BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                  AB 1962
                                                                  Page  1

          CONCURRENCE IN SENATE AMENDMENTS
          AB 1962 (Skinner)
          As Amended August 4, 2014
          Majority vote
           
           ----------------------------------------------------------------- 
          |ASSEMBLY:  |76-0 |(May 28, 2014)  |SENATE: |32-4 |(August 21,    |
          |           |     |                |        |     |2014)          |
           ----------------------------------------------------------------- 
            
           Original Committee Reference:   HEALTH  

           SUMMARY  :  Requires health plans and insurers that issue, sell,  
          renew, or offer specialized dental plans or policies to file an  
          annual report with appropriate state regulators 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).

           The Senate amendments  delay the required date for plans and  
          insurers to file an initial report to September 30, 2015, delete  
          annual reporting requirements to the Legislature, and authorize  
          state regulators, until January 1, 2018, to issue guidance  
          regarding compliance with these provisions, as specified. 

           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 medical loss ratios (MLRs),  
          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 Senate Appropriations  
          Committee, one-time costs of approximately $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.  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 (DMHC).

           COMMENTS  :  The ACA includes numerous provisions that change the  








                                                                  AB 1962
                                                                  Page  2

          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  
          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  :    Paula Villescaz / HEALTH / (916)  
          319-2097 


          FN: 0004889