Triggering event: loss of minimum essential coverage.

This bill, for purposes of the above, would specify that loss of minimum essential coverage includes loss of coverage due to circumstances in which a joint agreement between health care service plans or health insurers, or between a health care service plan and a health insurer, to provide coverage to an enrollee or insured located in a medically underserved area expires, dissolves, or is otherwise terminated. The bill would require a health care service plan or health insurer to provide a written or electronic notice to enrollees or insureds at least 60 days before the effective date of the expiration, dissolution, or other termination of that joint agreement and would require the notice to additionally indicate that the expiration, dissolution, or other termination of the joint agreement may constitute a loss of minimum essential coverage. Because a willful violation of these provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that no reimbursement is required by this act for a specified reason.