BILL NUMBER: AB 2115 AMENDED
BILL TEXT
AMENDED IN SENATE AUGUST 2, 2016
AMENDED IN ASSEMBLY MAY 11, 2016
AMENDED IN ASSEMBLY APRIL 20, 2016
AMENDED IN ASSEMBLY APRIL 5, 2016
AMENDED IN ASSEMBLY MARCH 18, 2016
INTRODUCED BY Assembly Member Wood
FEBRUARY 17, 2016
An act to amend Section 1366.50 of the Health and Safety Code, and
to amend Section 10786 of the Insurance Code, relating to health
care coverage.
LEGISLATIVE COUNSEL'S DIGEST
AB 2115, as amended, Wood. Health care coverage: disclosures.
Existing law, the federal Patient Protection and Affordable Care
Act, requires each state to, by January 1, 2014, establish an
American Health Benefit Exchange that makes available qualified
health plans to qualified individuals and small employers. Existing
state law establishes the California Health Benefit Exchange within
state government for the purpose of facilitating the enrollment of
qualified individuals and qualified small employers in qualified
health plans.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975,
provides for the regulation of health care service plans by the
Department of Managed Health Care and makes a willful violation of
the act a crime. Existing law provides for the regulation of health
insurers by the Department of Insurance. Existing law requires
specified health care service plans and health insurers to provide to
individuals who cease to be enrolled in individual or group health
care coverage a notice informing those individuals that they may be
eligible for reduced-cost coverage through the California Health
Benefit Exchange or no-cost coverage through Medi-Cal.
This bill would require a statement regarding patient assistance
programs to be included in the notice from health care service plans
and health insurers to individuals who cease to be enrolled in
individual or group health care coverage, as specified. Because a
willful violation of these requirements by a health care service plan
would be a crime, the bill would impose a state-mandated local
program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1366.50 of the Health and Safety Code is
amended to read:
1366.50. (a) (1) On and after January 1, 2017,
2018, a health care service plan providing individual or
group health care coverage shall provide to enrollees or subscribers
who cease to be enrolled in coverage a notice informing them that
they may be eligible for reduced-cost coverage through the California
Health Benefit Exchange established under Title 22 (commencing with
Section 100500) of the Government Code, or no-cost
coverage through Medi-Cal, or free or reduced cost
prescription medicines through a manufacturer's patient assistance
program. Medi-Cal. The notice shall include
information on obtaining coverage or assistance pursuant to those
programs, shall be in no less than 12-point type, and shall be
developed by the department, no later than July 1, 2017, in
consultation with the Department of Insurance, the Office of the
Patient Advocate, and the California Health Benefit Exchange.
(2) The notice shall include a statement clarifying that
assistance through a manufacturer's patient assistance program does
not constitute coverage under, and will indicating
that additional information on low- or no-cost programs for health
care and prescription medicines may be found on the Office of the
Patient Advocate's Internet Web site but that these programs may
not meet the requirements of the individual mandate
under, under the federal Patient Protection and
Affordable Care Act.
(3) The department shall include information in the notice on
locating free or reduced cost programs for health care and
prescription medicines, such as through the Internet Web site of the
Office of the Patient Advocate.
(b) The notice described in subdivision (a) may be incorporated
into or sent simultaneously with and in the same manner as any other
notices sent by the health care service plan.
(c) This section shall not apply with respect to a specialized
health care service plan contract or a Medicare supplemental plan
contract.
SEC. 2. Section 10786 of the Insurance Code is amended to read:
10786. (a) (1) On and after January 1, 2017,
2018, a health insurer providing health insurance coverage
shall provide to policyholders in individual policies or certificate
holders in group policies who cease to be enrolled in coverage a
notice informing them that they may be eligible for reduced-cost
coverage through the California Health Benefit Exchange established
under Title 22 (commencing with Section 100500) of the Government
Code, or no-cost coverage through Medi-Cal, or
free or reduced cost prescription medicines through a manufacturer's
patient assistance program. Medi-Cal. The notice
shall include information on obtaining coverage or assistance
pursuant to those programs, shall be in no less than 12-point type,
and shall be developed by the department, no later than July 1, 2017,
in consultation with the Department of Managed Health Care, the
Office of the Patient Advocate, and the California Health Benefit
Exchange.
(2) The notice shall include a statement clarifying that
assistance through a manufacturer's patient assistance program does
not constitute coverage under, and will indicating
that additional information on low- or no-cost programs for health
care and prescription medicines may be found on the Office of the
Patient Advocate's Internet Web site but that these programs may
not meet the requirements of the individual mandate
under, under the federal Patient Protection and
Affordable Care Act.
(3) The department shall include information in the notice on
locating free or reduced cost programs for health care and
prescription medicines, such as through the Internet Web site of the
Office of the Patient Advocate.
(b) The notice described in subdivision (a) may be incorporated
into or sent simultaneously with and in the same manner as any other
notices sent by the health insurer.
(c) This section shall not apply with respect to a specialized
health insurance policy or a health insurance policy consisting
solely of coverage of excepted benefits as described in Section 2722
of the federal Public Health Service Act (42 U.S.C. Sec. 300gg-21).
SEC. 3. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.