HomeMy WebLinkAboutMINUTES - 04052011 - C.31RECOMMENDATION(S):
SUPPORT Assembly Bill 792 (Bonilla): Health Care Coverage: Health Benefit Exchange, a bill that requires the
disclosure of information on health care coverage through the Health Benefit Exchange by health care service plans,
health insurers, the Employment Development Department, upon an initial claim for disability benefits, or by the
court, upon the filing of a petition for dissolution of marriage, nullity of marriage, legal separation, or adoption, as
recommended by the Director of the Health Services Department.
FISCAL IMPACT:
Because a willful violation of the bill's provisions relative to health care service plans 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: No reimbursement is
required by this act pursuant to Section 6 of Article XIIIB of the California Constitution because the only costs that
may be incurred by a local agency or school district
APPROVE OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD
COMMITTEE
Action of Board On: 04/05/2011 APPROVED AS RECOMMENDED OTHER
Clerks Notes:
VOTE OF SUPERVISORS
AYES 5 NOES ____
ABSENT ____ ABSTAIN ____
RECUSE ____
Contact: Lara DeLaney,
925-335-1097
I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of
the Board of Supervisors on the date shown.
ATTESTED: April 5, 2011
David J. Twa, County Administrator and Clerk of the Board of Supervisors
By: June McHuen, Deputy
cc:
C.31
To:Board of Supervisors
From:Legislation Committee
Date:April 5, 2011
Contra
Costa
County
Subject:SUPPORT Position for AB 792 (Bonilla): Health Care Coverage: Health Benefit
Exchange
FISCAL IMPACT: (CONT'D)
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.
BACKGROUND:
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 employers. Existing state law establishes the California Health Benefit Exchange within state government,
specifies the powers and duties of the board governing the Exchange relative to determining eligibility for enrollment
in the Exchange and arranging for coverage under qualified health plans, and requires the board to facilitate the
purchase of qualified health plans through the Exchange by qualified individuals and small employers by January 1,
2014.
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 imposes specified
requirements on health care service plans and health insurers that provide medical and hospital coverage under an
employer-sponsored group plan for an employer subject to COBRA or Cal-COBRA, as defined. Existing law
regulates the distribution of unemployment compensation or disability benefits by the Employment Development
Department. Existing law, under the Family Code, sets forth procedures related to a petition for dissolution of
marriage, nullity of marriage, or legal separation, or a petition for adoption.
This bill, AB 792, would require the disclosure of information on health care coverage through the California Health
Benefit Exchange, under specified circumstances, by health care service plans, health insurers, the Employment
Development Department, upon an initial claim for disability benefits, or by the court, upon the filing of a petition for
dissolution of marriage, nullity of marriage, legal separation, or adoption. On and after January 1, 2014, the bill
would also require specified health care service plans and health insurers to, upon a renewal in coverage of an
enrollee or insured, as specified, or with regard to COBRA or Cal-COBRA coverage under an employer-sponsored
group plan, and the Employment Development Department with regard to an applicant for unemployment
compensation, provide specified information to the California Health Benefit Exchange for purposes of enrolling
those enrollees, insureds, or applicants in the Exchange. The bill would allow an individual to opt out of that coverage
in writing to the Exchange.
The Exchange is designed to be a “one-stop shop” that will offer affordable high-quality health insurance options to
individuals and families that earn up to 400 percent of the federal poverty level (FPL). The Exchange will provide
options to those that have none or limited insurance from their employer and cannot afford to purchase insurance, in
the individual or group market. Furthermore, the Exchange will be available for small businesses that cannot afford
group health insurance.
Today when someone loses their job or loses a spouse through divorce or death, they get a COBRA or HIPAA
notice. However, COBRA is not a solution for all, only 20% of those eligible enroll in COBRA. The cost, of COBRA
coverage, and the precipitating event (loss of job, loss of spouse) often results in loss of income, therefore people’s
inability to afford coverage is impossible.
This bill ensures the design of the Exchange and redesign of Medi-Cal take into account the need to serve short-term
uninsured as well as provide long-term coverage. AB 792 will help ensure Californians are provided notices and that
they are automatically enrolled into either the Exchange or Medi-Cal. The pre-enrollment process and notices are
essential to ensure that when life changing situations occur, people are aware of their health care options.
