Sep 17, 2018
Below are bills that have passed the California Legislature. As of this date, Governor Jerry Brown has signed several into law.
UNIVERSAL COVERAGE
Signed into law: AB 2472 (Wood D): The bill requires Covered California to analyze the feasibility of a public health plan option.
MEDICAL LOSS RATIOS
Signed into law: AB 2499 (Arambula D): There have been efforts to weaken Medical Loss Ratio (MLR) requirements by the Administration, but California is going its own way with AB 2499. The bill would codify California’s MLR regulations into law to protect them from changes made at the federal level. This bill would exempt only specialized health care service plan contracts and specialized health insurance policies that provide only dental or vision services from the annual rebate requirement. As amended, AB 2499 no longer includes provisions to raise the MLR standard by 5% for small and large groups.
PRESCRIPTIONS
Signed into law: AB 2789 (Wood D): Under the bill, health care practitioners who are authorized to issue prescriptions must have the capability for electronic transmission prescriptions. And pharmacies must have the capability to receive those transmissions. California Health Underwriters (CAHU) says the bill is another measure to curb opioid addiction and abuse and decrease the associated high costs of prescription drugs on healthcare premiums. AB 2863 (Nazarian D): The bill would limit the amount that a health carrier can require a beneficiary to pay for a covered prescription at the point-of sale. It would have to be the lowest available cost whether it’s the applicable cost sharing amount or the retail price. If the beneficiary pays the cash price for a prescription, it would be applied to their deductible and out-of-pocket maximum.
SHORT-TERM HEALTH PLANS
Signed into law: SB 910 (Hernandez D): Commencing January 19, the bill would prohibit health insurers from issuing, selling, renewing, or offering a short-term limited duration health insurance policy.
DENTAL PLAN TRANSPARENCY
SB 1008 (Skinner D): The bill would require a uniform benefits and coverage disclosure for dental plans: matrix for dental plans.
PERSONAL CLIENT INFORMATION
Signed into law: SB 1121 (Dodd D): The bill would make it easier for consumers to sue companies that lack adequate safeguards for personal records. If there’s a security breach, consumers could seek up to $1,000 per consumer/per incident or actual damages, whichever is greater. CAHU warns that it would drastically expand the civil liability of agencies in California.
THIRD PARTY PAYMENTS
SB 1156 (Leyva D): The bill would require a health care service plan to accept payments from specified 3rd-party entities, including an Indian tribe or a local, state, or federal government program.
ASSOCIATION HEALTH PLANS
Signed into law: SB 1375 (Hernandez D): Self-employed individuals could not proclaim themselves as employees just to join an association health plan. Sole proprietors, partners of a partnership, and their spouses would no longer be considered “eligible employees.” According to CAHU, the bill would also revise the definition of “small employer” to include any small employer purchasing coverage for employees through any arrangement, rather than through a guaranteed association. Proponents of the bill say it would help maintain a healthy risk mix as well as stable, competitive, individual, and small group insurance markets.
BILLS THAT FAILED
Bills that failed include measures to create a universal single-payer health care system, require Covered California to offer more cost-sharing assistance, and increase fines for insurers or agents making misrepresentations.
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