CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Senate Bill No. 260Introduced by Senator HurtadoFebruary 12, 2019 An act to add Section 100503.4 to the Government Code, to amend Section 1366.50 of the Health and Safety Code, and to amend Section 10786 of the Insurance Code, relating to healthcare coverage. LEGISLATIVE COUNSEL'S DIGESTSB 260, as introduced, Hurtado. Automatic healthcare coverage enrollment.Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive healthcare services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing state law creates the California Health Benefit Exchange (Exchange), also known as Covered California, to facilitate the enrollment of qualified individuals and qualified small employers in qualified health plans as required under the federal Patient Protection and Affordable Care Act. Existing law requires a county to perform redeterminations of eligibility for Medi-Cal beneficiaries every 12 months. Under existing law, if a county determines that an individual is ineligible for Medi-Cal, the county is required to determine the individuals eligibility for other insurance affordability programs and transfer the individuals electronic account to insurance affordability programs, including the Exchange, for which the individual is eligible.This bill would require the Exchange to enroll an individual in the lowest cost silver plan or another plan, as specified, upon receiving the individuals electronic account from a county. The bill would require enrollment to occur before Medi-Cal coverage is terminated, and would prohibit the premium due date from being sooner than the 30th day of the first month of enrollment. The bill would require the Exchange to provide an individual who is automatically enrolled in the lowest cost silver plan with a notice that includes specified information, including the individuals right to select another available plan or to not enroll in the plan.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 provides for the regulation of health insurers by the Department of Insurance. Existing law requires a health care service plan providing individual or group healthcare coverage or a health insurer to notify an enrollee, subscriber, policyholder, or certificate holder who ceases to be enrolled in coverage that the individual may be eligible for coverage through the Exchange or Medi-Cal.This bill would require a health care service plan providing individual or group healthcare coverage or a health insurer to notify an enrollee, subscriber, policyholder, or certificate holder that the health care service plan or health insurer will provide the individuals contact information to the Exchange if the individual ceases to be enrolled in coverage. The bill would allow an individual to opt out of that transfer of information, and would require a health care service plan or health insurer to transfer the information of an individual who ceased to be enrolled in coverage and who did not opt out to the Exchange beginning January 1, 2021, in a manner prescribed by the Exchange. Because the bill would expand the scope of a crime with respect to health care service plans, 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.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YES Bill TextThe people of the State of California do enact as follows:SECTION 1. Section 100503.4 is added to the Government Code, to read:100503.4. (a) Upon receipt of an individuals electronic account pursuant to subdivision (o) of Section 14005.37 of the Welfare and Institutions Code, the Exchange shall use the available information to enroll the individual or individuals in the lowest cost silver plan available, unless the Exchange has information from the county, State Department of Health Care Services, Medi-Cal managed care plan, or individual that another plan is more appropriate.(b) Plan enrollment shall occur before the termination date of Medi-Cal coverage.(c) The plans premium due date shall be no sooner than the 30th day of the first month of enrollment.(d) The Exchange shall provide an individual who is enrolled in a plan pursuant to this section with a notice that includes the following information:(1) The plan in which the individual is enrolled.(2) The individuals right to select another available plan and any relevant deadlines for that selection.(3) How to receive assistance to select a plan.(4) The individuals right not to enroll in the plan.SEC. 2. Section 1366.50 of the Health and Safety Code is amended to read:1366.50. (a) (1) On and after January 1, 2014, a health care service plan providing individual or group health care healthcare coverage shall provide to enrollees or subscribers who cease to be enrolled in coverage a notice informing them that they may be eligible for reduced-cost coverage through the California Health Benefit Exchange (Exchange) established under Title 22 (commencing with Section 100500) of the Government Code or no-cost coverage through Medi-Cal. The notice shall include information on obtaining coverage pursuant to those programs, shall be in no less than 12-point type, and shall be developed by the department, no later than July 1, 2013, in consultation with the Department of Insurance and the California Health Benefit Exchange.(b)(2) The notice described in subdivision (a) paragraph (1) may be incorporated into or sent simultaneously with and in the same manner as any other notices sent by the health care service plan.(b) (1) A health care service plan providing individual or group healthcare coverage shall annually notify an enrollee or subscriber that if the enrollee or subscriber ceases to be enrolled in coverage, the health care service plan will provide information, including the enrollees or subscribers name, address, and other contact information, such as email address, to the Exchange so that the enrollee or subscriber may obtain other coverage. An enrollee or subscriber may opt out of this transfer of information to the Exchange.(2) Beginning January 1, 2021, a health care service plan providing individual or group healthcare coverage that has notified its enrollees or subscribers consistent with paragraph (1) shall provide to the Exchange the name, address, and other contact information of an enrollee or subscriber who ceased to be enrolled in coverage and who did not opt out of the information transfer. The information shall be provided in a manner prescribed by the Exchange.(3) The Exchange may use any contact method to communicate with and inform an enrollee or subscriber who ceases to be enrolled in coverage of available coverage options.(c) This section shall does not apply with respect to a specialized health care service plan contract or a Medicare supplemental plan contract.SEC. 3. Section 10786 of the Insurance Code is amended to read:10786. (a) (1) On and after January 1, 2014, a health insurer providing health insurance coverage shall provide to policyholders in individual policies or certificate holders in group policies who cease to be enrolled in coverage a notice informing them that they may be eligible for reduced-cost coverage through the California Health Benefit Exchange (Exchange) established under Title 22 (commencing with Section 100500) of the Government Code or no-cost coverage through Medi-Cal. The notice shall include information on obtaining coverage pursuant to those programs, shall be in no less than 12-point type, and shall be developed by the department, no later than July 1, 2013, in consultation with the Department of Managed Health Care and the California Health Benefit Exchange.(b)(2) The notice described in subdivision (a) paragraph (1) may be incorporated into or sent simultaneously with and in the same manner as any other notices sent by the health insurer.