BILL ANALYSIS                                                                                                                                                                                                    Ó



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          ASSEMBLY THIRD READING
          AB 1962 (Skinner)
          As Amended May 23, 2014
          Majority vote 

           HEALTH              15-3        APPROPRIATIONS      13-2        
           
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          |Ayes:|Pan, Maienschein,         |Ayes:|Gatto, Bigelow,           |
          |     |Ammiano, Holden, Bonilla, |     |Bocanegra, Bradford, Ian  |
          |     |Bonta, Chesbro, Gomez,    |     |Calderon, Campos, Eggman, |
          |     |Gonzalez, Roger           |     |Gomez, Holden, Pan,       |
          |     |Hernández, Nazarian,      |     |Quirk,                    |
          |     |Nestande, Ridley-Thomas,  |     |Ridley-Thomas, Weber      |
          |     |Wieckowski, Eggman        |     |                          |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Mansoor, Patterson,       |Nays:|Linder, Wagner            |
          |     |Wagner                    |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           SUMMARY  :  Requires dental plans to file annual reports on  
          medical loss ratios (MLRs). Specifically,  this bill  :  

          1)Requires health plans and insurers that issue, sell, renew, or  
            offer specialized dental plans or policies to file an annual  
            report with state regulators - the California Department of  
            Insurance (CDI) or the Department of Managed Health Care  
            (DMHC), as appropriate - that is organized by group and  
            product type and contains the same information required to be  
            reported by health plans and insurers under the federal  
            Patient Protection and Affordable Care Act (ACA).

          2)Requires state regulators, if they decide to conduct a  
            financial examination, as provided under current law, to  
            verify the dental plan's representations in the MLR annual  
            report, to notify the dental plan 30 days in advance.   
            Requires dental plans to submit all requested records, books,  
            and papers to state regulators within 30 days of notification.  


          3)Requires state regulators to make available to the public all  
            of the data provided to them under this bill.









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          4)Requires state regulators to submit an annual report to the  
            Legislature that includes an analysis of the filings.

          5)Exempts from the reporting requirements in this bill the  
            Medi-Cal program, the Healthy Families Program, the Access for  
            Infants and Mothers Program, the California Major Risk Medical  
            Insurance Program, and the Federal Temporary High Risk  
            Insurance Pool, to the extent consistent with federal law.

          6)State intent that the data reported under this bill be  
            considered by the Legislature in adopting an MLR standard for  
            dental plans by January 1, 2018.

           EXISTING LAW  requires health plans and insurers to provide an  
          annual rebate to each enrollee, on a pro rata basis, if the  
          amount of the premium revenue expended for clinical services and  
          quality improvement activities, or MLR, is less than 85% for  
          health plans and insurers offering large group health coverage  
          or less than 80% for health plans and insurers offering  
          individual and small group health coverage.
           FISCAL EFFECT  :  According to the Assembly Appropriations  
          Committee:

          1)One-time costs, likely under $200,000 to DMHC (Managed Care  
            Fund) and under $100,000 to CDI to modify information  
            technology systems and develop reporting requirements.

          2)Ongoing minor costs, under $50,000 annually to DMHC and CDI  
            (Managed Care Fund/ Insurance Fund) to examine reports, review  
            compliance, and report to the Legislature.

           COMMENTS  :  The ACA includes numerous provisions that change the  
          way commercial health insurance is offered and regulated in an  
          effort to provide better value to consumers and increase  
          transparency, including MLR standards.  MLR limits the portion  
          of premium that health insurers may spend on administration,  
          marketing and profits.  Under the ACA, health insurers must  
          publicly report the MLR in each state where they offer coverage  
          and if they fail to meet the minimum MLR standards must pay  
          rebates to consumers.  Dental plans and other plans providing  
          "excepted benefits" are exempted from these requirements.  The  
          MLR is a basic financial indicator, traditionally referring to  
          the percentage of insurance premium revenues health insurers  
          spent on enrollee medical claims.  The MLR definition in the ACA  








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          differs from the traditional MLR definition, most notably  
          because it allows insurers to include in their expenses spending  
          on activities to improve health care quality and to deduct from  
          their revenues certain tax payments and fees.  

          According to DMHC, dental health plans under their jurisdiction  
          reported average dental loss ratios (DLRs) of just over 60% in  
          2012.  However, the range varies substantially by health plan  
          from a low of 31% to a high of 81% and is not broken down by  
          market, individual, small or large group.  DMHC points out that  
          the reported DLRs are not based on standardized measurement or  
          calculation as is required for MLR and that a relatively low DLR  
          does not necessarily mean that the dental plan is in strong  
          financial condition or that the plan is earning huge profits.   
          This bill requires dental plans to report information required  
          in the standardized form required for plans under the ACA.

           
          Analysis Prepared by  :    Ben Russell / HEALTH / (916) 319-2097 


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