Bill Text: CA AB1507 | 2013-2014 | Regular Session | Amended

California Assembly Bill 1507 (Prior Session Legislation)

Bill Title: Health care coverage.

Sponsorship: Strong Partisan Bill (Republican 13-1)

Status: (Introduced - Dead) 2014-04-30 - From committee without further action pursuant to Joint Rule 62(a). [AB1507 Detail]

Download: California-2013-AB1507-Amended.html

BILL NUMBER: AB 1507	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  APRIL 21, 2014

INTRODUCED BY   Assembly Member Logue
   (Coauthors: Assembly Members Achadjian, Allen, Conway, Donnelly,
Beth Gaines, Grove, Hagman, Harkey, Jones, Melendez, Nestande,
 and Wagner   Wagner,   and Wilk 
)

                        JANUARY 14, 2014

   An act to add Section 1367.011 to the Health and Safety Code, and
to add Section 10112.299 to the Insurance Code, relating to health
care coverage, and declaring the urgency thereof, to take effect
immediately.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 1507, as amended, Logue. Health care coverage.
   Existing federal law, the federal Patient Protection and
Affordable Care Act (PPACA), enacts various health care coverage
market reforms that take effect with respect to plan years on or
after January 1, 2014. Among other things, PPACA requires each health
insurance issuer that offers health insurance coverage in the
individual or group market in a state to accept every employer and
individual in the state that applies for that coverage and to renew
that coverage at the option of the plan sponsor or the individual.
PPACA prohibits a group health plan and a health insurance issuer
offering group or individual health insurance coverage from imposing
any preexisting condition exclusion with respect to that plan or
coverage. PPACA allows the premium rate charged by a health insurance
issuer offering small group or individual coverage to vary only by
rating area, age, tobacco use, and whether the coverage is for an
individual or family and prohibits discrimination against individuals
based on health status. PPACA requires a health insurance issuer
that offers coverage in the small group or individual market to
ensure that the coverage includes the essential health benefits
package, as defined. However, guidance issued under PPACA grants
transitional relief to health insurance coverage in the individual or
small group market in effect on October 1, 2013, that is renewed for
a policy year starting between January 1, 2014, and October 1, 2014,
and exempts that coverage from certain PPACA reforms, as specified.
   Existing law, the Knox-Keene Health Care Service Plan Act of 1975,
provides for the licensure and regulation of health care service
plans by the Department of Managed Health Care. Existing law also
provides for the regulation of health insurers by the Department of
Insurance. Existing law implements the PPACA reforms described above
under the Knox-Keene Act and the laws governing health insurance.
   This bill would allow an individual or small employer health
benefit plan in effect on October 1, 2013, that does not qualify as a
grandfathered health plan under PPACA to be renewed until October 1,
2014, and to continue to be in force until December 31, 2014. The
bill would exempt an individual or small employer health benefit plan
in effect on October 1, 2013, that does not qualify as a
grandfathered health plan under PPACA and that is renewed between
January 1, 2014, and October, 1, 2014, from various provisions of
state law that implement the PPACA reforms described above. The bill
would require that these provisions be implemented only to the extent
permitted by PPACA.
   The bill would declare that it is to take effect immediately as an
urgency statute.
   Vote: 2/3. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 1367.011 is added to the Health and Safety
Code, to read:
   1367.011.  (a) An individual or small employer health benefit plan
in effect on October 1, 2013, that does not qualify as a
grandfathered health plan under Section 1251 of PPACA may be renewed
until October 1, 2014, and may continue to be in force until December
31, 2014, subject to applicable federal law, any other requirements
imposed  by   under  this chapter, and any
requirements imposed by the health benefit plan.
   (b) An individual or small employer health benefit plan in effect
on October 1, 2013, that does not qualify as a grandfathered health
plan under Section 1251 of PPACA and that is renewed for a plan or
policy year starting between January 1, 2014, and October 1, 2014,
inclusive, shall be treated as a "grandfathered health care service
plan contract," a "grandfathered health plan," a "grandfathered
health benefit plan," or "grandfathered coverage" under the following
provisions, as applicable, until December 31, 2014, subject to the
notice requirements imposed under PPACA:
   (1) Article 3.16 (commencing with Section 1357.500), except for
subdivision (i) of Section 1357.503.
   (2) Article 3.17 (commencing with Section 1357.600).
   (3) Article 3.15 (commencing with Section 1357.50), subject to
subdivision (c).
   (4) Section 1367.005.
   (5) Section 1367.0065.
   (6) Section 1367.008.
   (7) Section 1367.009.
   (8) Section 1389.4.
   (9) Article 11.8 (commencing with Section 1399.845), except for
subdivision (h) of Section 1399.849.
   (c)  Notwithstanding Section 1399.836, Sections 1399.826 and
1399.828 shall apply to an individual health benefit plan described
in subdivision (b) until December 31, 2014.
   (d) A small employer health benefit plan described in subdivision
(b) shall not be subject to Section 1367.007. This subdivision shall
become inoperative on December 31, 2014.
   (e) This section shall be implemented only to the extent permitted
by PPACA.
   (f) For purposes of this section, the following definitions shall
apply:
   (1)  "Health benefit plan" means any individual or group health
care service plan contract that provides medical, hospital, and
surgical benefits. The term does not include a specialized health
care service plan contract, a health care service plan contract
provided in the Medi-Cal program (Chapter 7 (commencing with Section
14000) of Part 3 of Division 9 of the Welfare and Institutions Code),
the Healthy Families Program (Part 6.2 (commencing with Section
12693) of Division 2 of the Insurance Code), the Access for Infants
and Mothers Program (Part 6.3 (commencing with Section 12695) of
Division 2 of the Insurance Code), the program under Part 6.4
(commencing with Section 12699.50) of Division 2 of the Insurance
Code, coverage of Medicare services pursuant to contracts with the
United States government, or Medicare supplement coverage, to the
extent consistent with PPACA.
   (2) "Plan year" or "policy year" have the meanings set forth in
Section 144.103 of Title 45 of the Code of Federal Regulations.
   (3) "PPACA" means the federal Patient Protection and Affordable
Care Act (Public Law 111-148), as amended by the federal Health Care
and Education Reconciliation Act of 2010 (Public Law 111-152), and
any rules, regulations, or guidance issued pursuant to that law.
   (4) "Small employer health benefit plan" means a group health
benefit plan issued to a small employer, as defined in Section
1357.500 or 1357.600.
  SEC. 2.  Section 10112.299 is added to the Insurance Code, to read:

