SB 1004 Summary

• Prohibits health care service plans and health insurers from requiring protected individuals to obtain policyholder or subscriber authorization to receive health care services or submit claims if the individual has the right to consent to care.

• Requires health care service plans and health insurers to direct all communications regarding sensitive health care services directly to the protected individual and prohibits disclosure of such information to policyholders or other enrollees without express written authorization.

• Expands the definition of "sensitive services" to include mental health, reproductive health, sexually transmitted infections, substance use disorder, transgender health including gender affirming care, and intimate partner violence.

• Allows insureds and subscribers to request confidential communications in their preferred form and format or at alternative locations without needing to justify the request based on sensitive services or danger.

• Effective January 1, 2021, and establishes that violations are crimes under existing law while providing no state reimbursement to local agencies for costs resulting from these new criminal provisions.