| 1 | | - | Assembly Bill No. 952 CHAPTER 125An 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. [ Approved by Governor July 27, 2023. Filed with Secretary of State July 27, 2023. ] LEGISLATIVE COUNSEL'S DIGESTAB 952, 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, including a specialized health care service plan or specialized health insurer covering dental services, to disclose whether an enrollees or insureds dental coverage is State Regulated through a provider portal, if available, or otherwise upon request, on or after January 1, 2025. The bill would require a plan or insurer to include the statement State Regulated, if the enrollees or insureds dental coverage is subject to regulation by the appropriate department, on an electronic or physical identification card, or both if available, for contracts covering dental services issued on or after January 1, 2025. 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) To assist a provider in determining if an enrollees health care service plan coverage is regulated by the State of California, the health care service plan shall disclose whether the enrollees dental coverage is State Regulated through a provider portal, if available, or otherwise upon request, on or after January 1, 2025.(b) A health care service plan shall include the statement State Regulated if the enrollees dental coverage is subject to regulation by the department on an electronic or physical identification card, or both if available, for contracts covering dental services issued on or after January 1, 2025.(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, including 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) To assist a provider in determining if an insureds dental coverage is regulated by the State of California, the health insurer shall disclose whether the insureds dental coverage is State Regulated through a provider portal, if available, or otherwise upon request, on or after January 1, 2025.(b) A health insurer shall include the statement State Regulated if the insureds dental coverage is subject to regulation by the department, on an electronic or physical identification card, or both if available, for policies covering dental services issued on or after January 1, 2025. (c) For purposes of this section, health insurer means a health insurer that issues, sells, renews, or offers a policy covering dental services, including 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. |
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| 1 | + | Enrolled July 14, 2023 Passed IN Senate June 29, 2023 Passed IN Assembly July 13, 2023 Amended IN Senate June 06, 2023 CALIFORNIA LEGISLATURE 20232024 REGULAR SESSION Assembly Bill No. 952Introduced by Assembly Member WoodFebruary 14, 2023An 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, 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, including a specialized health care service plan or specialized health insurer covering dental services, to disclose whether an enrollees or insureds dental coverage is State Regulated through a provider portal, if available, or otherwise upon request, on or after January 1, 2025. The bill would require a plan or insurer to include the statement State Regulated, if the enrollees or insureds dental coverage is subject to regulation by the appropriate department, on an electronic or physical identification card, or both if available, for contracts covering dental services issued on or after January 1, 2025. 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) To assist a provider in determining if an enrollees health care service plan coverage is regulated by the State of California, the health care service plan shall disclose whether the enrollees dental coverage is State Regulated through a provider portal, if available, or otherwise upon request, on or after January 1, 2025.(b) A health care service plan shall include the statement State Regulated if the enrollees dental coverage is subject to regulation by the department on an electronic or physical identification card, or both if available, for contracts covering dental services issued on or after January 1, 2025.(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, including 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) To assist a provider in determining if an insureds dental coverage is regulated by the State of California, the health insurer shall disclose whether the insureds dental coverage is State Regulated through a provider portal, if available, or otherwise upon request, on or after January 1, 2025.(b) A health insurer shall include the statement State Regulated if the insureds dental coverage is subject to regulation by the department, on an electronic or physical identification card, or both if available, for policies covering dental services issued on or after January 1, 2025. (c) For purposes of this section, health insurer means a health insurer that issues, sells, renews, or offers a policy covering dental services, including 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. |
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| 14 | 24 | | |
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| 15 | 25 | | LEGISLATIVE COUNSEL'S DIGEST |
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| 16 | 26 | | |
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| 17 | 27 | | ## LEGISLATIVE COUNSEL'S DIGEST |
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| 18 | 28 | | |
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| 19 | 29 | | AB 952, Wood. Dental coverage disclosures. |
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| 20 | 30 | | |
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| 21 | 31 | | 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, including a specialized health care service plan or specialized health insurer covering dental services, to disclose whether an enrollees or insureds dental coverage is State Regulated through a provider portal, if available, or otherwise upon request, on or after January 1, 2025. The bill would require a plan or insurer to include the statement State Regulated, if the enrollees or insureds dental coverage is subject to regulation by the appropriate department, on an electronic or physical identification card, or both if available, for contracts covering dental services issued on or after January 1, 2025. 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. |
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| 22 | 32 | | |
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| 23 | 33 | | 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. |
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| 24 | 34 | | |
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| 25 | 35 | | This bill would require a health care service plan or health insurer that issues, sells, renews, or offers a contract covering dental services, including a specialized health care service plan or specialized health insurer covering dental services, to disclose whether an enrollees or insureds dental coverage is State Regulated through a provider portal, if available, or otherwise upon request, on or after January 1, 2025. The bill would require a plan or insurer to include the statement State Regulated, if the enrollees or insureds dental coverage is subject to regulation by the appropriate department, on an electronic or physical identification card, or both if available, for contracts covering dental services issued on or after January 1, 2025. 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. |
