BILL NUMBER: AB 1234 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY JANUARY 6, 2014
INTRODUCED BY Assembly Member Levine
FEBRUARY 22, 2013
An act to amend Section 10234.93 1215.8
of the Insurance Code, relating to insurance.
LEGISLATIVE COUNSEL'S DIGEST
AB 1234, as amended, Levine. Insurance: long term care
insurance. registration statements .
Existing law governs the business of insurance and authorizes the
Insurance Commissioner to provide oversight over the insurance
industry, including conducting investigations and bringing
enforcement actions.
Existing law requires each insurer that is authorized to do
business in this state and that is a member of an insurance holding
company system to register with the commissioner and to file a
registration statement containing specified information, including
the capital structure and general financial condition of the insurer
and specified transactions between the insurer and its affiliates.
Existing law makes the information reported to the commissioner in
the registration statement and information disclosed in the course
of an examination or investigation of the registration statement
exempt from subpoena or public disclosure, except as specified.
This bill would provide that information reported to the
commissioner in the registration statement and information disclosed
in the course of an examination or investigation of the registration
statement is not subject to discovery or admissible into evidence in
any private civil action.
Existing law provides for the regulation of insurers by the
Department of Insurance, including insurers issuing policies of
long-term care insurance. Existing law regulates the marketing or
solicitation of long-term care insurance policies and, in that
regard, requires specified disclosures to prospective applicants or
enrollees. Existing law requires an insurer of long-term care
insurance to clearly post on its Internet Web site and provide
written notice at the time of solicitation that a specimen individual
policy form or group master policy and certificate form for each
policy form offered by the insurer is available upon request and to
provide that form within 15 calendar days upon request.
This bill would additionally require an insurer to clearly post on
its Internet Web site, and include on its policy application,
information about an Internet Web site provided by the Department of
Health Care Services, known as www.rureadyca.org.
Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1215.8 of the
Insurance Code is amended to read:
1215.8. (a) All information, documents, and copies thereof
obtained by or disclosed to the commissioner or any other person in
the course of an examination or investigation made pursuant to
Sections 1215.4 and 1215.5, and all information reported pursuant to
Section 1215.4, shall be kept confidential, shall not be subject to
disclosure pursuant to the California Public Records Act (Chapter 3.5
(commencing with Section 6250) of Division 7 of Title 1 of the
Government Code), and shall not be subject to
subpoena , and shall not be subject to discovery or admissible
into evidence in any private civil action . This information
shall not be made public by the commissioner or any other person
except to insurance departments of other states without the prior
written consent of the insurance company to which it pertains, unless
the commissioner, after giving the insurer and its affiliates who
would be affected thereby notice and opportunity to be heard,
determines that the interests of policyholders, shareholders, or the
public will be served by the publication thereof, in which event he
or she may publish all or any part thereof in a manner as he or she
may deem appropriate.
(b) In order to assist in the performance of the commissioner's
duties, the commissioner:
(1) May, upon request, be required to share documents, materials,
or other information, including the confidential and privileged
documents, materials, or information subject to subdivision (a), with
other state, federal, and international regulatory agencies, with
the NAIC and its affiliates and subsidiaries, and with state,
federal, and international law enforcement authorities, including
members of any supervisory college described in Section 1215.7;
provided that the recipient agrees in writing to maintain the
confidentiality and privileged status of the documents, materials, or
other information, and has verified in writing the legal authority
to maintain confidentiality.
(2) Notwithstanding paragraph (1), the commissioner may only share
confidential and privileged documents, materials, or information
reported pursuant to subdivision (m) of Section 1215.4 with
commissioners of states having statutes or regulations substantially
similar to subdivision (a) and who have agreed in writing not to
disclose the information.
(3) May receive documents, materials, or information, including
otherwise confidential and privileged documents, materials, or
information, from the NAIC and its affiliates and subsidiaries and
from regulatory and law enforcement officials of other foreign or
domestic jurisdictions, and shall maintain as confidential or
privileged any documents, materials, or information received with
notice or the understanding that it is confidential or privileged
under the laws of the jurisdiction that is the source of the
documents, materials, or information.
(4) May enter into written agreements with the NAIC governing
sharing and use of information provided pursuant to this subdivision
consistent with this subdivision that shall do the following:
(A) Specify procedures and protocols regarding the confidentiality
and security of information shared with the NAIC and its affiliates
and subsidiaries pursuant to this subdivision, including procedures
and protocols for sharing by the NAIC with other state, federal, or
international regulators.
(B) Specify that ownership of information shared with the NAIC and
its affiliates and subsidiaries pursuant to this subdivision remains
with the commissioner and the NAIC's use of the information is
subject to the direction of the commissioner.
(C) Require prompt notice to be given to an insurer whose
confidential information in the possession of the NAIC pursuant to
this subdivision is subject to a request or subpoena to the NAIC for
disclosure or production.
(D) Require the NAIC and its affiliates and subsidiaries to
consent to intervention by an insurer in any judicial or
administrative action in which the NAIC and its affiliates and
subsidiaries may be required to disclose confidential information
about the insurer shared with the NAIC and its affiliates and
subsidiaries pursuant to this subdivision.
