CA SB280

Large group health insurance policies issued, amended, or renewed on or after July 1, 2022, must cover medically necessary basic health care services including physician services, hospital services, diagnostic testing, home health services, preventive care, emergency services, and hospice care.

Insurers and their officials, employees, agents, and representatives are prohibited from using marketing practices or benefit designs that discourage enrollment of individuals with significant health needs or discriminate based on race, color, national origin, disability, age, sex, gender identity, sexual orientation, life expectancy, medical dependency, or other health conditions in large group health insurance.

Violations of the discrimination prohibition result in administrative penalties of up to $2,500 for the first violation and up to $5,000 for subsequent violations.

Violations that indicate a general business practice or knowing violations result in administrative penalties of not less than $15,000 and not more than $100,000 for each violation.

The Insurance Commissioner is authorized to adopt regulations to implement these provisions, and the requirements apply to disability insurance policies covering hospital, medical, or surgical benefits if Section 10112.27 expires.