During 2012 and 2013, AB 792 requires a notice (for the life changing situations listed below) that low cost or no
cost coverage will be available through the Exchange and Medi-Cal in 2014:
Loss of employment-based coverage
Loss of coverage due to loss of a spouse/parent
Loss of coverage due to loss of a spouse/parent
Divorce or adoption of a child
Unemployment insurance claim
Beginning January 1, 2014, AB 792:
Requires insurers and health plans to provide pre-enrollment, into the Exchange and COBRA. COBRA events
include loss of employment-based coverage, lack of coverage due to loss of a spouse or parent and other
COBRA qualifying events.
Requires courts to provide a notice to those seeking divorce or adopting a child on the availability of health
care coverage through the Exchange or Medi-Cal.
Requires employers to provide a notice to the Employment Development Department (EDD) when
terminations of employment occur.
EDD, in turn, is required to auto-enroll those eligible for the Unemployment Insurance and State Disability
Insurance into the exchange.
The Health Services Department states: "AB 792 assures notification of beneficiaries by the front line agencies
involved in the categories as outlined i.e. employers, courts, and EDD. This supports public awareness and assistance
and is a positive step."
Support:
Health Access (Sponsor)
Opposition:
None Received.
STATUS :
02/17/2011 INTRODUCED.
03/10/2011 To ASSEMBLY Committees on HEALTH and JUDICIARY.
CONSEQUENCE OF NEGATIVE ACTION:
The Board of Supervisors' support of this bill will not be formally recognized.
CHILDREN'S IMPACT STATEMENT:
None.
california legislature—2011–12 regular session
ASSEMBLY BILL No. 792
Introduced by Assembly Member Bonilla
February 17, 2011
An act to add Sections 2024.7 and 8613.7 to the Family Code, to add
Sections 1366.50 and 1366.51 to the Health and Safety Code, to add
Sections 10786 and 10787 to the Insurance Code, to amend Section
2800.2 of the Labor Code, and to add Sections 1342.5 and 2706.5 to
the Unemployment Insurance Code, relating to health care coverage.
legislative counsel’s digest
AB 792, as introduced, Bonilla.Health care coverage: California
Health Benefit Exchange.
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 employers. Existing state law establishes the California
Health Benefit Exchange within state government, specifies the powers
and duties of the board governing the Exchange relative to determining
eligibility for enrollment in the Exchange and arranging for coverage
under qualified health plans, and requires the board to facilitate the
purchase of qualified health plans through the Exchange by qualified
individuals and small employers by January 1, 2014.
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 imposes specified
requirements on health care service plans and health insurers that provide
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medical and hospital coverage under an employer-sponsored group plan
for an employer subject to COBRA or Cal-COBRA, as defined. Existing
law regulates the distribution of unemployment compensation or
disability benefits by the Employment Development Department.
Existing law, under the Family Code, sets forth procedures related to
a petition for dissolution of marriage, nullity of marriage, or legal
separation, or a petition for adoption.
This bill would require the disclosure of information on health care
coverage through the California Health Benefit Exchange, under
specified circumstances, by health care service plans, health insurers,
the Employment Development Department, upon an initial claim for
disability benefits, or by the court, upon the filing of a petition for
dissolution of marriage, nullity of marriage, legal separation, or
adoption. On and after January 1, 2014, the bill would also require
specified health care service plans and health insurers to, upon a renewal
in coverage of an enrollee or insured, as specified, or with regard to
COBRA or Cal-COBRA coverage under an employer-sponsored group
plan, and the Employment Development Department with regard to an
applicant for unemployment compensation, provide specified
information to the California Health Benefit Exchange for purposes of
enrolling those enrollees, insureds, or applicants in the Exchange. The
bill would allow an individual to opt out of that coverage in writing to
the Exchange.
Because a willful violation of the bill’s provisions relative to health
care service plans 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:
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SECTION 1.Section 2024.7 is added to the Family Code, to
read:
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2024.7.Upon the filing of a petition for dissolution of marriage,
nullity of marriage, or legal separation, the court shall provide to
the petitioner and the respondent the following notice:
“If you do not have affordable health care coverage, effective
January 1, 2014, you may obtain health care coverage through the
California Health Benefit Exchange. What you pay for coverage
through the Exchange will depend on how much you make. If your
income is low, you may qualify for no-cost coverage through
Medi-Cal. For more information, check www.healthcare.ca.gov
or call 1-888-Healthhelp (insert telephone number).”