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| 26 | 36 | | |
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| 27 | 37 | | 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. |
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| 28 | 38 | | |
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| 29 | 39 | | This bill would provide that no reimbursement is required by this act for a specified reason. |
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| 30 | 40 | | |
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| 31 | 41 | | ## Digest Key |
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| 32 | 42 | | |
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| 33 | 43 | | ## Bill Text |
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| 34 | 44 | | |
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| 35 | 45 | | 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) To assist a provider in determining if an enrollees health care service plan coverage is regulated by the State of California, the health care service plan shall disclose whether the enrollees dental coverage is State Regulated through a provider portal, if available, or otherwise upon request, on or after January 1, 2025.(b) A health care service plan shall include the statement State Regulated if the enrollees dental coverage is subject to regulation by the department on an electronic or physical identification card, or both if available, for contracts covering dental services issued on or after January 1, 2025.(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, including 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) To assist a provider in determining if an insureds dental coverage is regulated by the State of California, the health insurer shall disclose whether the insureds dental coverage is State Regulated through a provider portal, if available, or otherwise upon request, on or after January 1, 2025.(b) A health insurer shall include the statement State Regulated if the insureds dental coverage is subject to regulation by the department, on an electronic or physical identification card, or both if available, for policies covering dental services issued on or after January 1, 2025. (c) For purposes of this section, health insurer means a health insurer that issues, sells, renews, or offers a policy covering dental services, including 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. |
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| 36 | 46 | | |
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| 37 | 47 | | The people of the State of California do enact as follows: |
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| 38 | 48 | | |
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| 39 | 49 | | ## The people of the State of California do enact as follows: |
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| 40 | 50 | | |
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| 41 | 51 | | SECTION 1. Section 1374.18 is added to the Health and Safety Code, to read:1374.18. (a) To assist a provider in determining if an enrollees health care service plan coverage is regulated by the State of California, the health care service plan shall disclose whether the enrollees dental coverage is State Regulated through a provider portal, if available, or otherwise upon request, on or after January 1, 2025.(b) A health care service plan shall include the statement State Regulated if the enrollees dental coverage is subject to regulation by the department on an electronic or physical identification card, or both if available, for contracts covering dental services issued on or after January 1, 2025.(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, including a specialized health care service plan covering dental services. |
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| 42 | 52 | | |
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| 43 | 53 | | SECTION 1. Section 1374.18 is added to the Health and Safety Code, to read: |
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| 44 | 54 | | |
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| 45 | 55 | | ### SECTION 1. |
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| 46 | 56 | | |
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| 47 | 57 | | 1374.18. (a) To assist a provider in determining if an enrollees health care service plan coverage is regulated by the State of California, the health care service plan shall disclose whether the enrollees dental coverage is State Regulated through a provider portal, if available, or otherwise upon request, on or after January 1, 2025.(b) A health care service plan shall include the statement State Regulated if the enrollees dental coverage is subject to regulation by the department on an electronic or physical identification card, or both if available, for contracts covering dental services issued on or after January 1, 2025.(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, including a specialized health care service plan covering dental services. |
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| 48 | 58 | | |
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| 49 | 59 | | 1374.18. (a) To assist a provider in determining if an enrollees health care service plan coverage is regulated by the State of California, the health care service plan shall disclose whether the enrollees dental coverage is State Regulated through a provider portal, if available, or otherwise upon request, on or after January 1, 2025.(b) A health care service plan shall include the statement State Regulated if the enrollees dental coverage is subject to regulation by the department on an electronic or physical identification card, or both if available, for contracts covering dental services issued on or after January 1, 2025.(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, including a specialized health care service plan covering dental services. |
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| 50 | 60 | | |
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| 51 | 61 | | 1374.18. (a) To assist a provider in determining if an enrollees health care service plan coverage is regulated by the State of California, the health care service plan shall disclose whether the enrollees dental coverage is State Regulated through a provider portal, if available, or otherwise upon request, on or after January 1, 2025.(b) A health care service plan shall include the statement State Regulated if the enrollees dental coverage is subject to regulation by the department on an electronic or physical identification card, or both if available, for contracts covering dental services issued on or after January 1, 2025.(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, including a specialized health care service plan covering dental services. |
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| 52 | 62 | | |
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| 53 | 63 | | |
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| 54 | 64 | | |
