Health care coverage: portable HEPA purifiers.

The document was reformatted from the official enrolled bill layout (with page numbers, signature blocks, and traditional legislative formatting) to a web-based display format from the California Legislature website, adding navigation menus, a digest key with vote/appropriation/fiscal/local program flags, and reflowed paragraph structure. No changes to the actual statutory language.

The duration of HEPA purifier coverage was changed from 'until one year from the date the local or state emergency is lifted' to simply 'for a declaration made on or after January 1, 2025,' removing the explicit time limit and potentially extending coverage indefinitely while an emergency remains in effect.

The applicability provision for PERS plans was narrowed by removing the reference to CalSTRS members who receive health care benefits under CalSTRS from subsection (c)(1). CalSTRS members remain covered under a separate subsection (c)(2), so this appears to be a structural clarification rather than a loss of coverage.

The explicit exemption for specialized health care service plan contracts or health insurance policies that cover only dental or vision benefits was removed from the exclusion subsections, since these are already excluded by the main provision's language limiting coverage to non-specialized plans and policies.

Coverage requirement narrowed from all health care service plan contracts and health insurance policies to only large group plans, excluding specialized health care service plan contracts and specialized health insurance policies.

New condition that coverage is only required if the enrollee or insured is in a county where a local or state emergency has been declared due to wildfires. This makes the benefit conditional on an active wildfire emergency rather than a standing requirement.

Benefit is time-limited: an enrollee or insured is entitled to the HEPA purifier coverage until one year from the date the local or state emergency is lifted, whichever is later.

New cost cap: the cost of the HEPA purifier shall not exceed $500, adjusted for inflation.

CalPERS applicability language refined from 'a CalPERS sponsored health plan' to 'a health care benefit plan or contract entered into with the Board of Administration of the Public Employees' Retirement System pursuant to the Public Employees' Medical and Hospital Care Act.'

Section numbers changed: Health and Safety Code section moved from 1367.56 to 1368.8, and Insurance Code section moved from 10123.63 to 10112.96.

Coverage now extends to enrollees and insureds who are 'residing in or displaced from' a county with a declared wildfire emergency, rather than only those physically 'in' such a county. This captures evacuees who have left the affected area.

A new definition of 'local or state emergency' was added, specifying it means an emergency declared under Article 14 (Section 8630 et seq.) of Chapter 7 of Division 1 of Title 2 of the Government Code or a declaration by the Governor under Section 8625.

A new provision allows the relevant department (CDHHS for health care service plans, the insurance commissioner for large group policies) to issue guidance to plans and insurers until the emergency is terminated, without being subject to the Administrative Procedure Act.

A savings clause was added stating the section does not limit the Governor's authority under the California Emergency Services Act or the director's/commissioner's regulatory authority.

The PERS/CalSTRS applicability provision was restructured into two separate sub-paragraphs, explicitly listing CalSTRS members as an independent covered group in addition to those covered through the PERS contract.

The $500 HEPA purifier cost cap is now clarified to be adjusted for inflation only when the lowest-cost qualifying purifier exceeds that amount, meaning the cap can only increase, not decrease.

The one-year benefit duration provision now specifies it applies to emergency declarations made on or after January 1, 2025, establishing a retroactive applicability floor.

The Insurance Code section now applies only to 'large group health insurance policy' rather than any 'group health insurance policy,' narrowing which insurers must comply.

The exemption for self-insured employer plans governed by ERISA was removed from both the Health and Safety Code and Insurance Code sections.

Coverage for HEPA filters was removed. Plans are now only required to cover one portable HEPA purifier, not purifiers and filters as in the Assembly version.

The prohibition on deductibles, coinsurance, and copayments for the HEPA purifier was removed, along with the related high-deductible health plan exception. Plans can now impose cost-sharing on this benefit.

A new notice requirement was added: health care service plans and insurers must notify affected enrollees/insureds of this provision upon implementation or within 30 days of a wildfire emergency declaration.

A new requirement that the HEPA purifier must be prescribed by the enrollee's or insured's health care provider was added, creating a gatekeeping step before coverage applies.

The definition of portable HEPA purifier was simplified. The MERV 13+ alternative criterion was removed, leaving only the requirement that the filter remove at least 99 percent of airborne particles 10 microns in size. The separate definition for 'HEPA filter' was also eliminated.