(b) (1) A health insurer shall annually notify a policyholder or certificate holder that if the policyholder or certificate holder ceases to be enrolled in coverage, the health insurer will provide information, including the policyholders or certificate holders name, address, and other contact information, such as email address, to the Exchange so that the policyholder or certificate holder may obtain other coverage. A policyholder or certificate holder may opt out of this transfer of information to the Exchange.(2) Beginning January 1, 2021, a health insurer that has notified its policyholders or certificate holders consistent with paragraph (1) shall provide to the Exchange the name, address, and other contact information of a policyholder or certificate holder who ceased to be enrolled in coverage and who did not opt out of the information transfer. The information shall be provided in a manner prescribed by the Exchange.(3) The Exchange may use any contact method to communicate with and inform a policyholder or certificate holder who ceases to be enrolled in coverage of available coverage options.(c) This section shall does not apply with respect to a specialized health insurance policy or a health insurance policy consisting solely of coverage of excepted benefits as described in Section 2722 of the federal Public Health Service Act (42 U.S.C. Sec. 300gg-21).SEC. 4. 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 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 XIIIB of the California Constitution.
CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION Senate Bill No. 260Introduced by Senator HurtadoFebruary 12, 2019 An act to add Section 100503.4 to the Government Code, to amend Section 1366.50 of the Health and Safety Code, and to amend Section 10786 of the Insurance Code, relating to healthcare coverage. LEGISLATIVE COUNSEL'S DIGESTSB 260, as introduced, Hurtado. Automatic healthcare coverage enrollment.Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive healthcare services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing state law creates the California Health Benefit Exchange (Exchange), also known as Covered California, to facilitate the enrollment of qualified individuals and qualified small employers in qualified health plans as required under the federal Patient Protection and Affordable Care Act. Existing law requires a county to perform redeterminations of eligibility for Medi-Cal beneficiaries every 12 months. Under existing law, if a county determines that an individual is ineligible for Medi-Cal, the county is required to determine the individuals eligibility for other insurance affordability programs and transfer the individuals electronic account to insurance affordability programs, including the Exchange, for which the individual is eligible.This bill would require the Exchange to enroll an individual in the lowest cost silver plan or another plan, as specified, upon receiving the individuals electronic account from a county. The bill would require enrollment to occur before Medi-Cal coverage is terminated, and would prohibit the premium due date from being sooner than the 30th day of the first month of enrollment. The bill would require the Exchange to provide an individual who is automatically enrolled in the lowest cost silver plan with a notice that includes specified information, including the individuals right to select another available plan or to not enroll in the plan.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 provides for the regulation of health insurers by the Department of Insurance. Existing law requires a health care service plan providing individual or group healthcare coverage or a health insurer to notify an enrollee, subscriber, policyholder, or certificate holder who ceases to be enrolled in coverage that the individual may be eligible for coverage through the Exchange or Medi-Cal.This bill would require a health care service plan providing individual or group healthcare coverage or a health insurer to notify an enrollee, subscriber, policyholder, or certificate holder that the health care service plan or health insurer will provide the individuals contact information to the Exchange if the individual ceases to be enrolled in coverage. The bill would allow an individual to opt out of that transfer of information, and would require a health care service plan or health insurer to transfer the information of an individual who ceased to be enrolled in coverage and who did not opt out to the Exchange beginning January 1, 2021, in a manner prescribed by the Exchange. Because the bill would expand the scope of a crime with respect to health care service plans, 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.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YES
CALIFORNIA LEGISLATURE 20192020 REGULAR SESSION
Senate Bill No. 260
Introduced by Senator HurtadoFebruary 12, 2019
Introduced by Senator Hurtado
February 12, 2019
An act to add Section 100503.4 to the Government Code, to amend Section 1366.50 of the Health and Safety Code, and to amend Section 10786 of the Insurance Code, relating to healthcare coverage.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
SB 260, as introduced, Hurtado. Automatic healthcare coverage enrollment.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive healthcare services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing state law creates the California Health Benefit Exchange (Exchange), also known as Covered California, to facilitate the enrollment of qualified individuals and qualified small employers in qualified health plans as required under the federal Patient Protection and Affordable Care Act. Existing law requires a county to perform redeterminations of eligibility for Medi-Cal beneficiaries every 12 months. Under existing law, if a county determines that an individual is ineligible for Medi-Cal, the county is required to determine the individuals eligibility for other insurance affordability programs and transfer the individuals electronic account to insurance affordability programs, including the Exchange, for which the individual is eligible.This bill would require the Exchange to enroll an individual in the lowest cost silver plan or another plan, as specified, upon receiving the individuals electronic account from a county. The bill would require enrollment to occur before Medi-Cal coverage is terminated, and would prohibit the premium due date from being sooner than the 30th day of the first month of enrollment. The bill would require the Exchange to provide an individual who is automatically enrolled in the lowest cost silver plan with a notice that includes specified information, including the individuals right to select another available plan or to not enroll in the plan.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 provides for the regulation of health insurers by the Department of Insurance. Existing law requires a health care service plan providing individual or group healthcare coverage or a health insurer to notify an enrollee, subscriber, policyholder, or certificate holder who ceases to be enrolled in coverage that the individual may be eligible for coverage through the Exchange or Medi-Cal.This bill would require a health care service plan providing individual or group healthcare coverage or a health insurer to notify an enrollee, subscriber, policyholder, or certificate holder that the health care service plan or health insurer will provide the individuals contact information to the Exchange if the individual ceases to be enrolled in coverage. The bill would allow an individual to opt out of that transfer of information, and would require a health care service plan or health insurer to transfer the information of an individual who ceased to be enrolled in coverage and who did not opt out to the Exchange beginning January 1, 2021, in a manner prescribed by the Exchange. Because the bill would expand the scope of a crime with respect to health care service plans, 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.
