BILL ANALYSIS                                                                                                                                                                                                    Ó






                             SENATE INSURANCE COMMITTEE
                           Senator Ronald Calderon, Chair


          AB 228 (Fuentes)         Hearing Date: June 28, 2011

          As Amended: June 27, 2011
          Fiscal:             Yes
          Urgency:       No
          

           SUMMARY    Would confer limited authority, subject to a 
          12/21/2016 sunset and advertising restrictions, for SCIF to 
          provide specified California employers workers' compensation 
          coverage for their non-California employees as an accommodation 
          alongside their California-based employees via a contractual 
          arrangement, administered under a Request for Proposal process, 
          between SCIF and a qualified admitted insurer in another state; 
          in 3 years the DOI will report on its evaluation of the new 
          authority. 
          
           DIGEST
            
          Existing law
            
           1.  Provides that liability for an injured worker covered under the 
              workers' compensation system is determined "irrespective of the 
              fault of any party" and specifies that coverage is based on 
              defined employment relationships so every employer in California 
              must either carry workers' compensation insurance or obtain a 
              certificate of self-insurance;

           2.  Authorizes insurance to be obtained privately, through private 
              insurance carriers licensed and admitted to provide workers' 
              compensation insurance in California or through the state's own 
              insurance fund, the State Compensation Insurance Fund (SCIF), a 
              quasi-governmental entity; 

           3.  Establishes the State Compensation Insurance Fund as a 
              non-profit, public enterprise fund that operates like a mutual 
              insurance carrier. Its primary product is workers' compensation 
              insurance but the company also offers claims management, 
              coordinated care plans, and loss control services to 
              policyholders. Employers can purchase coverage directly from the 
              insurer or through independent brokers. Unused premium, in 
              excess of operating expenses, claims costs and expenses, and 






                                               AB 228 (Fuentes), Page 2


              necessary surplus are returned in the form of dividends to 
              policyholders. 

           4.  Provides that as an insurance provider, SCIF is administered by 
              an independent board of directors for the primary purpose of 
              providing workers compensation insurance to California 
              businesses.

           5.  Confers on SCIF the power to transact workers' compensation 
              insurance required or authorized by law of this state to the 
              same extent as any other insurer and provides that the fund 
              shall be subject to the powers and authority of the Insurance 
              Commissioner to the same extent as any other insurer transacting 
              workers' compensation insurance, except where specifically 
              exempted by reference. 

           6.  Authorizes SCIF to insure a California employer against the 
              employer's liability for workers' compensation benefits, under 
              the law of any other state, for California employees temporarily 
              working outside of California on a specific assignment if the 
              fund insures the employer's other employees who work within 
              California.


           
          This bill

           1.Provides a restricted grant of authority authorizing SCIF to 
            provide specified California employers the ability to acquire 
            workers' compensation coverage for their non-California 
            employees as an accommodation alongside their California-based 
            employees by contract with an insurer in the other state. More 
            specifically the bill provides: as follows: 

                a.     The fund is only authorized under this subdivision 
                 to insure an employer's out of state employees for 
                 workers compensation under the laws of another state if:
                     i.          The employer's principal place of 
                      business is in California;
                     ii.         The majority of the employer's operations 
                      and employees are located within California; and 
                     iii.        The fund insures the employer's employees 
                      who work within California.

                  The June 24th Amendment provides that SCIF shall not 
                 initiate paid advertising  or solicit sponsorship of 






                                               AB 228 (Fuentes), Page 3


                 advertising campaigns to market or promote to prospective 
                 insureds SCIF's ability to insure qualified employers 
                 under the law of another state. 
                  
                       
               b.     The fund is only authorized to transact insurance 
                 pursuant to this subdivision by contract with an insurer 
                 that is admitted to transact workers' compensation 
                 insurance in California and also in the out-of-state 
                 jurisdiction where the non-California employees are 
                 located.

                  The June 24th Amendment requires that SCIF use a "Request 
                 for Proposal" process to identify the qualified insurer 
                 with whom it enters into a contract pursuant to this Act.
                  
               c.     The fund may only contract with an admitted insurer 
                 for purposes of this subdivision if the insurer meets all 
                 of the following criteria:

                     i.          The insurer has an A minus (A-) rating or 
                      better from A.M. Best Company.
                     ii.         The insurer has substantial prior 
                      experience in transacting workers' compensation 
                      business on another insurer's behalf in a fronting 
                      arrangement.
                     iii.        The insurer has a minimum surplus of one 
                      hundred million dollars ($100,000,000).

               d.     To provide for an independent review and assessment 
                 of the impact of the limited grant of authority provided 
                 for by this bill, the measure requires that on or before 
                 March 1, 2015, the Department of Insurance shall provide 
                 to the Assembly Committee on Insurance and the Senate 
                 Committee on Insurance a report assessing the experience 
                 of the fund in exercising the authority provided by this 
                 Act. 

