |
        |     |Gomez, Gonzalez,          |     |Gomez, Holden, Jones,     |
        |     |Roger Hern�ndez, Mansoor, |     |Linder, Pan, Quirk,       |
        |     |Nazarian, Nestande,       |     |Ridley-Thomas, Wagner,    |
        |     |Patterson, Ridley-Thomas, |     |Weber                     |
        |     |Wagner, Wieckowski,       |     |                          |
        |     |Eggman                    |     |                          |
        |     |                          |     |                          |
         ----------------------------------------------------------------- 
         SUMMARY  :  Creates in state government the California Vision Care  
        Access Council (Council), modeled after the California Health  
        Benefit Exchange (Exchange), to create a marketplace for the  
        purchase of vision plans by individuals and employers.  Contains an  
        urgency clause in order to become effective immediately upon  
        enactment.  Specifically,  this bill :  

        1)Creates requirements for the government of the Council by an  
          uncompensated executive board, appointed by the Governor, the  
          Senate Rules Committee, and the Speaker of the Assembly that  
          complies with broad conflict of interest and open meeting  
          provisions.
         
        2)Gives the Council the following duties:

           a)   Construct, manage, and maintain a vision plan marketplace,  
             accessible through a website and through other means.  

           b)   Selectively contract for vision coverage in each region of  
             the state so as to provide options that offer the optimal  
             combination of choice, value, quality, and service.  Determine  
             and approve cost-sharing provisions for vision plans and  
             standardize products offered through the Council.

           c)   Work cooperatively with the Exchange to establish a direct  








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             link from the Exchange Web site to the Council Web site.  Refer  
             consumers to the Exchange if they have questions about Medi-Cal  
             or Exchange plan enrollment and eligibility.

           d)   Market and publicize the Council's vision plans, while  
             ensuring clear communication to consumers that federal  
             subsidies are not available for this coverage.  

           e)   Provide information in a culturally and linguistically  
             appropriate manner and conduct public outreach.

           f)   Assess a charge on the vision plans offered through the  
             marketplace that is reasonable and necessary to support the  
             development, operations, and prudent cash management of the  
             Council.  

        3)Gives the Council the authority to enter into contracts; adopt an  
          official seal; sue and be sued; adopt rules and regulations; and  
          receive and accept gifts, grants, or donations from government  
          agencies and from individuals, associations, private foundations,  
          or corporations, in compliance with conflict of interest  
          provisions adopted by the board at a public meeting.

        4)Prohibits the use of state General Fund moneys for the purposes of  
          this bill.  Creates the California Vision Care Access Trust Fund  
          (Fund) in the State Treasury, continuously appropriated to fund  
          the activities of the Council, and requires any costs associated  
          with the implementation of this bill to be paid from the fund.   
          Makes this bill's implementation contingent on the existence of at  
          least $250,000 in the fund.  

         FISCAL EFFECT  :  According to the Assembly Appropriations Committee:

        1)One-time costs as follows: 

           a)   Significant costs, likely millions of dollars at a minimum  
             (special fund), for information technology (IT) systems with  
             required functionality.

           b)   Indeterminate costs, likely in the range of hundreds of  
             thousands to low millions of dollars (special fund) for initial  
             policy and procedure development, hiring, training, equipment,  
             and other start-up activities.









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           c)   This bill makes implementation contingent upon $250,000 in  
             the fund, but does not provide a mechanism for funding start-up  
             costs.

        2)Ongoing costs of at least $5 million dollars (special fund/fee  
          revenue), for state staff and IT support of numerous activities  
          including enrollment, provision of information via a public facing  
          website, financial management, public outreach and communication,  
          and plan contracting and oversight.  

        This bill requires the Council to assess a charge on the vision  
          plans offered through the marketplace that is reasonable and  
          necessary to support Council activities, but does not require the  
          Council to be fully fee-supported.  

         COMMENTS  :  In 2012, the Exchange Board adopted a policy to offer  
        supplemental dental and vision benefits through the Exchange, on the  
        basis that stand-alone vision plans may increase the likelihood of  
        utilization and provide greater emphasis on preventive care, and  
        that offering stand-alone vision plans would bolster the consumer  
        friendliness of the Exchange.  However, subsequent federal guidance  
        indicated that stand-alone vision plans cannot be offered in or  
        through an exchange.

        VSP Global, the sponsor of this bill, notes that vision coverage,  
        particularly in California, is primarily provided through  
        stand-alone plans.  VSP further asserts that eye doctors are able to  
        detect previously undetected chronic conditions like diabetes,  
        hypertension, and high cholesterol.  Moreover, VSP asserts that  
        enrollees in stand-alone vision plans are more likely to utilize  
        their benefits than enrollees with vision benefits bundled with  
        other health care services.  This bill is intended to use federal  
        guidance to create a new marketplace for the purchase of affordable,  
        quality vision care coverage, thereby increasing access to vision  
        care through stand-alone vision plans.  
         

        Analysis Prepared by  :    Ben Russell / HEALTH / (916) 319-2097 

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