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive healthcare services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing state law creates the California Health Benefit Exchange (Exchange), also known as Covered California, to facilitate the enrollment of qualified individuals and qualified small employers in qualified health plans as required under the federal Patient Protection and Affordable Care Act. Existing law requires a county to perform redeterminations of eligibility for Medi-Cal beneficiaries every 12 months. Under existing law, if a county determines that an individual is ineligible for Medi-Cal, the county is required to determine the individuals eligibility for other insurance affordability programs and transfer the individuals electronic account to insurance affordability programs, including the Exchange, for which the individual is eligible.
This bill would require the Exchange to enroll an individual in the lowest cost silver plan or another plan, as specified, upon receiving the individuals electronic account from a county. The bill would require enrollment to occur before Medi-Cal coverage is terminated, and would prohibit the premium due date from being sooner than the 30th day of the first month of enrollment. The bill would require the Exchange to provide an individual who is automatically enrolled in the lowest cost silver plan with a notice that includes specified information, including the individuals right to select another available plan or to not enroll in the plan.
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 provides for the regulation of health insurers by the Department of Insurance. Existing law requires a health care service plan providing individual or group healthcare coverage or a health insurer to notify an enrollee, subscriber, policyholder, or certificate holder who ceases to be enrolled in coverage that the individual may be eligible for coverage through the Exchange or Medi-Cal.
This bill would require a health care service plan providing individual or group healthcare coverage or a health insurer to notify an enrollee, subscriber, policyholder, or certificate holder that the health care service plan or health insurer will provide the individuals contact information to the Exchange if the individual ceases to be enrolled in coverage. The bill would allow an individual to opt out of that transfer of information, and would require a health care service plan or health insurer to transfer the information of an individual who ceased to be enrolled in coverage and who did not opt out to the Exchange beginning January 1, 2021, in a manner prescribed by the Exchange. Because the bill would expand the scope of a crime with respect to health care service plans, 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.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. Section 100503.4 is added to the Government Code, to read:100503.4. (a) Upon receipt of an individuals electronic account pursuant to subdivision (o) of Section 14005.37 of the Welfare and Institutions Code, the Exchange shall use the available information to enroll the individual or individuals in the lowest cost silver plan available, unless the Exchange has information from the county, State Department of Health Care Services, Medi-Cal managed care plan, or individual that another plan is more appropriate.(b) Plan enrollment shall occur before the termination date of Medi-Cal coverage.(c) The plans premium due date shall be no sooner than the 30th day of the first month of enrollment.(d) The Exchange shall provide an individual who is enrolled in a plan pursuant to this section with a notice that includes the following information:(1) The plan in which the individual is enrolled.(2) The individuals right to select another available plan and any relevant deadlines for that selection.(3) How to receive assistance to select a plan.(4) The individuals right not to enroll in the plan.SEC. 2. Section 1366.50 of the Health and Safety Code is amended to read:1366.50. (a) (1) On and after January 1, 2014, a health care service plan providing individual or group health care healthcare coverage shall provide to enrollees or subscribers who cease to be enrolled in coverage a notice informing them that they may be eligible for reduced-cost coverage through the California Health Benefit Exchange (Exchange) established under Title 22 (commencing with Section 100500) of the Government Code or no-cost coverage through Medi-Cal. The notice shall include information on obtaining coverage pursuant to those programs, shall be in no less than 12-point type, and shall be developed by the department, no later than July 1, 2013, in consultation with the Department of Insurance and the California Health Benefit Exchange.(b)(2) The notice described in subdivision (a) paragraph (1) may be incorporated into or sent simultaneously with and in the same manner as any other notices sent by the health care service plan.(b) (1) A health care service plan providing individual or group healthcare coverage shall annually notify an enrollee or subscriber that if the enrollee or subscriber ceases to be enrolled in coverage, the health care service plan will provide information, including the enrollees or subscribers name, address, and other contact information, such as email address, to the Exchange so that the enrollee or subscriber may obtain other coverage. An enrollee or subscriber may opt out of this transfer of information to the Exchange.