                 The report is required to make recommendations concerning 
                 its continuation, limitation, or expansion with special 
                 attention to the extent of advantages this practice 
                 offers California employers, the California workers' 
                 compensation marketplace, and the impact of this class of 
                 insurance, whether pro or con, on the fund, its 
                 management, and the California marketplace.
                  






                                               AB 228 (Fuentes), Page 4


               e.     The bill requires that costs incurred by the 
                 Department of Insurance in the assessment, writing, and 
                 publication of this report shall be borne by the fund and 
                 provides that the report requirement shall be inoperative 
                 on March 1, 2019, pursuant to Section 10231.5 of the 
                 Government Code.

                  The June 24th Amendment provides that 22 months after the 
                 completion of the above study, on December 31st, 2016, 
                 this Act shall cease to be operative unless a later 
                 enacted statute removes or extends that date.
                  
                                                      
            
           COMMENTS

          1.  Purpose of the bill  According to the Author, "The State 
              Compensation Insurance Fund considers that as currently 
              written, "Insurance Codes §11780.5 and §11784 (d) are 
              ambiguous. Existing law says the fund can cover employees 
              who are temporarily working out of state. However, nowhere 
              is the fund prohibited from covering employees who are 
              permanently working out of state. Existing law is unclear on 
              this point. Existing law is also unclear as to what type of 
              reinsurance the fund president is authorized to purchase. We 
              want to ensure that the authority of State Compensation 
              Insurance Fund to provide out of state coverage is clearly 
              articulated." 

           2.  Background and Discussion:  

               a.     California's State Compensation Insurance Fund is a 
                 non-profit, public enterprise fund that operates like a 
                 mutual insurance carrier on the basis of an express 
                 Constitutional authorization and statutory guidance.  Its 
                 primary product is workers' compensation insurance but 
                 the company also offers claims management, coordinated 
                 care plans, and loss control services to policyholders. 
                 Employers can purchase coverage directly from the insurer 
                 or through independent brokers. Unused premium, in excess 
                 of operating expenses, claims costs and expenses, and 
                 necessary surplus are returned in the form of dividends 
                 to policyholders.

               b.     Under its statutory authority, SCIF may transact 
                 workers' compensation insurance required or authorized by 






                                               AB 228 (Fuentes), Page 5


                 law of this state to the same extent as any other 
                 insurer.  

               c.     SCIF's current statutory authority gives it 
                 permissive authority (may) to insure a California 
                 employer's employees who are engaged in traveling 
                 temporarily outside of the state.  This constitutes a 
                 limited grant of authority to insure certain employees of 
                 California employers who are temporarily out of the 
                 state. This statute, adopted in 1978, can be seen as a 
                 grant of authority which is limited, but serves 
                 nonetheless to confer a valuable accommodation to 
                 California businesses.

               d.     AB 228 proposes an updated "statute of 
                 accommodation" to permit SCIF to accommodate the desires 
                 of its California business clients in circumstances where 
                 those California-based companies have regular employees 
                 located in states other than California. 

               e.     Since California Insurance Code Section 11778 states 
                 SCIF "may transact workers' compensation insurance 
                 ?"authorized by law of this state to the same extent as 
                 any other insurer", any limitations must appear in the 
                 authorizing statute or it can, under CIC Section  11778, 
                 conduct the its business on the same terms as any other 
                 insurer.

               f.     It is expected that SCIF will function as the 
                 intermediary for the California employer with rates on 
                 the out of state employees subject to the other state's 
                 oversight and all claims administration to be conducted 
                 by the fronting carrier SCIF contracts with in accordance 
                 with the laws of the other jurisdiction.

               g.     The proponents all support the bill as a beneficial 
                 move in support of California employers and California's 
                 business climate.  Opponents raise questions of whether 
                 the limited authorization in AB 228 as amended on June 
                 16th may run counter to the underlying purposes of SCIF 
                 and enable "unfair competition" to ensue, to the 
                 detriment of private workers' compensation carriers.

               h.     Under the June 16th amendments, the DOI study which 
                 is required to appraise this law's impact on SCIF and the 
                 California marketplace will be able to focus its 






                                               AB 228 (Fuentes), Page 6


                 assessment on real world effects and the desirability or 
                 undesirability of this policy. By 2015, that study will 
                 be less speculative that some of the arguments pro and 
                 con on AB 228. DOI subject matter experts will have been 
                 able to confer informally with their national 
                 counterparts under the aegis of the NAIC's periodic 
                 national meetings and they will be able to review the 
                 facts arising from three years of real world marketplace 
                 experience, including experience with changes in the 
                 marketplace itself and the impact, whether good, bad or 
                 indifferent, of AB 228's change on the capacity of SCIF 
                 management to remain focused on the California 
                 marketplace which is its primary responsibility. 