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| 55 | 65 | | 1374.18. (a) To assist a provider in determining if an enrollees health care service plan coverage is regulated by the State of California, the health care service plan shall disclose whether the enrollees dental coverage is State Regulated through a provider portal, if available, or otherwise upon request, on or after January 1, 2025. |
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| 56 | 66 | | |
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| 57 | 67 | | (b) A health care service plan shall include the statement State Regulated if the enrollees dental coverage is subject to regulation by the department on an electronic or physical identification card, or both if available, for contracts covering dental services issued on or after January 1, 2025. |
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| 58 | 68 | | |
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| 59 | 69 | | (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, including a specialized health care service plan covering dental services. |
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| 60 | 70 | | |
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| 61 | 71 | | SEC. 2. Section 10120.42 is added to the Insurance Code, to read:10120.42. (a) To assist a provider in determining if an insureds dental coverage is regulated by the State of California, the health insurer shall disclose whether the insureds dental coverage is State Regulated through a provider portal, if available, or otherwise upon request, on or after January 1, 2025.(b) A health insurer shall include the statement State Regulated if the insureds dental coverage is subject to regulation by the department, on an electronic or physical identification card, or both if available, for policies covering dental services issued on or after January 1, 2025. (c) For purposes of this section, health insurer means a health insurer that issues, sells, renews, or offers a policy covering dental services, including a specialized health insurer covering dental services. |
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| 62 | 72 | | |
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| 63 | 73 | | SEC. 2. Section 10120.42 is added to the Insurance Code, to read: |
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| 64 | 74 | | |
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| 65 | 75 | | ### SEC. 2. |
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| 66 | 76 | | |
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| 67 | 77 | | 10120.42. (a) To assist a provider in determining if an insureds dental coverage is regulated by the State of California, the health insurer shall disclose whether the insureds dental coverage is State Regulated through a provider portal, if available, or otherwise upon request, on or after January 1, 2025.(b) A health insurer shall include the statement State Regulated if the insureds dental coverage is subject to regulation by the department, on an electronic or physical identification card, or both if available, for policies covering dental services issued on or after January 1, 2025. (c) For purposes of this section, health insurer means a health insurer that issues, sells, renews, or offers a policy covering dental services, including a specialized health insurer covering dental services. |
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| 68 | 78 | | |
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| 69 | 79 | | 10120.42. (a) To assist a provider in determining if an insureds dental coverage is regulated by the State of California, the health insurer shall disclose whether the insureds dental coverage is State Regulated through a provider portal, if available, or otherwise upon request, on or after January 1, 2025.(b) A health insurer shall include the statement State Regulated if the insureds dental coverage is subject to regulation by the department, on an electronic or physical identification card, or both if available, for policies covering dental services issued on or after January 1, 2025. (c) For purposes of this section, health insurer means a health insurer that issues, sells, renews, or offers a policy covering dental services, including a specialized health insurer covering dental services. |
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| 70 | 80 | | |
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| 71 | 81 | | 10120.42. (a) To assist a provider in determining if an insureds dental coverage is regulated by the State of California, the health insurer shall disclose whether the insureds dental coverage is State Regulated through a provider portal, if available, or otherwise upon request, on or after January 1, 2025.(b) A health insurer shall include the statement State Regulated if the insureds dental coverage is subject to regulation by the department, on an electronic or physical identification card, or both if available, for policies covering dental services issued on or after January 1, 2025. (c) For purposes of this section, health insurer means a health insurer that issues, sells, renews, or offers a policy covering dental services, including a specialized health insurer covering dental services. |
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| 72 | 82 | | |
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| 73 | 83 | | |
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| 74 | 84 | | |
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| 75 | 85 | | 10120.42. (a) To assist a provider in determining if an insureds dental coverage is regulated by the State of California, the health insurer shall disclose whether the insureds dental coverage is State Regulated through a provider portal, if available, or otherwise upon request, on or after January 1, 2025. |
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| 76 | 86 | | |
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| 77 | 87 | | (b) A health insurer shall include the statement State Regulated if the insureds dental coverage is subject to regulation by the department, on an electronic or physical identification card, or both if available, for policies covering dental services issued on or after January 1, 2025. |
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| 78 | 88 | | |
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| 79 | 89 | | (c) For purposes of this section, health insurer means a health insurer that issues, sells, renews, or offers a policy covering dental services, including a specialized health insurer covering dental services. |
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| 80 | 90 | | |
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| 81 | 91 | | 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. |
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| 82 | 92 | | |
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| 83 | 93 | | 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. |
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| 84 | 94 | | |
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| 85 | 95 | | 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. |
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| 86 | 96 | | |
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| 87 | 97 | | ### SEC. 3. |
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