BILL NUMBER: AB 745	ENROLLED
	BILL TEXT

	PASSED THE SENATE  SEPTEMBER 2, 2009
	PASSED THE ASSEMBLY  MAY 14, 2009
	AMENDED IN ASSEMBLY  MAY 7, 2009

INTRODUCED BY   Assembly Member Coto

                        FEBRUARY 26, 2009

   An act to add Section 1759.11 to the Insurance Code, relating to
health care coverage.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 745, Coto. Self-funded dental benefit plans: administrators.
   Existing law provides for the regulation of insurers by the
Department of Insurance. Existing law requires administrators who
perform certain acts in connection with life or health insurance
coverage or annuities to be registered with the Insurance
Commissioner and to comply with certain other requirements.
   This bill would require an administrator providing administrative
services for a self-funded dental benefit plan to include certain
language in explanation of benefits documents and in forms sent to
claimants in response to claims for benefits.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  The Legislature finds and declares that third-party
administrators of insurance are regulated by the Insurance
Commissioner. Therefore, the requirements of this act constitute a
regulation of insurance within the meaning of subparagraph (A) of
paragraph (2) of subdivision (b) of Section 1144 of Title 29 of the
United States Code.
  SEC. 2.  Section 1759.11 is added to the Insurance Code, to read:
   1759.11.  (a) This section shall only apply to an administrator
that provides administrative services for a self-funded dental
benefit plan otherwise subject to the jurisdiction of the federal
government.
   (b) The administrator shall include the following language in
explanation of benefits documents and in forms sent to claimants in
response to claims for benefits:


"This dental benefit plan is self-funded and subject to compliance
with the federal Employee Retirement Income Security Act. As such, it
is not subject to state law governing health care coverage for
dental care. Any questions, appeals, or disputes arising from the
payment of a submitted claim should be directed to the entity
providing the coverage, or to the United States Department of Labor,
Office of Participant Assistance. You can contact the Office of
Participant Assistance at ____."
   (c) The administrator shall fill in the blank in the notice
required by subdivision (b) with the appropriate telephone number for
the Office of Participant Assistance.