California Vision Care Access Council.

Existing law, the federal Patient Protection and Affordable Care Act, requires each state to establish an American Health Benefits Exchange to facilitate the purchase of qualified health plans by qualified individuals and small employers. PPACA prohibits an Exchange from making available any health plan other than a qualified health plan, except for certain stand-alone dental plans. Existing state law establishes the California Health Benefit Exchange within state government, specifies the powers and duties of the board governing the Exchange, and requires the board to facilitate the purchase of qualified health plans through the Exchange by qualified individuals and small employers by January 1, 2014. This bill would establish the California Vision Care Access Council within state government and would require that the Council be governed by the executive board that governs the California Health Benefit Exchange. The bill would require the Council to establish an interagency agreement with the California Health Benefit Exchange allowing the Council to utilize the executive, administrative, and other related resources of the Exchange and would prohibit the use of specified Exchange funds for purposes of the Council. The bill would require the Council to construct, manage, and maintain an Internet Web site to inform consumers about individual and employer-based vision plans offered by participating carriers. The bill would require the Council to work with the Exchange to establish a direct link between that Internet Web site and the Internet Web site of the Exchange. The bill would require the Council to refer consumer questions regarding health care eligibility and enrollment options to the Exchange and to licensed insurance agents, as specified. This bill would impose specified requirements on participating carriers and would also require the Council to establish other requirements for carrier participation and the standards and criteria for participating vision plans that are in the best interests of individuals and employers eligible to purchase coverage through the Exchange. The bill would require participating vision plans to be issued on a guarantee issue basis without preexisting condition provisions and would require a participating carrier to make available to consumers an electronic directory of contracting vision care providers. The bill would also enact other related provisions. This bill would create the California Vision Care Access Trust Fund, the moneys of which would be available to the board for purposes of the bill's provisions upon appropriaton by the Legislature, would authorize the Council to assess a charge on participating vision plans that is reasonable and necessary to support the development, operations, and prudent cash management of the Council, and would make the implementation of the bill's provisions contingent on a determination by the board that sufficient moneys exist in the fund to implement the bill's provisions. The bill would prohibit General Fund moneys from being used for any of these purposes and would require that any costs associated with the implementation of these provisions be paid from the California Vision Care Access Trust Fund. This bill would declare that it is to take effect immediately as an urgency statute.