CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Assembly Bill No. 952Introduced by Assembly Member WoodFebruary 14, 2023 An act to add Section 1374.18 to the Health and Safety Code, and to add Section 10120.42 to the Insurance Code, relating to dental coverage. LEGISLATIVE COUNSEL'S DIGESTAB 952, as introduced, Wood. Dental coverage disclosures. 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 acts requirements a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law imposes specified coverage and disclosure requirements on health care service plans and health insurers, including specialized plans and insurers, that cover dental services.This bill would require a health care service plan or health insurer that issues, sells, renews, or offers a contract covering dental services, or a specialized health care service plan or specialized health insurer covering dental services, to disclose whether or not an enrollees or insureds dental coverage is subject to regulation by the appropriate department at the time a treatment plan is communicated to the plan or insurer. The bill would also require that plan or insurer to include whether or not an enrollees or insureds dental coverage is subject to regulation by the appropriate department on an identification card, membership card, coverage card, or other documentation of coverage. Because a willful violation of these provisions by a health care service plan 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.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 1374.18 is added to the Health and Safety Code, to read:1374.18. (a) At the time that an enrollees treatment plan is communicated by a provider to a health care service plan for purposes of eligibility and benefit determination, the health care service plan shall disclose whether or not the enrollees dental coverage is subject to regulation by the department.(b) An identification card, membership card, coverage card, or other documentation of coverage issued to a contractholder or enrollee by a health care service plan shall include whether or not the enrollees dental coverage is subject to regulation by the department.(c) For purposes of this section, health care service plan means a health care service plan that issues, sells, renews, or offers a contract covering dental services or a specialized health care service plan covering dental services.SEC. 2. Section 10120.42 is added to the Insurance Code, to read:10120.42. (a) At the time that an insureds treatment plan is communicated by a provider to a health insurer for purposes of eligibility and benefit determination, the health insurer shall disclose whether or not the insureds dental coverage is subject to regulation by the department.(b) An identification card, membership card, coverage card, or other documentation of coverage issued to a policyholder or insured by a health insurer shall include whether or not the insureds dental coverage is subject to regulation by the department.(c) For purposes of this section, health insurer means a health insurer that issues, sells, renews, or offers a policy covering dental services or a specialized health insurer covering dental services.SEC. 3. 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 20232024 REGULAR SESSION Assembly Bill No. 952Introduced by Assembly Member WoodFebruary 14, 2023 An act to add Section 1374.18 to the Health and Safety Code, and to add Section 10120.42 to the Insurance Code, relating to dental coverage. LEGISLATIVE COUNSEL'S DIGESTAB 952, as introduced, Wood. Dental coverage disclosures. 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 acts requirements a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law imposes specified coverage and disclosure requirements on health care service plans and health insurers, including specialized plans and insurers, that cover dental services.This bill would require a health care service plan or health insurer that issues, sells, renews, or offers a contract covering dental services, or a specialized health care service plan or specialized health insurer covering dental services, to disclose whether or not an enrollees or insureds dental coverage is subject to regulation by the appropriate department at the time a treatment plan is communicated to the plan or insurer. The bill would also require that plan or insurer to include whether or not an enrollees or insureds dental coverage is subject to regulation by the appropriate department on an identification card, membership card, coverage card, or other documentation of coverage. Because a willful violation of these provisions by a health care service plan 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.Digest Key Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program: YES
CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION
Assembly Bill
No. 952
Introduced by Assembly Member WoodFebruary 14, 2023
Introduced by Assembly Member Wood
February 14, 2023
An act to add Section 1374.18 to the Health and Safety Code, and to add Section 10120.42 to the Insurance Code, relating to dental coverage.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
AB 952, as introduced, Wood. Dental coverage disclosures.
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 acts requirements a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law imposes specified coverage and disclosure requirements on health care service plans and health insurers, including specialized plans and insurers, that cover dental services.This bill would require a health care service plan or health insurer that issues, sells, renews, or offers a contract covering dental services, or a specialized health care service plan or specialized health insurer covering dental services, to disclose whether or not an enrollees or insureds dental coverage is subject to regulation by the appropriate department at the time a treatment plan is communicated to the plan or insurer. The bill would also require that plan or insurer to include whether or not an enrollees or insureds dental coverage is subject to regulation by the appropriate department on an identification card, membership card, coverage card, or other documentation of coverage. Because a willful violation of these provisions by a health care service plan 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.