   10112.299.  (a) An individual or small employer health benefit
plan in effect on October 1, 2013, that does not qualify as a
grandfathered health plan under Section 1251 of PPACA may be renewed
until October 1, 2014, and may continue to be in force until December
31, 2014, subject to applicable federal law, any other requirements
imposed  by   under  this part, and any
requirements imposed by the health benefit plan.
   (b) An individual or small employer health benefit plan in effect
on October 1, 2013, that does not qualify as a grandfathered health
plan under Section 1251 of PPACA and that is renewed for a plan or
policy year starting between January 1, 2014, and October 1, 2014,
inclusive, shall be treated as a "grandfathered health insurance
policy," a "grandfathered health plan," a "grandfathered health
benefit plan," or "grandfathered coverage" under the following
provisions, as applicable, until December 31, 2014, subject to the
notice requirements imposed under PPACA:
   (1) Chapter 8.01 (commencing with Section 10753), except for
subdivision (k) of Section 10753.05.
   (2) Chapter 8.02 (commencing with Section 10755).
   (3) Article 7 (commencing with Section 10198.6), subject to
subdivision (c).
   (4) Section 10112.27.
   (5) Section 10112.285.
   (6) Section 10112.295.
   (7) Section 10112.297.
   (8) Section 10113.95.
   (9) Chapter 9.9 (commencing with Section 10965), except for
subdivision (h) of Section 10965.3.
   (c)  Notwithstanding Section 10960.5, Sections 10951 and 10953
shall apply to an individual health benefit plan described in
subdivision (b) until December 31, 2014.
   (d) A small employer health benefit plan described in subdivision
(b) shall not be subject to Section 10112.29. This subdivision shall
become inoperative on December 31, 2014.
   (e) This section shall be implemented only to the extent permitted
by PPACA.
   (f) For purposes of this section, the following definitions shall
apply:
   (1) "Health benefit plan" means any individual or group policy of
health insurance that provides medical, hospital, and surgical
benefits. The term does not include a policy that provides excepted
benefits as described in Sections 2722 and 2791 of the federal Public
Health Service Act (42 U.S.C. Sec. 300gg-21; 42 U.S.C. Sec.
300gg-91), a health insurance policy provided in the Medi-Cal program
(Chapter 7 (commencing with Section 14000) of Part 3 of Division 9
of the Welfare and Institutions Code), the Healthy Families Program
(Part 6.2 (commencing with Section 12693) of Division 2), the Access
for Infants and Mothers Program (Part 6.3 (commencing with Section
12695) of Division 2), or the program under Part 6.4 (commencing with
Section 12699.50) of Division 2, coverage of Medicare services
pursuant to contracts with the United States government, or Medicare
supplement coverage, to the extent consistent with PPACA.
   (2) "Plan year" or "policy year" have the meanings set forth in
Section 144.103 of Title 45 of the Code of Federal Regulations.
   (3) "PPACA" means the federal Patient Protection and Affordable
Care Act (Public Law 111-148), as amended by the federal Health Care
and Education Reconciliation Act of 2010 (Public Law 111-152), and
any rules, regulations, or guidance issued pursuant to that law.
   (4) "Small employer health benefit plan" means a group health
benefit plan issued to a small employer, as defined in Section 10753
or 10755.
  SEC. 3.  This act is an urgency statute necessary for the immediate
preservation of the public peace, health, or safety within the
meaning of Article IV of the Constitution and shall go into immediate
effect. The facts constituting the necessity are:
   In order to carry out the transitional policy under the federal
Patient Protection and Affordable Care Act announced by the President
of the United States on November 14, 2013, and to allow individuals
and small businesses to reenroll in their current health care
coverage, it is necessary that this act take effect immediately.