Employee Benefits Compliance, State-Specific Information

California: Recent Benefits News 8/1/14

Update on the California waiting period limits

In a nutshell:  There is nothing official yet, but the Assembly unanimously passed SB 1034 on June 30th. SB 1034 is the bill that removes the 60 day waiting period limitation from California law.  It has been sent back to the Senate for concurrence on some amendments that were made in the Assembly.  The California legislature is now in recess and does not return until August 4th.  So, for now, employers should comply with whatever their particular carrier requires.  E.g., some will only allow an employer to impose a waiting period of up to 60 days.

SB 1034 says that the Legislature intends to allow plan sponsors to impose waiting periods consistent with section 2708 of the Affordable Care Act.  This is the section under which the waiting period and orientation period regulation was issued (allowing an orientation period of up to one month, immediately before the allowable waiting period of up to 90 days).  SB 1034 also says the Legislature intends to prohibit insurers or HMOs from imposing separate waiting or affiliation periods in addition to the waiting period imposed by the employer plan sponsor.

Three Health Care Bills on Agenda when Calif. Lawmakers Reconvene

When California lawmakers reconvene the first week of August, they will consider three health care bills that largely are supported by consumer advocates and opposed by insurers, Capital Public Radio’s “KXJZ News” reports.

  • SB 1176 would require insurers to track and record out-of-pocket costs paid by their members and reimburse them if they go over a set limit.
  • AB 1917 aims to make the cost of specialty medications more affordable for patients with chronic conditions It  also would require commercial insurers to cover hepatitis C screenings
  • AB 2533 would require insurers to pay for out-of-network providers when an in-network provider is not immediately available to provide care.

From http://www.californiahealthline.org/articles/2014/7/23/three-health-care-bills-on-agenda-when-calif-lawmakers-reconvene,  7-23-14.


3.4 Million Previously Uninsured in Calif. Gained Coverage After ACA

A Kaiser Family Foundation survey finds that about 60% of California residents who were uninsured prior to the Affordable Care Act’s first open enrollment period have since gained health coverage. Reaching the remaining uninsured population during the second open enrollment period could present new challenges. Los Angeles Times‘ “L.A. Now” et al.



Jones: Rates for Health Insurance Plans Rose Significantly in 2014

A report released July 29th by California Insurance Commissioner Dave Jones found that health insurance premiums for California residents were 22% to 88% higher in 2014 than in 2013. Insurers criticized the report as misleading. Los Angeles Times et al.