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 acts requirements a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law imposes specified coverage and disclosure requirements on health care service plans and health insurers, including specialized plans and insurers, that cover dental services.
This bill would require a health care service plan or health insurer that issues, sells, renews, or offers a contract covering dental services, or a specialized health care service plan or specialized health insurer covering dental services, to disclose whether or not an enrollees or insureds dental coverage is subject to regulation by the appropriate department at the time a treatment plan is communicated to the plan or insurer. The bill would also require that plan or insurer to include whether or not an enrollees or insureds dental coverage is subject to regulation by the appropriate department on an identification card, membership card, coverage card, or other documentation of coverage. Because a willful violation of these provisions by a health care service plan 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.
## Digest Key
## Bill Text
The people of the State of California do enact as follows:SECTION 1. Section 1374.18 is added to the Health and Safety Code, to read:1374.18. (a) At the time that an enrollees treatment plan is communicated by a provider to a health care service plan for purposes of eligibility and benefit determination, the health care service plan shall disclose whether or not the enrollees dental coverage is subject to regulation by the department.(b) An identification card, membership card, coverage card, or other documentation of coverage issued to a contractholder or enrollee by a health care service plan shall include whether or not the enrollees dental coverage is subject to regulation by the department.(c) For purposes of this section, health care service plan means a health care service plan that issues, sells, renews, or offers a contract covering dental services or a specialized health care service plan covering dental services.SEC. 2. Section 10120.42 is added to the Insurance Code, to read:10120.42. (a) At the time that an insureds treatment plan is communicated by a provider to a health insurer for purposes of eligibility and benefit determination, the health insurer shall disclose whether or not the insureds dental coverage is subject to regulation by the department.(b) An identification card, membership card, coverage card, or other documentation of coverage issued to a policyholder or insured by a health insurer shall include whether or not the insureds dental coverage is subject to regulation by the department.(c) For purposes of this section, health insurer means a health insurer that issues, sells, renews, or offers a policy covering dental services or a specialized health insurer covering dental services.SEC. 3. 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 1374.18 is added to the Health and Safety Code, to read:1374.18. (a) At the time that an enrollees treatment plan is communicated by a provider to a health care service plan for purposes of eligibility and benefit determination, the health care service plan shall disclose whether or not the enrollees dental coverage is subject to regulation by the department.(b) An identification card, membership card, coverage card, or other documentation of coverage issued to a contractholder or enrollee by a health care service plan shall include whether or not the enrollees dental coverage is subject to regulation by the department.(c) For purposes of this section, health care service plan means a health care service plan that issues, sells, renews, or offers a contract covering dental services or a specialized health care service plan covering dental services.
SECTION 1. Section 1374.18 is added to the Health and Safety Code, to read:
### SECTION 1.
1374.18. (a) At the time that an enrollees treatment plan is communicated by a provider to a health care service plan for purposes of eligibility and benefit determination, the health care service plan shall disclose whether or not the enrollees dental coverage is subject to regulation by the department.(b) An identification card, membership card, coverage card, or other documentation of coverage issued to a contractholder or enrollee by a health care service plan shall include whether or not the enrollees dental coverage is subject to regulation by the department.(c) For purposes of this section, health care service plan means a health care service plan that issues, sells, renews, or offers a contract covering dental services or a specialized health care service plan covering dental services.
1374.18. (a) At the time that an enrollees treatment plan is communicated by a provider to a health care service plan for purposes of eligibility and benefit determination, the health care service plan shall disclose whether or not the enrollees dental coverage is subject to regulation by the department.(b) An identification card, membership card, coverage card, or other documentation of coverage issued to a contractholder or enrollee by a health care service plan shall include whether or not the enrollees dental coverage is subject to regulation by the department.(c) For purposes of this section, health care service plan means a health care service plan that issues, sells, renews, or offers a contract covering dental services or a specialized health care service plan covering dental services.
