SB 1100 Summary

• Requires health care service plans and health insurers to provide notice of continuity of care processes in every evidence of coverage issued after January 1, 2015, and to provide written copies to contracting providers, provider groups, and enrollees upon request.

• Expands continuity of care eligibility for newly covered enrollees receiving services from nonparticipating providers by eliminating the requirement that their prior coverage was terminated during a specific period (December 1, 2013 to March 31, 2014).

• Allows health care service plans and insurers to require nonparticipating providers to accept contractual terms and conditions comparable to currently contracting providers, including credentialing and quality assurance requirements.

• Maintains the six qualifying conditions for continuity of care: acute conditions, serious chronic conditions, pregnancy, terminal illness, newborn care (birth to 36 months), and authorized surgeries or procedures within 180 days.

• Specifies that no state reimbursement is required because costs incurred by local agencies will result from changes to criminal penalties, which are exempt from reimbursement under the California Constitution.