(2) Beginning January 1, 2021, a health care service plan providing individual or group healthcare coverage that has notified its enrollees or subscribers consistent with paragraph (1) shall provide to the Exchange the name, address, and other contact information of an enrollee or subscriber who ceased to be enrolled in coverage and who did not opt out of the information transfer. The information shall be provided in a manner prescribed by the Exchange.(3) The Exchange may use any contact method to communicate with and inform an enrollee or subscriber who ceases to be enrolled in coverage of available coverage options.(c) This section shall does not apply with respect to a specialized health care service plan contract or a Medicare supplemental plan contract.SEC. 3. Section 10786 of the Insurance Code is amended to read:10786. (a) (1) On and after January 1, 2014, a health insurer providing health insurance coverage shall provide to policyholders in individual policies or certificate holders in group policies who cease to be enrolled in coverage a notice informing them that they may be eligible for reduced-cost coverage through the California Health Benefit Exchange (Exchange) established under Title 22 (commencing with Section 100500) of the Government Code or no-cost coverage through Medi-Cal. The notice shall include information on obtaining coverage pursuant to those programs, shall be in no less than 12-point type, and shall be developed by the department, no later than July 1, 2013, in consultation with the Department of Managed Health Care and the California Health Benefit Exchange.(b)(2) The notice described in subdivision (a) paragraph (1) may be incorporated into or sent simultaneously with and in the same manner as any other notices sent by the health insurer.(b) (1) A health insurer shall annually notify a policyholder or certificate holder that if the policyholder or certificate holder ceases to be enrolled in coverage, the health insurer will provide information, including the policyholders or certificate holders name, address, and other contact information, such as email address, to the Exchange so that the policyholder or certificate holder may obtain other coverage. A policyholder or certificate holder may opt out of this transfer of information to the Exchange.(2) Beginning January 1, 2021, a health insurer that has notified its policyholders or certificate holders consistent with paragraph (1) shall provide to the Exchange the name, address, and other contact information of a policyholder or certificate holder who ceased to be enrolled in coverage and who did not opt out of the information transfer. The information shall be provided in a manner prescribed by the Exchange.(3) The Exchange may use any contact method to communicate with and inform a policyholder or certificate holder who ceases to be enrolled in coverage of available coverage options.(c) This section shall does not apply with respect to a specialized health insurance policy or a health insurance policy consisting solely of coverage of excepted benefits as described in Section 2722 of the federal Public Health Service Act (42 U.S.C. Sec. 300gg-21).SEC. 4. 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 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 XIIIB of the California Constitution.
The people of the State of California do enact as follows:
## The people of the State of California do enact as follows:
SECTION 1. Section 100503.4 is added to the Government Code, to read:100503.4. (a) Upon receipt of an individuals electronic account pursuant to subdivision (o) of Section 14005.37 of the Welfare and Institutions Code, the Exchange shall use the available information to enroll the individual or individuals in the lowest cost silver plan available, unless the Exchange has information from the county, State Department of Health Care Services, Medi-Cal managed care plan, or individual that another plan is more appropriate.(b) Plan enrollment shall occur before the termination date of Medi-Cal coverage.(c) The plans premium due date shall be no sooner than the 30th day of the first month of enrollment.(d) The Exchange shall provide an individual who is enrolled in a plan pursuant to this section with a notice that includes the following information:(1) The plan in which the individual is enrolled.(2) The individuals right to select another available plan and any relevant deadlines for that selection.(3) How to receive assistance to select a plan.(4) The individuals right not to enroll in the plan.
SECTION 1. Section 100503.4 is added to the Government Code, to read:
### SECTION 1.
100503.4. (a) Upon receipt of an individuals electronic account pursuant to subdivision (o) of Section 14005.37 of the Welfare and Institutions Code, the Exchange shall use the available information to enroll the individual or individuals in the lowest cost silver plan available, unless the Exchange has information from the county, State Department of Health Care Services, Medi-Cal managed care plan, or individual that another plan is more appropriate.(b) Plan enrollment shall occur before the termination date of Medi-Cal coverage.(c) The plans premium due date shall be no sooner than the 30th day of the first month of enrollment.(d) The Exchange shall provide an individual who is enrolled in a plan pursuant to this section with a notice that includes the following information:(1) The plan in which the individual is enrolled.(2) The individuals right to select another available plan and any relevant deadlines for that selection.(3) How to receive assistance to select a plan.(4) The individuals right not to enroll in the plan.