1374.18. (a) At the time that an enrollees treatment plan is communicated by a provider to a health care service plan for purposes of eligibility and benefit determination, the health care service plan shall disclose whether or not the enrollees dental coverage is subject to regulation by the department.(b) An identification card, membership card, coverage card, or other documentation of coverage issued to a contractholder or enrollee by a health care service plan shall include whether or not the enrollees dental coverage is subject to regulation by the department.(c) For purposes of this section, health care service plan means a health care service plan that issues, sells, renews, or offers a contract covering dental services or a specialized health care service plan covering dental services.
1374.18. (a) At the time that an enrollees treatment plan is communicated by a provider to a health care service plan for purposes of eligibility and benefit determination, the health care service plan shall disclose whether or not the enrollees dental coverage is subject to regulation by the department.
(b) An identification card, membership card, coverage card, or other documentation of coverage issued to a contractholder or enrollee by a health care service plan shall include whether or not the enrollees dental coverage is subject to regulation by the department.
(c) For purposes of this section, health care service plan means a health care service plan that issues, sells, renews, or offers a contract covering dental services or a specialized health care service plan covering dental services.
SEC. 2. Section 10120.42 is added to the Insurance Code, to read:10120.42. (a) At the time that an insureds treatment plan is communicated by a provider to a health insurer for purposes of eligibility and benefit determination, the health insurer shall disclose whether or not the insureds dental coverage is subject to regulation by the department.(b) An identification card, membership card, coverage card, or other documentation of coverage issued to a policyholder or insured by a health insurer shall include whether or not the insureds dental coverage is subject to regulation by the department.(c) For purposes of this section, health insurer means a health insurer that issues, sells, renews, or offers a policy covering dental services or a specialized health insurer covering dental services.
SEC. 2. Section 10120.42 is added to the Insurance Code, to read:
### SEC. 2.
10120.42. (a) At the time that an insureds treatment plan is communicated by a provider to a health insurer for purposes of eligibility and benefit determination, the health insurer shall disclose whether or not the insureds dental coverage is subject to regulation by the department.(b) An identification card, membership card, coverage card, or other documentation of coverage issued to a policyholder or insured by a health insurer shall include whether or not the insureds dental coverage is subject to regulation by the department.(c) For purposes of this section, health insurer means a health insurer that issues, sells, renews, or offers a policy covering dental services or a specialized health insurer covering dental services.
10120.42. (a) At the time that an insureds treatment plan is communicated by a provider to a health insurer for purposes of eligibility and benefit determination, the health insurer shall disclose whether or not the insureds dental coverage is subject to regulation by the department.(b) An identification card, membership card, coverage card, or other documentation of coverage issued to a policyholder or insured by a health insurer shall include whether or not the insureds dental coverage is subject to regulation by the department.(c) For purposes of this section, health insurer means a health insurer that issues, sells, renews, or offers a policy covering dental services or a specialized health insurer covering dental services.
10120.42. (a) At the time that an insureds treatment plan is communicated by a provider to a health insurer for purposes of eligibility and benefit determination, the health insurer shall disclose whether or not the insureds dental coverage is subject to regulation by the department.(b) An identification card, membership card, coverage card, or other documentation of coverage issued to a policyholder or insured by a health insurer shall include whether or not the insureds dental coverage is subject to regulation by the department.(c) For purposes of this section, health insurer means a health insurer that issues, sells, renews, or offers a policy covering dental services or a specialized health insurer covering dental services.
10120.42. (a) At the time that an insureds treatment plan is communicated by a provider to a health insurer for purposes of eligibility and benefit determination, the health insurer shall disclose whether or not the insureds dental coverage is subject to regulation by the department.
(b) An identification card, membership card, coverage card, or other documentation of coverage issued to a policyholder or insured by a health insurer shall include whether or not the insureds dental coverage is subject to regulation by the department.
(c) For purposes of this section, health insurer means a health insurer that issues, sells, renews, or offers a policy covering dental services or a specialized health insurer covering dental services.
SEC. 3. 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. 3. 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. 3. 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. 3.