Mexican prepaid health plans.

Assembly Member Alvarez proposes expanding access to Mexican prepaid health plans in California's border counties while increasing financial oversight requirements. The legislation modifies existing regulations to allow these plans to serve all legally employed individuals in San Diego and Imperial counties, regardless of nationality, provided employers offer alternative health coverage through full-service plans or insurance policies.

The measure raises minimum tangible net equity requirements for Mexican prepaid health plans from $1 million to $2.3 million, though plans may propose alternative reimbursement arrangements subject to regulatory approval. Plans must maintain compliance with Mexican law, deposit subscriber funds in U.S. banks, and make records available within 24 hours of regulatory requests. The legislation establishes a 45-day window for plans to demonstrate compliance if Mexican operating authority lapses, followed by a 180-day period to either restore compliance or obtain standard California licensure before operations must cease.

For services delivered in Mexico, plans may employ Mexico-licensed medical directors but must maintain a California-licensed director for any U.S. care. The legislation requires all marketing materials to carry notices in English and Spanish regarding benefit limitations under state and federal law. Plans must submit to California and U.S. jurisdiction for contract disputes involving U.S.-based providers and group policyholders.