Legislative Update: CAHU And California Advocates, Inc. Presents
CAHU Top Priority Bills: Preparing for Capitol Summit, 2019
As of April 11, 2019
By: Dorothy Cociu, RHU, REBC, GBA, RPA, OCAHU V.P. of Communications & Public Affairs, President, Advanced Benefit Consulting & Insurance Services, Inc.
The County of Orange News (The COIN), May, 2019
In place of the single payer update this issue, and to prepare any members who will be joining us at Capitol Summit in Sacramento May 20-22, I thought a legislative report overall on CAHU activity would be helpful. So please forgive me for not including the Single Payer Update in this issue. I promise it will return, as soon as there is news to report to you.
The CAHU Legislative Chairs and interested other CAHU and local chapter board members attended a Bill Review session this spring to discuss the priority bills that CAHU will be focusing in the coming months. The complete status report provided by CAHU is 11 pages in length, so I can’t cover all of the bills in the limited space available in the COIN. Instead, we will focus on the top priority bills as of now, due to limited space (and because our brains generally can’t handle too many bill details at once… at least mine can’t!).
First is AB 5 – (Gonzalez D) Worker Status: Independent Contractors. This bill is a high priority due to the Dynamex case (see page 9). This bill would state the intent of the Legislature to codify the decision in the Dynamex case and clarify its application. The bill would provide that the factors of the “ABC” test be applied in order to determine the status of a worker as an employee or independent contractor for all provisions of the Labor Code, unless another definition or specification of employee” is provided. The bill would, according to CAHU, codify existing exemptions for specified professions that are not subject to wage orders of the Industrial Welfare Commission or the ruling in the Dynamex case. The bill would state that its provisions do not constitute a change in, but are declaratory of, existing law.
CAHU is in support of AB 5.
CAHU is in SUPPORT of AB 5, which clarifies that a recent California Supreme Court ruling, Dynamex Operations West Inc. v. Superior Court (Dynamex), does not alter an insurance agent or broker’s ability to be an independent contractor. Without this clarification, many agents could be forced to become W-2 employees. This would have negatively impacted agents and brokers by restricting commissions and the ability to work independently while impacting existing tax reporting and deductions.
Next is AB 651 – (Grayson D) Air Ambulance Services. This bill would require a health care service plan contract or a health insurance policy issued, amended, or renewed on or after January 1, 2020, to provide that if an enrollee, insured, or subscriber (individual) receives covered services from a noncontracting air ambulance provider, the individual shall pay no more than the same cost sharing that the individual would pay for the same covered services received from a contracting air ambulance provider, referred to as the in-network cost-sharing amount.
The bill would provide that an individual would not owe the noncontracting provider more than the in-network cost-sharing amount for services.
CAHU is in support of AB 651.
CAHU SUPPORTS AB 651 CAHU because our members provide ongoing service and support for clients to effectively adjust and utilize their healthcare coverage as medical necessity and coverage options change. Through these efforts, we see firsthand the importance for our clients to have clear coverage options, without the confusion and financial instability that balance billing creates, especially when it comes to exorbitant out-of-pocket costs for life saving treatment.
The third bill to discuss is AB 1309- (Bauer-Kahan D)- Health care coverage: enrollment periods. This bill would require a health care service plan and a health insurer, for policy years beginning on or after January 1, 2020, to provide a special enrollment period to allow individuals to enroll in individual health benefit plans through the Exchange from December 16 of the preceding calendar year, to January 31 of the benefit year, inclusive.
CAHU is in support of this bill.
CAHU SUPPORTS AB 1309, which helps agents by extending enrollment periods for 2020 under which people may purchase health insurance through Covered California and the individual insurance market.
Next is AB 1611 – Emergency hospital services: Costs. We also refer to this as the surprise bills or balance billing bill. This bill would require a health care service plan contract or insurance policy issued, amended, or renewed on or after January 1, 2020, to provide that if an enrollee or insured receives covered services from a noncontracting hospital, the enrollee or insured is prohibited from paying more than the same cost sharing that the enrollee or insured would pay for the same covered services received from a contracting hospital. The bill would require a health care service plan or insurer to pay a noncontracting hospital for emergency services rendered to an enrollee or insured pursuant to a specified formula, would require a noncontracting hospital to bill, collect, and make refunds in a specified manner, and would provide a dispute resolution procedure if any party is dissatisfied with payment.
CAHU supports this bill.
CAHU is in SUPPORT of AB 1611, which bans hospitals from sending surprise bills to patients for emergency room care beyond their regular co-payment or deductible. It also closes the loophole that leaves workers with self-insured or federally-regulated coverage through their job exposed to surprise bills.
This issue is also a popular topic on the hill in Washington, DC.
Next is SB 260 – (Hurtado D) – Automatic Health Care Coverage Enrollment. This bill would require the Exchange, beginning no later than July 1, 2020, to enroll an individual in the lowest cost silver plan or another plan, as specified, upon receiving the individual’s electronic account from a county, or upon receiving information from the State Department of Health Care Services regarding an individual terminated from department-administered health coverage. The bill would require enrollment to occur before Medi-Cal coverage or coverage administered by the State Department of Health Care Services is terminated, and would prohibit the premium due date from being sooner than the last day of the first month of enrollment.
CAHU’s official position on this bill is to WATCH.
CAHU is WATCHING SB 260, which requires Covered California to enroll an individual or individuals who are determined ineligible for Medi-Cal in the lowest cost silver plan upon receipt of information from a county unless Covered California has information that another plan is more appropriate. The bill also requires a health plan or insurer to annually notify an enrollee, subscriber, policy holder, or certificate holder when they cease to be enrolled in coverage, their contact information will be provided to Covered California to assist them in obtaining other coverage, or that they may opt out of this transfer of information.
There are issues with the agent of origin on this bill. CAHU will ask members who are visiting the author if they intend to recognize the original enrollment entity?
I will be discussing one or two other bills that are on the top priorities list of CAHU in the HIPAA Privacy & Security Updates found on page 12.
In addition, I suggest that you visit the CAHU website and print the CAHU Top Priority Bill Status Report, which is updated frequently. ##
