Governor Signs Disability Policy Bill

Governor Brown signed Assembly Bill 387 into law. It will improve the department’s ability to review and approve disability policy filings more effectively and completely in the specified timeframe. The law extends the period from 30 to 120 calendar days for the department to review and approve policy forms and any associated risks and premium rates. The bill was authored by Assembly Member Kevin McCarty and co-sponsored by Insurance Commissioner Dave Jones. The new law authorizes the Commissioner to develop and publish new guidelines on the department’s public website to expedite the department’s file review process for life and disability insurance forms. It will provide clear guidelines for insurers to follow when submitting policies for approval. AB 387 reflects an agreement between the California Department of Insurance and the Association of California Life and Health Insurance Companies.

Governor Signs Health Bills

As featured in the CAHU president’s blog from Michael Lujan, Governor Brown signed the following bills into law:

  • Co-pay Drug Caps: AB 339 caps prescription drug costs. It was authored by Assemblyman Rich Gordon (D-Menlo Park), and is effective January 1, 2017. It applies caps to copays and coinsurance for a single 30-day prescription at $250 to $500, depending on the insurance plan type.  For high-deductible health plans, the caps will take effect only when the consumer reaches the deductible. It provides relief to people with chronic conditions, such as cancer, HIV/AIDS, hepatitis, and multiple sclerosis. These patients can reach their annual out-of-pocket limit, which can be as high as $6,600, with just one 30-day prescription.
  • Provider Directories: S.B. 137, authored by Sen. Ed Hernandez (D-West Covina), is effective July 1, 2016: It will require health plans to update their provider directories weekly. The updates will include office location, whether the provider is accepting new patients, and which languages, other than English, are spoken by the provider and staff.  It also requires the Department of Managed Health Care and the Department of Insurance to develop a standard template for these directories. It helps protect Californians from higher-than-expected bills from out-of-network doctors and other providers due to inaccurate or outdated directories.
  • Cost-sharing limits on family plans: AB 1305 limits cost-sharing on family plans. It was authored by Assemblyman Rob Bonta (D-Oakland) and is effective January 1, 2017:  It closes a loophole in some plans that requires individuals, who are part of a family health insurance policy, to meet the much larger family deductible before their insurance coverage kicks in. It requires family policies to include both an individual deductible and a per-individual out-of-pocket limit.

Lujan also reports that several agents and CAHU board members attended a recent Covered California board meeting to testify on behalf of agents enrolling in Medi-Cal. Funding for Medi-Cal enrollment ended this summer, yet the current agent agreement still requires agents to enroll people in Medi-Cal. CAHU says that the policy creates an undue burden on agents who want to help, but simply need help when they reach their capacity or have complex eligibility issues. “To make sure our position was heard, CAHU initiated a VoterVoice campaign that sent more than 600 emails to Peter Lee, CA HHS Secretary Diana Dooley, and members of the Covered California Board of Directors. Over the past months, CAHU met with leaders from Covered California, the Department of Healthcare Services and County Offices to discuss the agent’s role in enrolling consumers in Medi-Cal,” he added.

“CAHU’s legislative advocate Julianne Broyles, several CAHU board members, and I testified and shared real examples of the great work being done by agents and need for compensation. After much discussion, Peter Lee assured us that the current agent agreement language will provide the flexibility agents need to continue with partnerships and/or work with County offices and seek their help when needed. We will hold him to his word. To address the Medi-Cal service issues, CAHU offered to help the county offices better support agents when inquiring about application status or related work on behalf of clients. CAHU also helped develop an agent toolkit and will provide additional training for agents. And lastly, we will continue our work to identify ongoing funding for compensating agents for Medi-Cal enrollment, similar to the grant provided by The California Endowment,” Lujan added.

Last Updated 11/13/2019

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