AB 1461 Summary

• Requires health care service plans to offer all individual health benefit plans to all individuals and dependents in their service areas starting October 1, 2013, with coverage effective January 1, 2014, while limiting enrollment to open and special enrollment periods.

• Prohibits plans from imposing preexisting condition exclusions and from establishing eligibility rules based on health status, medical conditions, claims experience, genetic information, or other health status-related factors beginning January 1, 2014.

• Restricts rate-setting for individual health benefit plans to only age (with a 3-to-1 ratio), geographic region (19 designated regions), and whether coverage is individual or family; eliminates health-based rating starting January 1, 2014.

• Authorizes the Department of Managed Health Care to waive or modify disclosure requirements through January 1, 2015 to comply with federal Patient Protection and Affordable Care Act (PPACA) provisions regarding summary of benefits and coverage.

• Makes multiple provisions inoperative if corresponding PPACA provisions are repealed; becomes operative only if Senate Bill 961 of the 2011-12 Regular Session is enacted.