100503.4. (a) Upon receipt of an individuals electronic account pursuant to subdivision (o) of Section 14005.37 of the Welfare and Institutions Code, the Exchange shall use the available information to enroll the individual or individuals in the lowest cost silver plan available, unless the Exchange has information from the county, State Department of Health Care Services, Medi-Cal managed care plan, or individual that another plan is more appropriate.(b) Plan enrollment shall occur before the termination date of Medi-Cal coverage.(c) The plans premium due date shall be no sooner than the 30th day of the first month of enrollment.(d) The Exchange shall provide an individual who is enrolled in a plan pursuant to this section with a notice that includes the following information:(1) The plan in which the individual is enrolled.(2) The individuals right to select another available plan and any relevant deadlines for that selection.(3) How to receive assistance to select a plan.(4) The individuals right not to enroll in the plan.
100503.4. (a) Upon receipt of an individuals electronic account pursuant to subdivision (o) of Section 14005.37 of the Welfare and Institutions Code, the Exchange shall use the available information to enroll the individual or individuals in the lowest cost silver plan available, unless the Exchange has information from the county, State Department of Health Care Services, Medi-Cal managed care plan, or individual that another plan is more appropriate.(b) Plan enrollment shall occur before the termination date of Medi-Cal coverage.(c) The plans premium due date shall be no sooner than the 30th day of the first month of enrollment.(d) The Exchange shall provide an individual who is enrolled in a plan pursuant to this section with a notice that includes the following information:(1) The plan in which the individual is enrolled.(2) The individuals right to select another available plan and any relevant deadlines for that selection.(3) How to receive assistance to select a plan.(4) The individuals right not to enroll in the plan.
100503.4. (a) Upon receipt of an individuals electronic account pursuant to subdivision (o) of Section 14005.37 of the Welfare and Institutions Code, the Exchange shall use the available information to enroll the individual or individuals in the lowest cost silver plan available, unless the Exchange has information from the county, State Department of Health Care Services, Medi-Cal managed care plan, or individual that another plan is more appropriate.
(b) Plan enrollment shall occur before the termination date of Medi-Cal coverage.
(c) The plans premium due date shall be no sooner than the 30th day of the first month of enrollment.
(d) The Exchange shall provide an individual who is enrolled in a plan pursuant to this section with a notice that includes the following information:
(1) The plan in which the individual is enrolled.
(2) The individuals right to select another available plan and any relevant deadlines for that selection.
(3) How to receive assistance to select a plan.
(4) The individuals right not to enroll in the plan.
SEC. 2. Section 1366.50 of the Health and Safety Code is amended to read:1366.50. (a) (1) On and after January 1, 2014, a health care service plan providing individual or group health care healthcare coverage shall provide to enrollees or subscribers who cease to be enrolled in coverage a notice informing them that they may be eligible for reduced-cost coverage through the California Health Benefit Exchange (Exchange) established under Title 22 (commencing with Section 100500) of the Government Code or no-cost coverage through Medi-Cal. The notice shall include information on obtaining coverage pursuant to those programs, shall be in no less than 12-point type, and shall be developed by the department, no later than July 1, 2013, in consultation with the Department of Insurance and the California Health Benefit Exchange.(b)(2) The notice described in subdivision (a) paragraph (1) may be incorporated into or sent simultaneously with and in the same manner as any other notices sent by the health care service plan.(b) (1) A health care service plan providing individual or group healthcare coverage shall annually notify an enrollee or subscriber that if the enrollee or subscriber ceases to be enrolled in coverage, the health care service plan will provide information, including the enrollees or subscribers name, address, and other contact information, such as email address, to the Exchange so that the enrollee or subscriber may obtain other coverage. An enrollee or subscriber may opt out of this transfer of information to the Exchange.(2) Beginning January 1, 2021, a health care service plan providing individual or group healthcare coverage that has notified its enrollees or subscribers consistent with paragraph (1) shall provide to the Exchange the name, address, and other contact information of an enrollee or subscriber who ceased to be enrolled in coverage and who did not opt out of the information transfer. The information shall be provided in a manner prescribed by the Exchange.(3) The Exchange may use any contact method to communicate with and inform an enrollee or subscriber who ceases to be enrolled in coverage of available coverage options.(c) This section shall does not apply with respect to a specialized health care service plan contract or a Medicare supplemental plan contract.
SEC. 2. Section 1366.50 of the Health and Safety Code is amended to read:
### SEC. 2.
1366.50. (a) (1) On and after January 1, 2014, a health care service plan providing individual or group health care healthcare coverage shall provide to enrollees or subscribers who cease to be enrolled in coverage a notice informing them that they may be eligible for reduced-cost coverage through the California Health Benefit Exchange (Exchange) established under Title 22 (commencing with Section 100500) of the Government Code or no-cost coverage through Medi-Cal. The notice shall include information on obtaining coverage pursuant to those programs, shall be in no less than 12-point type, and shall be developed by the department, no later than July 1, 2013, in consultation with the Department of Insurance and the California Health Benefit Exchange.(b)(2) The notice described in subdivision (a) paragraph (1) may be incorporated into or sent simultaneously with and in the same manner as any other notices sent by the health care service plan.(b) (1) A health care service plan providing individual or group healthcare coverage shall annually notify an enrollee or subscriber that if the enrollee or subscriber ceases to be enrolled in coverage, the health care service plan will provide information, including the enrollees or subscribers name, address, and other contact information, such as email address, to the Exchange so that the enrollee or subscriber may obtain other coverage. An enrollee or subscriber may opt out of this transfer of information to the Exchange.(2) Beginning January 1, 2021, a health care service plan providing individual or group healthcare coverage that has notified its enrollees or subscribers consistent with paragraph (1) shall provide to the Exchange the name, address, and other contact information of an enrollee or subscriber who ceased to be enrolled in coverage and who did not opt out of the information transfer. The information shall be provided in a manner prescribed by the Exchange.(3) The Exchange may use any contact method to communicate with and inform an enrollee or subscriber who ceases to be enrolled in coverage of available coverage options.(c) This section shall does not apply with respect to a specialized health care service plan contract or a Medicare supplemental plan contract.
