BILL ANALYSIS                                                                                                                                                                                                    �



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          SENATE THIRD READING
          SB 959 (Ed Hernandez)
          As Amended August 4, 2014
          Majority vote

           SENATE VOTE  :24-7  
           
           HEALTH              19-0        APPROPRIATIONS      17-0        
           
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          |Ayes:|Pan, Maienschein,         |Ayes:|Gatto, Bigelow,           |
          |     |Ammiano, Bonilla, Bonta,  |     |Bocanegra, Bradford, Ian  |
          |     |Ch�vez, Chesbro, Gomez,   |     |Calderon, Campos,         |
          |     |Gonzalez, Roger           |     |Donnelly, Eggman, Gomez,  |
          |     |Hern�ndez, Lowenthal,     |     |Holden, Jones, Linder,    |
          |     |Mansoor, Nazarian,        |     |Pan, Quirk,               |
          |     |Nestande, Patterson,      |     |Ridley-Thomas, Wagner,    |
          |     |Ridley-Thomas, Rodriguez, |     |Weber                     |
          |     |Wagner, Wieckowski        |     |                          |
          |     |                          |     |                          |
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           SUMMARY  :  Requires health plans and insurers to deliver notice  
          of rate changes at least 15 days in advance of the annual open  
          enrollment period and makes numerous additional changes to  
          current law related to health plans and insurers.  Specifically,  
           this bill  :  

          1)Limits the requirement to sell catastrophic coverage through  
            the California Health Benefit Exchange (Exchange, now known as  
            Covered California) to individual market plans and insurers  
            and requires small group plans and insurers in the Small  
            Business Health Options Program plans to offer bronze, silver,  
            gold, and platinum plans, but not catastrophic.

          2)Includes participation fees paid by health plans and insurers  
            that sell products through the Exchange in the calculation  
            (under current law) of the index rate upon which premium rates  
            are based.

          3)Updates the definition of "small employer," for purposes of  
            law governing products sold through the Exchange and for the  
            purposes of statutes governing essential health benefits in  
            the small group market, to the existing definition that  
            applies to nongrandfathered plans under the federal Patient  








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            Protection and Affordable Care Act (ACA).  Beginning in 2016,  
            this expands the definition of small employer to include  
            employers with up to 100 employees, rather than 50.

          4)Deletes an obsolete requirement for health plans and insurers  
            that offer small group coverage at a rate that is higher than  
            the standard employee risk rate to provide a reason for the  
            decision to offer coverage at a higher rate.  Deletes a  
            similar obsolete requirement for health plans and insurers  
            that deny coverage for an individual.

          5)Updates requirements that require plans and insurers to notify  
            individuals who are denied coverage about coverage options  
            through the Major Risk Medical Insurance Program, as  
            specified, to apply to only specific circumstances under which  
            an individual might be denied coverage:  a grandfathered  
            individual health plan or insurer rejects the addition of a  
            dependent, or a Medicare supplement plan rejects an applicant  
            due to the applicant having end-stage renal disease.  Requires  
            plans and insurers, in these circumstances, to also inform the  
            applicant about new coverage options through Covered  
            California, as specified.
          
          6)Deletes a requirement for small group and individual health  
            plan contract and insurance policy rate filings to be  
            concurrent with notices to enrollees required to be delivered  
            60 days in advance.

          7)Updates rate filing requirements to reflect the 19 rating  
            regions established in current law governing the individual  
            and small group market.
          
          8)Corrects and updates code section references and makes other  
            minor, technical, and clarifying changes.

           FISCAL EFFECT  :  According the Assembly Appropriations Committee,  
          negligible state fiscal effect.  

           COMMENTS  :  The author asserts this bill is necessary to make  
          sure there are not ambiguities or uncertainty about California's  
          health insurance laws, which have undergone significant changes  
          with the passage of the ACA.  This bill is a 2014 omnibus health  
          insurance clean-up bill.  Among its many changes, this bill  
          requires plans and insurers to send enrollees a notice of a rate  








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          increase at least 15 days prior to open enrollment.  Under  
          current law, this notice could be sent in the middle of the open  
          enrollment period, making it less useful for a consumer who  
          might want to shop for other coverage during open enrollment.   
          In addition, this bill allows health plans and insurers, when  
          setting their premium rates in the individual market, to factor  
          in the fees they pay for participation in the Exchange.  This  
          change is in conformity with federal regulations. 

          Health Access California, in support, writes that California has  
          enacted numerous pieces of landmark legislation to implement and  
          improve on the federal ACA.  These laws have eliminated denials  
          of coverage based on pre-existing conditions, provided public  
          scrutiny of health insurance rates, and otherwise imposed  
          consumer protections.  This bill makes numerous conforming and  
          clarifying corrections to these laws.

          There is no opposition on file.


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


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