California AB 2165: Triggering event: loss of minimum essential coverage.

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 |Add To My Favorites |Track Bill | Version: 03/16/26 - Amended Assembly
 02/18/26 - Introduced

 AB-2165 Triggering event: loss of minimum essential coverage.(2025-2026)

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 Date Published: 03/16/2026 09:00 PM

AB2165:v98#DOCUMENTBill Start

 Amended
 IN 
 Assembly
 March 16, 2026

 CALIFORNIA LEGISLATURE—
 2025–2026 REGULAR SESSION

 Assembly Bill

No. 2165

Introduced by Assembly Member Macedo

February 18, 2026

 An act to amend Section 1368.017 of 1399.849 of, and to add Section 1368.018 to, the Health and Safety Code, and to amend Section 10965.3 of, and to add Section 10123.1992 to, the Insurance Code, relating to health care coverage. 

LEGISLATIVE COUNSEL'S DIGEST

AB 2165, as amended, Macedo.
 Behavioral health and wellness screenings. Triggering event: loss of minimum essential coverage.

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, 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. Existing law requires a health care service plan or health insurer to allow an individual to enroll in or change their health benefit plan as a result of a specified triggering event, including when the individual or the individual’s dependent loses minimum essential coverage, as provided.

This bill, for purposes of the above, would specify that loss of minimum essential coverage includes loss of coverage due to circumstances in which a joint
 agreement between health care service plans or health insurers, or between a health care service plan and a health insurer, to provide coverage to an enrollee or insured located in a medically underserved area expires, dissolves, or is otherwise terminated. The bill would require a health care service plan or health insurer to provide a written or electronic notice to enrollees or insureds at least 60 days before the effective date of the expiration, dissolution, or other termination of that joint agreement and would require the notice to additionally indicate that the expiration, dissolution, or other termination of the joint agreement may constitute a loss of minimum essential coverage. Because a willful violation of these provisions by a health care service plan would be a crime, the bill 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.

Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care. Existing law requires a health care service plan to annually provide to enrollees a written or electronic notice regarding the benefits of a behavioral health and wellness screening for children and adolescents 8 to 18 years of age.

This bill would make a technical, nonsubstantive change to that provision.

Digest Key

 Vote:
 MAJORITY 
 Appropriation:
 NO 
 Fiscal Committee:
 NOYES 
 Local Program:
 NOYES 

Bill Text

The people of the State of California do enact as follows:

SECTION 1.

 Section 1368.018 is added to the Health and Safety Code, to read:

1368.018.

 (a) A health care service plan shall provide to enrollees a written or electronic notice in the instance of expiration, dissolution, or other termination of a joint agreement between health care service plans or between a health care service plan and a health insurer to provide coverage to an enrollee. The notice shall be sent to the enrollee at least 60 days before the effective date of the expiration, dissolution, or other termination of the joint agreement.

(b) The notice described in subdivision (a) shall also indicate that the expiration, dissolution, or other termination of the joint agreement may constitute a loss of minimum essential coverage, as provided in subdivision (d) of Section
 1399.849.

SEC. 2.

 Section 1399.849 of the Health and Safety Code is amended to read:

1399.849.

 (a) (1) On and after October 1, 2013, a