1366.50. (a) (1) On and after January 1, 2014, a health care service plan providing individual or group health care healthcare coverage shall provide to enrollees or subscribers who cease to be enrolled in coverage a notice informing them that they may be eligible for reduced-cost coverage through the California Health Benefit Exchange (Exchange) established under Title 22 (commencing with Section 100500) of the Government Code or no-cost coverage through Medi-Cal. The notice shall include information on obtaining coverage pursuant to those programs, shall be in no less than 12-point type, and shall be developed by the department, no later than July 1, 2013, in consultation with the Department of Insurance and the California Health Benefit Exchange.(b)(2) The notice described in subdivision (a) paragraph (1) may be incorporated into or sent simultaneously with and in the same manner as any other notices sent by the health care service plan.(b) (1) A health care service plan providing individual or group healthcare coverage shall annually notify an enrollee or subscriber that if the enrollee or subscriber ceases to be enrolled in coverage, the health care service plan will provide information, including the enrollees or subscribers name, address, and other contact information, such as email address, to the Exchange so that the enrollee or subscriber may obtain other coverage. An enrollee or subscriber may opt out of this transfer of information to the Exchange.(2) Beginning January 1, 2021, a health care service plan providing individual or group healthcare coverage that has notified its enrollees or subscribers consistent with paragraph (1) shall provide to the Exchange the name, address, and other contact information of an enrollee or subscriber who ceased to be enrolled in coverage and who did not opt out of the information transfer. The information shall be provided in a manner prescribed by the Exchange.(3) The Exchange may use any contact method to communicate with and inform an enrollee or subscriber who ceases to be enrolled in coverage of available coverage options.(c) This section shall does not apply with respect to a specialized health care service plan contract or a Medicare supplemental plan contract.
1366.50. (a) (1) On and after January 1, 2014, a health care service plan providing individual or group health care healthcare coverage shall provide to enrollees or subscribers who cease to be enrolled in coverage a notice informing them that they may be eligible for reduced-cost coverage through the California Health Benefit Exchange (Exchange) established under Title 22 (commencing with Section 100500) of the Government Code or no-cost coverage through Medi-Cal. The notice shall include information on obtaining coverage pursuant to those programs, shall be in no less than 12-point type, and shall be developed by the department, no later than July 1, 2013, in consultation with the Department of Insurance and the California Health Benefit Exchange.(b)(2) The notice described in subdivision (a) paragraph (1) may be incorporated into or sent simultaneously with and in the same manner as any other notices sent by the health care service plan.(b) (1) A health care service plan providing individual or group healthcare coverage shall annually notify an enrollee or subscriber that if the enrollee or subscriber ceases to be enrolled in coverage, the health care service plan will provide information, including the enrollees or subscribers name, address, and other contact information, such as email address, to the Exchange so that the enrollee or subscriber may obtain other coverage. An enrollee or subscriber may opt out of this transfer of information to the Exchange.(2) Beginning January 1, 2021, a health care service plan providing individual or group healthcare coverage that has notified its enrollees or subscribers consistent with paragraph (1) shall provide to the Exchange the name, address, and other contact information of an enrollee or subscriber who ceased to be enrolled in coverage and who did not opt out of the information transfer. The information shall be provided in a manner prescribed by the Exchange.(3) The Exchange may use any contact method to communicate with and inform an enrollee or subscriber who ceases to be enrolled in coverage of available coverage options.(c) This section shall does not apply with respect to a specialized health care service plan contract or a Medicare supplemental plan contract.
1366.50. (a) (1) On and after January 1, 2014, a health care service plan providing individual or group health care healthcare coverage shall provide to enrollees or subscribers who cease to be enrolled in coverage a notice informing them that they may be eligible for reduced-cost coverage through the California Health Benefit Exchange (Exchange) established under Title 22 (commencing with Section 100500) of the Government Code or no-cost coverage through Medi-Cal. The notice shall include information on obtaining coverage pursuant to those programs, shall be in no less than 12-point type, and shall be developed by the department, no later than July 1, 2013, in consultation with the Department of Insurance and the California Health Benefit Exchange.
(b)
(2) The notice described in subdivision (a) paragraph (1) may be incorporated into or sent simultaneously with and in the same manner as any other notices sent by the health care service plan.
(b) (1) A health care service plan providing individual or group healthcare coverage shall annually notify an enrollee or subscriber that if the enrollee or subscriber ceases to be enrolled in coverage, the health care service plan will provide information, including the enrollees or subscribers name, address, and other contact information, such as email address, to the Exchange so that the enrollee or subscriber may obtain other coverage. An enrollee or subscriber may opt out of this transfer of information to the Exchange.
