BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2345
                                                                  Page  1


          ASSEMBLY THIRD READING
          AB 2345 (De La Torre)
          As Amended April 22, 2010
          Majority vote 

           HEALTH              13-0                                        
           
           -------------------------------- 
          |Ayes:|Monning, Ammiano, Carter, |
          |     |                          |
          |     |De La Torre, De Leon,     |
          |     |Eng, Hayashi, Hernandez,  |
          |     |Jones, Bonnie Lowenthal,  |
          |     |Nava, V. Manuel Perez,    |
          |     |Salas                     |
          |     |                          |
           -------------------------------- 
           SUMMARY  :  Requires health insurers to annually post specified  
          information used for rating and underwriting decisions related  
          to individual health insurance policies on their Web sites.
            
           EXISTING LAW  :

          1)Provides for the regulation of health insurers by the  
            California Department of Insurance (CDI) and requires insurers  
            to have written policies, procedures, and underwriting  
            guidelines establishing the criteria and process whereby the  
            insurer makes its decision to provide or to deny coverage to  
            individuals who apply for coverage and sets the rate for that  
            coverage. 

          2)Requires an insurer to annually file with the commissioner a  
            general description of the criteria, policies, procedures, or  
            guidelines that the insurer uses for rating and underwriting  
            decisions related to individual health insurance policies, as  
            specified.  

           FISCAL EFFECT  :  None

          COMMENTS  :  According to the author, while existing law requires  
          CDI to post insurers' written policies, procedures, and  
          underwriting guidelines for the decision making process on  
          denials, they are difficult for the layperson to find.   
          Furthermore, when a person shops for insurance they typically  








                                                                  AB 2345
                                                                  Page  2


          look at an individual health insurer's Web sites, not CDI's  
          site.  Therefore, the author argues that this information should  
          be posted on the same Web site as the rest of the information  
          the consumer uses to make decisions about what health insurance  
          to purchase.

          SB 1163 (Leno) contains a provision substantially similar to  
          that contained in this bill and makes a number of other changes  
          to existing law related to health insurance rates and  
          underwriting, including:

          1)Extending requirements placed on health plans and insurers  
            when they deny individual coverage to when plans and insurers  
            deny group purchasers.

          2)Requiring health plans and insurers to provide data and  
            demographic information on individual and large group denials  
            of coverage, any changes in rates, any changes in cost  
            sharing, and any changes in covered benefits.

          3)Requiring health plans and insurers to provide to its  
            regulator specified information, such as provider prices and  
            utilization increases, with respect to rate increases for each  
            product. 

          SB 1163 passed by a vote of 5-0 when it was heard in the Senate  
          Health Committee on April 21, 2010.

          AB 356 (Chan), Chapter 526, Statutes of 2006, requires health  
          plans and insurers selling products in the individual market to  
          disclose specified information to individuals applying for  
          coverage, and to those who have such coverage, and to report a  
          general description of their rating and underwriting criteria  
          and policies to the Department of Managed Health Care and CDI,  
          as specified.

           
          Analysis Prepared by  :    Melanie Moreno / HEALTH / (916)  
          319-2097 

                                                                FN: 0004213