BILL ANALYSIS                                                                                                                                                                                                    Ó




                   Senate Appropriations Committee Fiscal Summary
                            Senator Kevin de León, Chair


          AB 2088 (R. Hernandez) - Health insurance: minimum value: large  
          group market policies.
          
          Amended: July 1, 2014           Policy Vote: Health 6-2
          Urgency: No                     Mandate: Yes
          Hearing Date: August 14, 2014                           
          Consultant: Brendan McCarthy    
          
          SUSPENSE FILE. AS AMENDED.
          
          
          Bill Summary: AB 2088 would require a health insurer or health  
          plan that sells a product in the large group market that does  
          not provide minimum essential coverage to ensure that enrollees  
          have other coverage that meets minimum essential coverage  
          requirements.

          Fiscal Impact (as approved on August 14, 2014): 
              Minor costs to the Department of Insurance to enforce  
              compliance (Insurance Fund).

              One-time costs of $170,000 in 2014-15 and $95,000 in  
              2015-16 for development of regulations and review of health  
              plan filings and ongoing costs of $67,000 per year  
              thereafter for enforcement by the Department of Managed  
              Health Care (Managed Care Fund).

          Background: Under current law, health insurers are regulated by  
          the Department of Insurance and health plans are regulated by  
          the Department of Managed Health Care (collectively referred to  
          as "carriers"). 

          The federal Affordable Care Act, and implementing legislation  
          enacted in California, makes a variety of changes to the  
          individual and group health insurance market. Changes to the  
          market include a requirement for "guaranteed issue" of coverage  
          if premiums are paid, a prohibition on denials of coverage for  
          preexisting conditions, and many other regulatory requirements. 

          Under the Affordable Care Act, employers with more than 50  
          employees are required to provide health care coverage that  
          meets minimum essential coverage, which is comprehensive health  








          AB 2088 (R. Hernandez)
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          care coverage that covers at least 60 percent of the total cost  
          of health care services covered by the plan.

          The Affordable Care Act, and implementing legislation in  
          California, made a number of changes to the health care  
          marketplace, with the overall impact of requiring qualifying  
          health plans to offer comprehensive benefits with high levels of  
          actuarial value. However, current law does not prohibit the sale  
          of health plans or insurance policies that do not meet these  
          requirements. For example, specialty coverage (dental plans,  
          vision plans) or limited benefit insurance plans.

          Proposed Law: AB 2088 would require a health insurer or health  
          plan that sells a product in the large group market that does  
          not provide minimum essential coverage to ensure that enrollees  
          have other coverage that meets minimum essential coverage  
          requirements.

          Related Legislation: AB 1972 (Gomez) would require the  
          Department of Finance to prepare an annual report that  
          identifies each employer in the state that employs 50 or more  
          employees who receive benefits from specified public assistance  
          programs. That bill is pending in this committee.

          Staff Comments: The intent of this bill is to ensure that large  
          employers do not offer their employees coverage that does not  
          meet minimum essential coverage. Rather than place this  
          requirement on the employer, however, this bill requires the  
          health plan or insurer to ensure that its enrollees are offered  
          coverage by the employer that meets minimum essential coverage  
          requirements.

          The only costs that may be incurred by a local agency under the  
          bill relate to crimes and infractions. Under the California  
          Constitution, such costs are not reimbursable by the state.

          Author's amendments: make minor changes to the disclosure  
          requirements in the bill.