(2) Beginning January 1, 2021, a health care service plan providing individual or group healthcare coverage that has notified its enrollees or subscribers consistent with paragraph (1) shall provide to the Exchange the name, address, and other contact information of an enrollee or subscriber who ceased to be enrolled in coverage and who did not opt out of the information transfer. The information shall be provided in a manner prescribed by the Exchange.
(3) The Exchange may use any contact method to communicate with and inform an enrollee or subscriber who ceases to be enrolled in coverage of available coverage options.
(c) This section shall does not apply with respect to a specialized health care service plan contract or a Medicare supplemental plan contract.
SEC. 3. Section 10786 of the Insurance Code is amended to read:10786. (a) (1) On and after January 1, 2014, a health insurer providing health insurance coverage shall provide to policyholders in individual policies or certificate holders in group policies who cease to be enrolled in coverage a notice informing them that they may be eligible for reduced-cost coverage through the California Health Benefit Exchange (Exchange) established under Title 22 (commencing with Section 100500) of the Government Code or no-cost coverage through Medi-Cal. The notice shall include information on obtaining coverage pursuant to those programs, shall be in no less than 12-point type, and shall be developed by the department, no later than July 1, 2013, in consultation with the Department of Managed Health Care and the California Health Benefit Exchange.(b)(2) The notice described in subdivision (a) paragraph (1) may be incorporated into or sent simultaneously with and in the same manner as any other notices sent by the health insurer.(b) (1) A health insurer shall annually notify a policyholder or certificate holder that if the policyholder or certificate holder ceases to be enrolled in coverage, the health insurer will provide information, including the policyholders or certificate holders name, address, and other contact information, such as email address, to the Exchange so that the policyholder or certificate holder may obtain other coverage. A policyholder or certificate holder may opt out of this transfer of information to the Exchange.(2) Beginning January 1, 2021, a health insurer that has notified its policyholders or certificate holders consistent with paragraph (1) shall provide to the Exchange the name, address, and other contact information of a policyholder or certificate holder who ceased to be enrolled in coverage and who did not opt out of the information transfer. The information shall be provided in a manner prescribed by the Exchange.(3) The Exchange may use any contact method to communicate with and inform a policyholder or certificate holder who ceases to be enrolled in coverage of available coverage options.(c) This section shall does not apply with respect to a specialized health insurance policy or a health insurance policy consisting solely of coverage of excepted benefits as described in Section 2722 of the federal Public Health Service Act (42 U.S.C. Sec. 300gg-21).
SEC. 3. Section 10786 of the Insurance Code is amended to read:
### SEC. 3.
10786. (a) (1) On and after January 1, 2014, a health insurer providing health insurance coverage shall provide to policyholders in individual policies or certificate holders in group policies who cease to be enrolled in coverage a notice informing them that they may be eligible for reduced-cost coverage through the California Health Benefit Exchange (Exchange) established under Title 22 (commencing with Section 100500) of the Government Code or no-cost coverage through Medi-Cal. The notice shall include information on obtaining coverage pursuant to those programs, shall be in no less than 12-point type, and shall be developed by the department, no later than July 1, 2013, in consultation with the Department of Managed Health Care and the California Health Benefit Exchange.(b)(2) The notice described in subdivision (a) paragraph (1) may be incorporated into or sent simultaneously with and in the same manner as any other notices sent by the health insurer.(b) (1) A health insurer shall annually notify a policyholder or certificate holder that if the policyholder or certificate holder ceases to be enrolled in coverage, the health insurer will provide information, including the policyholders or certificate holders name, address, and other contact information, such as email address, to the Exchange so that the policyholder or certificate holder may obtain other coverage. A policyholder or certificate holder may opt out of this transfer of information to the Exchange.(2) Beginning January 1, 2021, a health insurer that has notified its policyholders or certificate holders consistent with paragraph (1) shall provide to the Exchange the name, address, and other contact information of a policyholder or certificate holder who ceased to be enrolled in coverage and who did not opt out of the information transfer. The information shall be provided in a manner prescribed by the Exchange.(3) The Exchange may use any contact method to communicate with and inform a policyholder or certificate holder who ceases to be enrolled in coverage of available coverage options.(c) This section shall does not apply with respect to a specialized health insurance policy or a health insurance policy consisting solely of coverage of excepted benefits as described in Section 2722 of the federal Public Health Service Act (42 U.S.C. Sec. 300gg-21).
