Plain English Breakdown
The official text states that willful violation is a crime but does not specify the exact penalties or prison terms.
Changes to Rules for Mexican Prepaid Health Plans in California
This law allows certain health plans from Mexico to cover workers of any nationality in San Diego and Imperial counties, requires employers to offer alternative coverage, and raises the amount of money these plans must hold.
What This Bill Does
- Allows prepaid health plans operating under Mexican laws to sell group contracts to individuals legally employed in San Diego or Imperial counties, regardless of their nationality, instead of only for Mexican nationals.
- Requires employers buying these specific plans from Mexico-based companies to also provide alternative full-service health coverage through a different plan or insurance policy.
- Increases the required amount of money (tangible net equity) that these prepaid plans must hold from $1 million to $2.3 million.
- Keeps the option for plans to show an acceptable alternative payment arrangement instead of holding the higher cash amount, if approved by the Director.
- Makes it a crime for a plan to willfully break these new rules.
Who It Names or Affects
- Prepaid health plans operating under Mexican laws that sell services in California.
- Employers in San Diego or Imperial counties who offer group health coverage from Mexico-based plans.
- Workers and their dependents legally employed in San Diego or Imperial counties, regardless of nationality.
Terms To Know
- Prepaid health plan
- A company that collects money upfront to pay for medical care services later.
- Tangible net equity
- The actual amount of real assets or cash a business owns after paying its debts.
- Employer-sponsored group plan
- Health coverage that an employer buys for their workers and the workers' families.
Limits and Unknowns
- The law only applies to health care services provided wholly in Mexico, except as specified by other rules.
- The Director of the Department of Managed Health Care decides if a plan's alternative payment arrangement is acceptable.
- No state reimbursement is required for local agencies regarding this act.