               i.     As amended AB 228  on June 16th AB 228 set out a  
                 carefully limited authorization for SCIF to undertake 
                 entry into writing workers' compensation risks for the 
                 employees of California based businesses located outside 
                 California using a fronting arrangement  of a carrier 
                 admitted both in California and the state of interest 
                 which has substantial workers' compensation fronting 
                 experience. 

               j.     The June 27th amendments further limit the scope of 
                 the authorization by requiring the use of an RFP process 
                 to govern the contracting out process, prohibiting 
                 advertising programs using this new authority as a 
                 marketing device to prospective insureds and by adding a 
                 December 2016 sunset.
          
               aa.       The bill as amended constitutes a limited entry 
                 into this market with a DOI administered formal "look 
                 back" study to be concluded by March 2015. A December 
                 31st 2016 sunset was added on June 27th to require 
                 re-enactment of AB 228's authorization, if it is to be 
                 retained, once the study compiled by the DOI's subject 
                 matter experts has been received and reviewed by the 
                 Legislature.  
          


           3.  Summary of Arguments in Support:   

             a.   According to the Author, "Right now, a California 
               employer that is insured with State Compensation Insurance 
               Fund must obtain a separate policy to cover their employees 






                                               AB 228 (Fuentes), Page 7


               who work outside of California. Amending the insurance code 
               to authorize State Compensation Insurance Fund to offer out 
               of state coverage will reduce red tape, improve efficiency, 
               and remove obstacles to doing business in California."

             b.   As stated by the State Compensation Insurance Fund, 
               (SCIF), this bill's Sponsor:

                    "Instead of having to go through the application 
                    process with two or more insurance companies, brokers 
                    and their clients could get coverage for all of a 
                    company's employees from State Fund in a one-stop shop 
                    - saving California businesses time and money. This 
                    legislation will significantly streamline the 
                    insurance process for employers and brokers who are 
                    interested in getting a quote from State Fund and 
                    provide greater choice and stability to the businesses 
                    of our state. 

                    This is currently being done in many other states. Of 
                    the 26 State Funds around the country, 16 currently 
                    serve their state's employers by providing coverage 
                    for out of state employees. "

             c.   The Insurance Brokers and Agents of the West  (IBA West) 
               states "AB 228 will enhance competition in the California 
               workers' compensation marketplace and provide an option for 
               California insurance agents and brokers to serve their 
               California clients"

             d.   The California Farm Bureau Federation states "With 
               California's current fiscal crisis and job loss the state 
               cannot afford to discourage business and job growth. Every 
               effort should be made to remove obstacles and additional 
               operating costs that cut into the ability to create jobs 
               and generate income.? AB 228 will accomplish that."


           1.  Summary of Arguments in Opposition:    

               a.     The Association of California Insurance Companies 
                 (ACIC) states in opposition:  

                     "Allowing SCIF to expand its jurisdiction is a sharp 
                    departure from its original mission, unfair to private 
                    carriers because of the Fund's tax exempt status, and 






                                               AB 228 (Fuentes), Page 8


                    would subject the Fund, and ultimately its California 
                    policy holders, to assessments and regulations of 
                    other states.

                    SCIF was created as a public enterprise to assure that 
                    California had an "insurer of last resort" for 
                    California employers. In exchange, it was given a 
                    federal tax exempt status, an advantage not enjoyed by 
                    any other private workers' compensation carrier. 
                    Allowing SCIF to use its beneficial tax status that is 
                    derived from its mandate in California is unfair to 
                    private carriers and to other state funds." 
                     

          2.  Amendments:  

               a.     None proposed. 

           3.  Prior and Related Legislation:   

               a.     None

           LIST OF REGISTERED SUPPORT/OPPOSITION
          
          Support
           
          State Compensation Insurance Fund (SCIF) (Sponsor)
          Allen Lawrence & Associates, Inc.
          Arroyo Insurance Services
          BB & T Tanner Insurance Services
          Bowermaster and Associates
          B & B Premier Insurance Solutions
          California Farm Bureau Federation
          Cal Insurance & Associates, Inc.
          Haggerty Insurance Services, Inc.
          Hoffman Brown Company
          Insurance Brokers and Agents of the West (IBA West)
          Interwest Insurance Services
          Invensure Insurance Brokers
          Leavitt Barlocker Insurance
          McGee & Thielen Insurance Brokers, Inc.
          Northridge Insurance Agency, LLC
          Thoits Insurance
          USI Insurance Services of Northern California, Inc.
           
          Opposition






                                               AB 228 (Fuentes), Page 9


               
          Association of California Insurance Companies (ACIC)

          Consultant: Ken Cooley (916) 651-4110