SEC. 2.Section 8613.7 is added to the Family Code, to read:
8613.7.Upon the filing of a petition for adoption pursuant to
this part, the court shall provide to the petitioner the following
notice:
“If you do not have affordable health care coverage, effective
January 1, 2014, you may obtain health care coverage through the
California Health Benefit Exchange. What you pay for coverage
through the Exchange will depend on how much you make. If your
income is low, you may qualify for no-cost coverage through
Medi-Cal. For more information, check www.healthcare.ca.gov
or call 1-888-Healthhelp (insert telephone number).”
SEC. 3.Section 1366.50 is added to the Health and Safety
Code, to read:
1366.50.(a) Except for a specialized health care service plan,
every health care service plan contract that is issued, amended,
delivered, or renewed in this state on or after January 1, 2014, that
provides medical and hospital coverage under an
employer-sponsored group plan for an employer subject to
COBRA, as defined in subdivision (e) of Section 1373.621, or an
employer group for which the plan is required to offer Cal-COBRA
coverage, as defined in subdivision (f) of Section 1373.621,
including a carrier providing replacement coverage under Section
1399.63, shall further offer the former employee or former
dependent of an employee the opportunity to continue benefits as
required under subdivision (b), and shall further offer the former
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employee or former dependent of an employee the opportunity to
continue benefits as required under subdivision (b).
(b) (1) The health care service plan shall provide to the
California Health Benefit Exchange information regarding the
former employee and any dependents covered under the group
coverage. The information provided shall include the name or
names, most recent address, and any other information that is in
the possession of the plan and that the Exchange may require in a
manner to be prescribed by the Exchange.
(2) The information shall constitute an application for enrollment
in coverage within the meaning of Section 100503 of the
Government Code.
(c) (1) On and after January 1, 2014, notification provided to
employees, members, former employees, dependents, or former
dependents under subdivisions (a) and (b) shall also include the
following notification in 12-point type:
“Because you are no longer enrolled in coverage provided by
your employer or the employer of a family member, an application
for health care coverage through the California Health Benefit
Exchange has been made for you. You are not required to accept
coverage from the Exchange. Your payment for this coverage will
be based on your income last year. If you make significantly less
or more this year than you made last year, please tell the California
Health Benefit Exchange and your charges will be based on your
current income. If your income is low, you may qualify for no-cost
coverage through Medi-Cal. For more information, check
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number).”
(2) To decline health care coverage pursuant to this section, the
individual shall elect to do so by notifying the Exchange in writing
within 63 calendar days of the date of termination of group
coverage.
SEC. 4.Section 1366.51 is added to the Health and Safety
Code, to read:
1366.51.(a) Except for a specialized health care service plan,
every health care service plan contract that is issued, amended,
delivered, or renewed in this state on or after January 1, 2014, that
provides medical and hospital coverage to an individual shall
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further offer notice 60 days in advance of renewal of the
opportunity to continue benefits as required under subdivision (b),
and shall further offer the individual or former dependent of an
individual the opportunity to continue benefits as required under
subdivision (b).
(b) (1) The health care service plan shall provide to the
California Health Benefit Exchange information regarding the
former covered individual and any dependents that chose not to
renew individual coverage. The information provided shall include
the name or names, most recent address, and any other information
that is in the possession of the plan and that the Exchange may
require in a manner to be prescribed by the Exchange.
(2) The information shall constitute an application for enrollment
in coverage within the meaning of Section 100503 of the
Government Code.
(c) (1) On and after January 1, 2014, notification provided to
employees, members, former employees, dependents, or former
dependents under subdivisions (a) and (b) shall also include the
following notification in 12-point type:
“Because you are no longer enrolled in coverage purchased by
you as an individual or as the dependent of a family member, an
application for health care coverage through the California Health
Benefit Exchange has been made for you. You are not required to
accept coverage from the Exchange. Your payment for coverage
will be based on your income last year. If you make significantly
less or more this year than you made last year, please tell the
California Health Benefit Exchange and your charges will be based
on your current income. If your income is low, you may qualify
for no-cost coverage through Medi-Cal. For more information,
check www.healthcare.ca.gov or call 1-888-Healthhelp (insert
telephone number).”
(2) To decline health care coverage pursuant to this section, the
individual shall elect to do so by notifying the Exchange in writing
within 63 calendar days of the date of termination of individual
coverage.
