Student health insurance.

Existing law provides for the regulation of disability insurers by the Department of Insurance. Under existing law, disability insurance includes health insurance and blanket disability insurance that covers hospital, medical, or surgical benefits. Existing law requires, among other things, a health insurer to offer, market, and sell all of its health benefit plans to all individuals and dependents in each service area in which the insurer provides health care services, and requires all individual health benefit plans to be renewable, as specified. Existing law also requires a health insurer to establish specified enrollment periods and to provide specified levels of insurance coverage. Under existing law, a health insurer is required to consider the claims experience of all insureds and enrollees as a single risk pool for rating purposes in the individual market. This bill, for policy years beginning on or after January 1, 2024, would require student health insurance coverage, as defined, to be considered individual health insurance coverage. The bill would define student health insurance coverage as a blanket disability policy provided to students enrolled in an institution of higher education and to their dependents, that covers hospital, medical, or surgical benefits. The bill, except as specified, would require a blanket disability insurance policy that meets the definition of student health insurance coverage to comply with insurance provisions that are applicable to nongrandfathered individual health insurance, including, among others, essential health benefits requirements and annual limits on out-of-pocket expenses. The bill would exempt student health insurance coverage from certain requirements otherwise applicable to health insurers and health benefit plans, including the establishment of specified enrollment periods, guaranteed availability and renewability, specified coverage level requirements, and single risk pool rating requirements. The bill would require a notice be provided in the student health insurance enrollment materials informing a student, or dependent of a student, of the requirement that California residents and their dependents obtain health coverage and various options to meet this requirement. Existing law prohibits the alteration of any written application for any disability policy by any person other than the applicant without the applicant's consent, except as specified. Under existing law, the making of any other alteration without the consent of the applicant is a misdemeanor. This bill would subject student health insurance coverage to this prohibition. Because this bill would expand the application of an existing crime, it 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.