Bill Text: CA SB1181 | 2015-2016 | Regular Session | Introduced

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Bill Title: Health care service plan contracts.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Failed) 2016-11-30 - From committee without further action. [SB1181 Detail]

Download: California-2015-SB1181-Introduced.html

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BILL NUMBER: SB 1181	INTRODUCED
	BILL TEXT


INTRODUCED BY   Senator Monning

                        FEBRUARY 18, 2016

   An act to amend Section 1374.21 of the Health and Safety Code,
relating to health care service plans.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 1181, as introduced, Monning. Health care service plan
contracts.
   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 and makes a willful
violation of the act a crime. Existing law regulates the manner in
which a plan makes premium or coverage changes to a contract,
including requiring prescribed notice to enrollees within a specified
time period.
   This bill would make technical, nonsubstantive changes to these
provisions.
   Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.


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

  SECTION 1.  Section 1374.21 of the Health and Safety Code is
amended to read:
   1374.21.  (a) (1) A change in premium rates or changes in coverage
stated in a group health care service plan contract shall not become
effective unless the plan has delivered  in writing
 a  written  notice indicating the change or
changes at least 60 days prior to the contract renewal effective
date.
   (2) The notice delivered pursuant to paragraph (1) for large group
health plans shall also include the following information:
   (A) Whether the rate proposed to be in effect is greater than the
average rate increase for individual market products negotiated by
the California Health Benefit Exchange for the most recent calendar
year for which the rates are final.
   (B) Whether the rate proposed to be in effect is greater than the
average rate increase negotiated by the Board of Administration of
the Public Employees' Retirement System for the most recent calendar
year for which the rates are final.
   (C) Whether the rate change includes any portion of the excise tax
paid by the health plan.
   (b) A health care service plan that declines to offer coverage
 to   to,  or denies enrollment 
for   for,  a large group applying for coverage
shall, at the time of the denial of coverage, provide the applicant
with the specific reason or reasons for the decision in writing, in
clear, easily understandable language.