SEC. 5.Section 10786 is added to the Insurance Code, to read:
10786.(a) Every health insurance policy that is issued,
amended, delivered, or renewed in this state on or after January
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1, 2014, that provides medical and hospital coverage under an
employer-sponsored group plan for an employer subject to
COBRA, as defined in subdivision (e) of Section 10116.5, or an
employer group for which the plan is required to offer Cal-COBRA
coverage, as defined in subdivision (f) of Section 10116.5,
including a carrier providing replacement coverage under Section
10128.3, shall further offer the former employee or former
dependent of an employee the opportunity to continue benefits as
required under subdivision (b), and shall further offer the former
employee or former dependent of an employee the opportunity to
continue benefits as required under subdivision (b).
(b) (1) The health insurer shall provide to the California Health
Benefit Exchange information regarding the former employee and
any dependents covered under the group coverage. The information
provided shall include the name or names, most recent address,
and any other information that is in the possession of the insurer
and that the Exchange may require in a manner to be prescribed
by the Exchange.
(2) The information shall constitute an application for enrollment
in coverage within the meaning of Section 100503 of the
Government Code.
(c) (1) On and after January 1, 2014, notification provided to
employees, members, former employees, dependents, or former
dependents under subdivisions (a) and (b) shall also include the
following notification in 12-point type:
“Because you are no longer enrolled in coverage provided by
your employer or the employer of a family member, an application
for health care coverage through the California Health Benefit
Exchange has been made for you. You are not required to accept
coverage from the Exchange. Your payment for this coverage will
be based on your income last year. If you make significantly less
or more this year than you made last year, please tell the California
Health Benefit Exchange and your charges will be based on your
current income. If your income is low, you may qualify for no-cost
coverage through Medi-Cal. For more information, check
www.healthcare.ca.gov or call 1-888-Healthhelp (insert telephone
number).”
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(2) To decline health care coverage pursuant to this section, the
individual shall elect to do so by notifying the Exchange in writing
within 63 calendar days of the date of termination of group
coverage.
SEC. 6.Section 10787 is added to the Insurance Code, to read:
10787.(a) Every health insurance policy that is issued,
amended, delivered, or renewed in this state on or after January
1, 2014, that provides medical and hospital coverage to an
individual shall further offer notice 60 days in advance of renewal
of the opportunity to continue benefits as required under
subdivision (b), and shall further offer the individual or former
dependent of an individual the opportunity to continue benefits as
required under subdivision (b).
(b) (1) The health insurer shall provide to the California Health
Benefit Exchange information regarding the former covered
individual and any dependents that chose not to renew individual
coverage. The information provided shall include the name or
names, most recent address, and any other information that is in
the possession of the insurer and that the Exchange may require
in a manner to be prescribed by the Exchange.
(2) The information shall constitute an application for enrollment
in coverage within the meaning of Section 100503 of the
Government Code.
(c) (1) On and after January 1, 2014, notification provided to
employees, members, former employees, dependents, or former
dependents under subdivisions (a) and (b) shall also include the
following notification in 12-point type:
“Because you are no longer enrolled in coverage purchased by
you as an individual or as the dependent of a family member, an
application for health care coverage through the California Health
Benefit Exchange has been made for you. You are not required to
accept coverage from the Exchange. Your payment for coverage
will be based on your income last year. If you make significantly
less or more this year than you made last year, please tell the
California Health Benefit Exchange and your charges will be based
on your current income. If your income is low, you may qualify
for no-cost coverage through Medi-Cal. For more information,
check www.healthcare.ca.gov or call 1-888-Healthhelp (insert
telephone number).”
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(2) To decline health care coverage pursuant to this section, the
individual shall elect to do so by notifying the Exchange in writing
within 63 calendar days of the date of termination of individual
coverage.
SEC. 7.Section 2800.2 of the Labor Code is amended to read:
2800.2.(a) Any employer, employee association, or other
entity otherwise providing hospital, surgical, or major medical
benefits to its employees or members is solely responsible for
notification of its employees or members of the conversion
coverage made available pursuant to Part 6.1 (commencing with
Section 12670) of Division 2 of the Insurance Code or Section
1373.6 of the Health and Safety Code.