(c) The sharing of information by the commissioner pursuant to
this subdivision shall not constitute a delegation of regulatory
authority or rulemaking, and the commissioner is solely responsible
for the administration, execution, and enforcement of the provisions
of this article.
(d) No waiver of any applicable privilege or claim of
confidentiality in the documents, materials, or information shall
occur as a result of disclosure to the commissioner under this
section or as a result of sharing as authorized in subdivision (c).
(e) Documents, materials, or other information filed in the
possession or control of the NAIC pursuant to this subdivision shall
be confidential by law and privileged, shall not be subject to
subpoena, and shall not be subject to discovery or admissible in
evidence in any private civil action.
SECTION 1. Section 10234.93 of the Insurance
Code is amended to read:
10234.93. (a) Every insurer of long-term care in California
shall:
(1) Establish marketing procedures to assure that any comparison
of policies by its agents or other producers will be fair and
accurate.
(2) Establish marketing procedures to assure excessive insurance
is not sold or issued.
(3) Submit to the commissioner within six months of the effective
date of this act, a list of all agents or other insurer
representatives authorized to solicit individual consumers for the
sale of long-term care insurance. These submissions shall be updated
at least semiannually.
(4) Provide the following training and require that each agent or
other insurer representative authorized to solicit individual
consumers for the sale of long-term care insurance shall
satisfactorily complete the following training requirements that, for
resident licensees, shall count toward the licensee's continuing
education requirement, but may still result in completing more than
the minimum number of continuing education hours set forth in this
section:
(A) For licensees issued a license after January 1, 1992, eight
hours of training in each of the first four 12-month periods
beginning from the date of original license issuance and thereafter
eight hours of training prior to each license renewal.
(B) For licensees issued a license before January 1, 1992, eight
hours of training prior to each license renewal.
(C) For nonresident licensees that are not otherwise subject to
the continuing education requirements set forth in Section 1749.3,
the evidence of training required by this section shall be filed with
and approved by the commissioner as provided in subdivision (g) of
Section 1749.4.
Licensees shall complete the initial training requirements of this
section prior to being authorized to solicit individual consumers
for the sale of long-term care insurance.
The training required by this section shall consist of topics
related to long-term care services and long-term care insurance,
including, but not limited to, California regulations and
requirements, available long-term care services and facilities,
changes or improvements in services or facilities, and alternatives
to the purchase of private long-term care insurance. On or before
July 1, 1998, the following additional training topics shall be
required: differences in eligibility for benefits and tax treatment
between policies intended to be federally qualified and those not
intended to be federally qualified, the effect of inflation in
eroding the value of benefits and the importance of inflation
protection, and NAIC consumer suitability standards and guidelines.
(5) Display prominently on page one of the policy or certificate
and the outline of coverage: "Notice to buyer: This policy may not
cover all of the costs associated with long-term care incurred by the
buyer during the period of coverage. The buyer is advised to review
carefully all policy limitations."
(6) Inquire and otherwise make every reasonable effort to identify
whether a prospective applicant or enrollee for long-term care
insurance already has accident and sickness or long-term care
insurance and the types and amounts of any such insurance.
(7) Every insurer or entity marketing long-term care insurance
shall establish auditable procedures for verifying compliance with
this subdivision.
(8) Every insurer shall provide to a prospective applicant, at the
time of solicitation, written notice that the Health Insurance
Counseling and Advocacy Program (HICAP) provides health insurance
counseling to senior California residents free of charge. Every agent
shall provide the name, address, and telephone number of the local
HICAP program and the statewide HICAP number, 1-800-434-0222.
(9) Provide a copy of the long-term care insurance shoppers guide
developed by the California Department of Aging to each prospective
applicant prior to the presentation of an application or enrollment
form for insurance.
(10) Clearly post on its Internet Web site and provide written
notice at the time of solicitation that a specimen individual policy
form or group master policy and certificate form for each policy form
offered in this state is available to a prospective applicant upon
request. The individual specimen policy form or group master policy
and certificate form shall be provided to a requesting party within
15 calendar days or receipt of a request.
(11) Clearly post on its Internet Web site, and include on its
policy application, information about an Internet Web site provided
by the Department of Health Care Services, known as
www.rureadyca.org.
(b) In addition to other unfair trade practices, including those
identified in this code, the following acts and practices are
prohibited:
(1) Twisting. Knowingly making any misleading representation or
incomplete or fraudulent comparison of any insurance policies or
insurers for the purpose of inducing, or tending to induce, any
person to lapse, forfeit, surrender, terminate, retain, pledge,
assign, borrow on, or convert any insurance policy or to take out a
policy of insurance with another insurer.
(2) High pressure tactics. Employing any method of marketing
having the effect of or tending to induce the purchase of insurance
through force, fright, threat, whether explicit or implied, or undue
pressure to purchase or recommend the purchase of insurance.
(3) Cold lead advertising. Making use directly or indirectly of
any method of marketing which fails to disclose in a conspicuous
manner that a purpose of the method of marketing is solicitation of
insurance and that contact will be made by an insurance agent or
insurance company.