SB 961 Summary

• Requires health insurers starting October 1, 2013 to offer all individual health benefit plans to all individuals and dependents in their service areas, with coverage effective January 1, 2014 or later, but limits enrollment to open and special enrollment periods.

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

• Restricts individual health plan rating to only age (with a 3-to-1 ratio maximum), geographic region (divided into 19 California regions), and whether coverage is individual or family, effective January 1, 2014.

• Requires health insurers to issue annual notices to grandfathered health plan subscribers at least 60 days before renewal informing them of new health insurance options and consumer protections available outside grandfathered plans.

• Makes key provisions inoperative if federal law provisions under the Patient Protection and Affordable Care Act (specifically Sections 2701 and 2702 of the Public Health Service Act) are repealed, and conditions the bill's effectiveness on enactment of Assembly Bill 1461.