Health care coverage: nonprofit charitable organizations.

Existing law, the Knox-Keene Health Care Service Plan Act of 1975 (Knox-Keene Act) , provides for the licensure and regulation of health care service plans, as defined, by the Department of Managed Health Care. Existing law also provides for the regulation of health insurers by the Department of Insurance and requires insurers to obtain a certificate of authority from the Insurance Commissioner. Existing law provides an exemption from those licensure and certification requirements for plans operated by a public entity or joint labor management trust if, among other requirements, the plan maintains a fiscally sound operation and makes adequate provision against the risk of insolvency, as evidenced by financial statements submitted to the Director of the Department of Managed Health Care, as specified. This bill would exempt a plan operated by a joint venture formed by 2 or more nonprofit charitable organizations, as defined, from the licensure and certification requirements if the plan satisfies certain criteria, including maintaining a fiscally sound operation and making adequate provision against the risk of insolvency, as evidenced by financial statements submitted to the Director of the Department of Managed Health Care, as specified, and submitting a declaration under penalty of perjury stating the plan's compliance with those criteria. The bill would also authorize a joint venture formed between 2 or more nonprofit charitable organizations to contract with a health care service plan or health insurer for the purpose of providing health care coverage to the employees and retirees, and dependents thereof, of the participating nonprofit charitable organizations. By expanding the scope of the crime of perjury, 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.