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AB-1644 Out-of-state carriers.(2007-2008)

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CALIFORNIA LEGISLATURE— 2007–2008 REGULAR SESSION

Assembly Bill
No. 1644

Introduced  by  Assembly Member Niello
 (Coauthor(s): Assembly Member Benoit, Maze, Smyth, Strickland, Tran, Villines)

February 23, 2007

An act to add Section 1349.3 to the Health and Safety Code, and to add Section 699.6 to the Insurance Code, relating to health care coverage.


LEGISLATIVE COUNSEL'S DIGEST


AB 1644, as introduced, Niello. Out-of-state carriers.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, requires, subject to specified exceptions, that a health care service plan be licensed by the Department of Managed Health Care and provide basic health care services, as defined, unless exempted from that requirement by the director. Existing law also requires, subject to specified exceptions, that an insurer obtain a certificate of authority from the Insurance Commissioner in order to transact business in this state and that the insurer operate in accordance with specified requirements.
This bill would allow a carrier domiciled in another state to offer, sell, or renew in this state an essential health benefit plan meeting certain unspecified requirements, without holding a license issued by the department or a certificate of authority issued by the commissioner, and would exempt the essential health benefit plan from requirements otherwise applicable to plans and insurance policies providing health care coverage in this state. The bill would require that the carrier maintain a dispute resolution process and be lawfully authorized to issue an essential health benefit plan and to transact business in its domiciliary state.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Section 1349.3 is added to the Health and Safety Code, to read:

1349.3.
 (a) Notwithstanding any other provision of law, a carrier domiciled in another state is exempt from Section 1349 if it meets the following criteria:
(1) It offers, sells, or renews an essential health benefit plan in this state that complies with the requirements of subdivision (b).
(2) It is authorized to issue an essential health benefit plan in the state where it is domiciled and to transact business there.
(3) It maintains a process to resolve disputes between it and a resident of this state pertaining to the essential health benefit plan.
(b) An essential health benefit plan shall meet the following requirements:____.
(c) Notwithstanding any other provision of law, an essential health benefit plan offered, sold, or renewed in this state by a carrier that satisfies the criteria of subdivision (a) is exempt from all other provisions of this chapter, other than as provided in subdivision (b).

SEC. 2.

 Section 699.6 is added to the Insurance Code, to read:

699.6.
 (a) Notwithstanding any other provision of law, a carrier domiciled in another state is exempt from Section 700 if it meets the following criteria:
(1) It offers, sells, or renews an essential health benefit plan in this state that complies with the requirements of subdivision (b).
(2) It is authorized to issue an essential health benefit plan in the state where it is domiciled and to transact business there.
(3) It maintains a process to resolve disputes between it and a resident of this state pertaining to the essential health benefit plan.
(b) An essential health benefit plan shall meet the following requirements:____.
(c) Notwithstanding any other provision of law, an essential health benefit plan offered, sold, or renewed in this state by a carrier that satisfies the criteria of subdivision (a) is exempt from all other provisions of this code, other than as provided under subdivision (b).