(b) Any employer, employee association, or other entity, whether
private or public, that provides hospital, medical, or surgical
expense coverage that a former employee may continue under
Section 4980B of Title 26 of the United States Code, Section 1161
et seq. of Title 29 of the United States Code, or Section 300bb of
Title 42 of the United States Code, as added by the Consolidated
Omnibus Budget Reconciliation Act of 1985 (Public Law 99-272),
and as may be later amended (hereafter “COBRA”), shall, in
conjunction with the notification required by COBRA that COBRA
continuation coverage will cease and conversion coverage is
available, and as a part of the notification required by subdivision
(a), also notify the former employee, spouse, or former spouse of
the availability of the continuation coverage under Section
1373.621 of the Health and Safety Code, and Sections 10116.5
and 11512.03 of the Insurance Code.
(c) (1) On or after July 1, 2006, until January 1, 2012,
notification provided to employees, members, former employees,
spouses, or former spouses under subdivisions (a) and (b) shall
also include the following notification:
“Please examine your options carefully before declining this
coverage. You should be aware that companies selling individual
health insurance typically require a review of your medical history
that could result in a higher premium or you could be denied
coverage entirely.”
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(2) On and after January 1, 2012, until December 31, 2013,
notification provided to employees, members, former employees,
spouses, or former spouses under subdivisions (a) and (b) shall
also include the following notification:
“Please examine your options carefully before declining this
coverage. Until January 1, 2014, you should be aware that
companies selling individual health insurance to adults who are
19 years of age or older typically require a review of your medical
history that could result in a higher premium or you could be
denied coverage entirely. Effective January 1, 2010, children under
19 years of age cannot be denied individual coverage based on
medical history but may pay a higher premium depending on
medical history.”
(3) On and after January 1, 2014, notification provided to
employees, members, former employees, spouses, or former spouses
under subdivisions (a) and (b) shall also include the following
notification:
“Because you are no longer enrolled in coverage purchased by
you as an individual or as the dependent of a family member, an
application for health care coverage through the California Health
Benefit Exchange has been made for you. You are not required to
accept coverage from the Exchange. You will be charged for
Exchange coverage based on your income last year. If you make
significantly less or more this year than you made last year, please
tell the California Health Benefit Exchange and your charges will
be based on your current income. If your income is low, you may
qualify for no-cost coverage through Medi-Cal. For more
information, check www.healthcare.ca.gov or call
1-888-Healthhelp (insert telephone number).”
(d) To decline health care coverage pursuant to this section,
the individual shall elect to do so by notifying the Exchange in
writing within 63 calendar days of the date of termination of
individual coverage.
SEC. 8.Section 1342.5 is added to the Unemployment
Insurance Code, to read:
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1342.5.(a) On and after January 1, 2014, when an individual
files a new claim for unemployment compensation under this
chapter, the department shall do all of the following:
(1) (A) Provide to the California Health Benefit Exchange the
name, address, and any other identifying information that is in the
possession of the department as the Exchange may require in a
manner to be prescribed by the Exchange.
(B) The information shall constitute an application for
enrollment in coverage within the meaning of Section 100503 of
the Government Code.
(b) Provide the following notice to the individual:
“Because you have applied for unemployment compensation,
an application for health care coverage through the California
Health Benefit Exchange has been made for you. You are not
required to accept coverage from the Exchange. You will be
charged for Exchange coverage based on your income last year.
If you make significantly less or more this year than you made last
year, please tell the California Health Benefit Exchange and your
charges will be based on your current income. If your income is
low, you may qualify for no-cost coverage through Medi-Cal. For
more information, check www.healthcare.ca.gov or call
1-888-Healthhelp (insert telephone number).”
(c) To decline health care coverage pursuant to this section, the
individual shall elect to do so by notifying the Exchange in writing.
SEC. 9.Section 2706.5 is added to the Unemployment
Insurance Code, to read:
2706.5.(a) When an individual files a new claim for disability
benefits under this part, the department shall provide the following
notice to the individual:
“If you do not have affordable health care coverage, effective
January 1, 2014, you may obtain health care coverage through the
California Health Benefit Exchange. What you pay for coverage
through the Exchange will depend on how much you make. If your
income is low, you may qualify for no-cost coverage through
Medi-Cal. For more information, check www.healthcare.ca.gov
or call 1-888-Healthhelp (insert telephone number).”
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(b) This notice shall be provided upon initial application whether
or not the individual is eligible for disability benefits.
SEC. 10.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.
O
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