Aaaaanod Schwarzenegger

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just signed into law in California a bill to help parents of adults with disibilites maintain medical coverage for their children.
Adult children with disabilities are already required to be covered, but before the insurance companies could drop them at a certain age without notifying them. Insurance companies must now give adequate notice before children are dropped from the policy, allowing parents to tell the companies if their children require to be covered longer.

It also requires that children with disabilities continue receiving coverage when a parent switches jobs or switches insurance policies.

yeah, Arnold!

what a relief for parents in California !

This is good news for people who have severely handicapped children. I'll have to read up on this new law in some depth.

Because, up to now: The catch has been that you have to have your kid formally diagnosed and considered by the insurance company to be disabled before a given cutoff age to be kept on your policy. In our case, we've been fighting with insurance for three years now - they don't consider my kid disabled because she is not TOTALLY disabled. She is an Aspie, has some serious other health issues, and has had seizures. That's not enough. Since she can work part time, they don't consider her disabled enough to be covered by that law. Since she'll have hell getting insurance, we really need to keep her on my policy. Most likely she will never work full-time. She has to be considered disabled by the time she turns 21 to be kept on my policy. We have two months. Hopefully the new law will change this.

Thanks for the heads-up!

Last edited by Nan on 14 Nov 2007, 12:33 pm, edited 1 time in total.

Again, thanks for the heads up. It won't help us, as we would have to prove that the kid would never be able to function well enough to hold ANY job that would be considered self-supporting. Since the definition of "self supporting" is extremely strict (i.e., she really would have to not be able to hold any job at all, including floor sweeper or cardboard box assembler at minimum wage, even though she couldn't live on that and wouldn't get insurance at that kind of job), the fact that she can hold a part-time secretarial job, as she does now, seems to disqualify her from any protections of this bill. There's nothing in it that protects the significantly disabled, but not totally disabled.

But for people who have kids who are severely disabled and who have them on their plans, this is helpful legislation, I think. Even if all it does is require that the insurance company fire warning notices before they pull coverage and gives the parents a longer period of time in which to provide proof of total disability. Anything is good, when it helps the family, in these situations. Nice of the Governator to actually sign it.

Here it is:

Assembly Bill No. 910
CHAPTER 617
An act to amend Sections 3751 and 3752.5 of the Family Code, to amend
Section 1373 of the Health and Safety Code, and to amend Sections 10277
and 10278 of the Insurance Code, relating to disabled persons.
[Approved by Governor October 13, 2007. Filed with
Secretary of State October 13, 2007.]
legislative counsel’s digest

AB 910, Karnette. Disabled persons: support and health care coverage.

(1) 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 by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Under existing law, a plan and a health insurer are required to provide that coverage for a dependent child who attains a limiting age specified in the plan or policy shall not terminate if the child is and continues to be both incapable of
self-sustaining employment by reason of mental retardation or a physical handicap and chiefly dependent upon the subscriber or insured for support, provided that proof of those facts is furnished within 31 days of the request for the information or the child’s attainment of the limiting age, as specified.

(Ah, it looks as if we have THREE months in our case, under the old law. Old law= shall not terminate when the kid hits 21 if she was already considered completely disabled.)

This bill would change the first criterion, requiring a health care service plan and a health insurer to provide that coverage of a dependent child shall not terminate upon attaining the limiting age if, in addition to meeting the 2nd criterion, as specified, the child is and continues to be incapable of self-sustaining employment by reason of a physically or mentally disabling injury, illness, or condition. The bill would require the plan and insurer to notify the subscriber or insured at least 90 days before the dependent child attains the limiting age and would require the subscriber or insured to submit proof, within 60 days of receiving that notice, that the child meets the criteria.
(Ok, so it looks like under the new law that if she had been qualified as "disabled" to the point that she could never support herself by the company before she hit 21, they would now have had to give us 3 months warning that they were going to terminate coverage, and we'd have two months to come up with medical documentation sufficient to argue the point.)


The bill would require the plan or insurer upon request from the subscriber, group member, or policyholder and proof the child meets the criteria for continued coverage, to determine whether the child meets that criteria before the date the child attains the limiting age. (Ok, if we requested a determination, under the new law they MUST give us a final answer prior to her turning 21. Of course, their answer may not be what we hoped, but they have to give us one and not keep putting us off. This is good.)

The bill would also require, after a change in carriers, that the new plan or insurer continue coverage of the dependent child and would authorize that new plan or insurer to request
information about the dependent child initially and not more frequently than annually thereafter in order to determine if the child continues to meet the criteria. The bill would require the subscriber, group member, or policyholder to submit the information requested by the new plan or insurer within 60 days of receiving the request. (Ok, this seems to mean that IF we got her covered, they can come back every so often (possibly yearly? Quarterly?) and ask for proof of continued disability.That doesn't sound unreasonable, except that it makes me wonder if people will find the companies slipping over the line into harassing behavior.... farther down in this it says they can't contact the family more than once a year, after the first two years. That's good.)

Because the bill would specify additional requirements under the Knox-Keene Act, the willful violation of which would be a crime, it would impose a state-mandated local program.

(2) Existing law requires health insurance coverage, as defined, for a supported child to be included in a court’s order for support if that insurance is available at no cost or at a reasonable cost to the parents. Existing law also requires a child support order to include a provision requiring the child
support obligor and obligee to inform each other of the availability of health insurance coverage, as specified, and requires the Judicial Council to modify the form of the order to include those provisions. The bill would require a support order to direct the parent or parents who, at the time of the order or subsequently, provide health insurance coverage for a supported child to seek continuation of coverage for the child upon his or her attaining the limiting age under the coverage if the child is incapable of self-sustaining employment and otherwise meets the criteria described in paragraph (1). The bill would require a child support order to include a provision for the obligor and obligee to provide information about the availability of health insurance coverage for a child or an adult who meets that criteria and would not require the Judicial Council to modify the order’s form for this purpose until January 1, 2010. (Nice touch - assuming that whoever is ordered to get insurance for the kid in the first place actually does it. But a nice touch, just the same.)

(3) 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.


The remainder (very long) can be found here. http://www.leginfo.ca.gov/pub/07-08/bil ... ptered.pdf