BILL ANALYSIS                                                                                                                                                                                                    Ó




                   Senate Appropriations Committee Fiscal Summary
                            Senator Kevin de León, Chair


          AB 1962 (Skinner) - Dental plans: medical loss ratios: reports.
          
          Amended: August 4, 2014         Policy Vote: Health 7-1
          Urgency: No                     Mandate: Yes
          Hearing Date: August 4, 2014                            
          Consultant: Brendan McCarthy    
          
          This bill meets the criteria for referral to the Suspense File.
          
          
          Bill Summary: AB 1962 would require insurers and health plans  
          that sell dental plans to file an annual report on the plan's  
          medical loss ratio.

          Fiscal Impact: 
              One-time costs of about $400,000 to develop guidance and  
              regulations and renew initial reports. Ongoing costs of  
              $170,000 per year to review and analyze reports by the  
              Department of Insurance (Insurance Fund).

              One-time costs of $500,000 in 2014-15 and $290,000 in  
              2015-16 for the development of policies, implementation of  
              information technology upgrades and review of plan filings.  
              Ongoing costs of $250,000 per year for enforcement by the  
              Department of Managed Health Care (Managed Care Fund).

          Background: Under current law, the Department of Insurance  
          regulates health insurers and the Department of Managed Health  
          Care regulates health plans (collectively, these are referred to  
          as "carriers").

          In general, a medical loss ratio is the amount of premium  
          revenue expended by a plan on clinical services divided by the  
          total amount of premium revenue, less certain fees and taxes.  
          The federal Affordable Care Act requires health plans and health  
          insurers to meet medical loss ratio requirements. For health  
          plans and health insurers in the large group market, the medical  
          loss ratio must be at least 85 percent and in the small group or  
          individual market the medical loss ratio must be at least 80  
          percent. If the medical loss ratio falls below prescribed  
          levels, carriers are required to provide rebates to enrollees.  
          Carriers are required to file annual reports on their medical  








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          loss ratios.

          Proposed Law: AB 1962 would require insurers and health plans  
          that sell dental plans to file an annual report on the plan's  
          medical loss ratio.

          Specific provisions of the bill would:
              Require health plans and health insurers that sell dental  
              plans to file a medical loss ratio report to their  
              respective regulator by September 30th of each year;
              Require carriers to use the specifications of the federal  
              medical loss ratio reports;
              Authorize the regulators to conduct investigations, if  
              necessary, to verify information in the reports;
              Require all information provided to the regulators to be  
              made available to the public;
              Exempt plans under certain state public health care  
              programs such as Medi-Cal;
              State legislative intent that data reported under the bill  
              be used by the Legislature in adopting a medical loss ratio  
              requirement for dental plans by January 1, 2018;
              Authorize the regulators to issue guidance to carriers  
              without complying with the requirements of the  
              Administrative Procedure Act, but also make that guidance  
              valid only until regulations are adopted.

          Related Legislation: AB 18 (Pan, 2013) would have required  
          health plans and insurers offering pediatric dental coverage  
          through Covered California to maintain a medical loss ratio of  
          75 percent. That bill was held in the Assembly Appropriations  
          Committee.

          Staff Comments: The bill does not explicitly require carriers to  
          meet a minimum medical loss ratio. However, the bill does state  
          legislative intent to enact a medical loss ratio for dental  
          plans by January 1, 2018. 

          The only costs that may be incurred by a local agency under the  
          bill relate to crimes and infractions. Under the California  
          Constitution, such costs are not reimbursable by the state.












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