10786. (a) (1) On and after January 1, 2014, a health insurer providing health insurance coverage shall provide to policyholders in individual policies or certificate holders in group policies who cease to be enrolled in coverage a notice informing them that they may be eligible for reduced-cost coverage through the California Health Benefit Exchange (Exchange) established under Title 22 (commencing with Section 100500) of the Government Code or no-cost coverage through Medi-Cal. The notice shall include information on obtaining coverage pursuant to those programs, shall be in no less than 12-point type, and shall be developed by the department, no later than July 1, 2013, in consultation with the Department of Managed Health Care and the California Health Benefit Exchange.(b)(2) The notice described in subdivision (a) paragraph (1) may be incorporated into or sent simultaneously with and in the same manner as any other notices sent by the health insurer.(b) (1) A health insurer shall annually notify a policyholder or certificate holder that if the policyholder or certificate holder ceases to be enrolled in coverage, the health insurer will provide information, including the policyholders or certificate holders name, address, and other contact information, such as email address, to the Exchange so that the policyholder or certificate holder may obtain other coverage. A policyholder or certificate holder may opt out of this transfer of information to the Exchange.(2) Beginning January 1, 2021, a health insurer that has notified its policyholders or certificate holders consistent with paragraph (1) shall provide to the Exchange the name, address, and other contact information of a policyholder or certificate holder who ceased to be enrolled in coverage and who did not opt out of the information transfer. The information shall be provided in a manner prescribed by the Exchange.(3) The Exchange may use any contact method to communicate with and inform a policyholder or certificate holder who ceases to be enrolled in coverage of available coverage options.(c) This section shall does not apply with respect to a specialized health insurance policy or a health insurance policy consisting solely of coverage of excepted benefits as described in Section 2722 of the federal Public Health Service Act (42 U.S.C. Sec. 300gg-21).
10786. (a) (1) On and after January 1, 2014, a health insurer providing health insurance coverage shall provide to policyholders in individual policies or certificate holders in group policies who cease to be enrolled in coverage a notice informing them that they may be eligible for reduced-cost coverage through the California Health Benefit Exchange (Exchange) established under Title 22 (commencing with Section 100500) of the Government Code or no-cost coverage through Medi-Cal. The notice shall include information on obtaining coverage pursuant to those programs, shall be in no less than 12-point type, and shall be developed by the department, no later than July 1, 2013, in consultation with the Department of Managed Health Care and the California Health Benefit Exchange.(b)(2) The notice described in subdivision (a) paragraph (1) may be incorporated into or sent simultaneously with and in the same manner as any other notices sent by the health insurer.(b) (1) A health insurer shall annually notify a policyholder or certificate holder that if the policyholder or certificate holder ceases to be enrolled in coverage, the health insurer will provide information, including the policyholders or certificate holders name, address, and other contact information, such as email address, to the Exchange so that the policyholder or certificate holder may obtain other coverage. A policyholder or certificate holder may opt out of this transfer of information to the Exchange.(2) Beginning January 1, 2021, a health insurer that has notified its policyholders or certificate holders consistent with paragraph (1) shall provide to the Exchange the name, address, and other contact information of a policyholder or certificate holder who ceased to be enrolled in coverage and who did not opt out of the information transfer. The information shall be provided in a manner prescribed by the Exchange.(3) The Exchange may use any contact method to communicate with and inform a policyholder or certificate holder who ceases to be enrolled in coverage of available coverage options.(c) This section shall does not apply with respect to a specialized health insurance policy or a health insurance policy consisting solely of coverage of excepted benefits as described in Section 2722 of the federal Public Health Service Act (42 U.S.C. Sec. 300gg-21).
10786. (a) (1) On and after January 1, 2014, a health insurer providing health insurance coverage shall provide to policyholders in individual policies or certificate holders in group policies who cease to be enrolled in coverage a notice informing them that they may be eligible for reduced-cost coverage through the California Health Benefit Exchange (Exchange) established under Title 22 (commencing with Section 100500) of the Government Code or no-cost coverage through Medi-Cal. The notice shall include information on obtaining coverage pursuant to those programs, shall be in no less than 12-point type, and shall be developed by the department, no later than July 1, 2013, in consultation with the Department of Managed Health Care and the California Health Benefit Exchange.
(b)
(2) The notice described in subdivision (a) paragraph (1) may be incorporated into or sent simultaneously with and in the same manner as any other notices sent by the health insurer.
(b) (1) A health insurer shall annually notify a policyholder or certificate holder that if the policyholder or certificate holder ceases to be enrolled in coverage, the health insurer will provide information, including the policyholders or certificate holders name, address, and other contact information, such as email address, to the Exchange so that the policyholder or certificate holder may obtain other coverage. A policyholder or certificate holder may opt out of this transfer of information to the Exchange.
(2) Beginning January 1, 2021, a health insurer that has notified its policyholders or certificate holders consistent with paragraph (1) shall provide to the Exchange the name, address, and other contact information of a policyholder or certificate holder who ceased to be enrolled in coverage and who did not opt out of the information transfer. The information shall be provided in a manner prescribed by the Exchange.
(3) The Exchange may use any contact method to communicate with and inform a policyholder or certificate holder who ceases to be enrolled in coverage of available coverage options.
(c) This section shall does not apply with respect to a specialized health insurance policy or a health insurance policy consisting solely of coverage of excepted benefits as described in Section 2722 of the federal Public Health Service Act (42 U.S.C. Sec. 300gg-21).
SEC. 4. 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 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 XIIIB of the California Constitution.
SEC. 4. 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 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 XIIIB of the California Constitution.
SEC. 4. 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 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 XIIIB of the California Constitution.
### SEC. 4.