BILL NUMBER: AB 2366	AMENDED
	BILL TEXT

	AMENDED IN SENATE  JUNE 13, 2016
	AMENDED IN ASSEMBLY  MARCH 16, 2016

INTRODUCED BY   Assembly Member Dababneh
    (   Coauthor:   Assembly Member  
Brown   ) 

                        FEBRUARY 18, 2016

   An act to amend Section 10235.52 of the Insurance Code, relating
to long-term care insurance.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 2366, as amended, Dababneh. Long-term care insurance.
   Existing law provides for the regulation of long-term care
insurance, as defined, and requires the Insurance Commissioner to
review and approve individual and group policies, certificates,
riders, and outlines of coverage. Existing law requires every
long-term care policy to contain a provision that, in the event the
insurer develops new benefits or benefit eligibility or new policies
with new benefits or benefit eligibility not included in the
previously issued policy, the insurer shall grant specified current
policyholders certain rights, namely notifying the policyholders of
the new benefits or benefit eligibility or new policy within 12
months and offering the new benefits or benefit eligibility to those
policyholders, as specified. The insurer is required to file the
notice to current policyholders with the Department of Insurance at
the same time as the new policy or rider.
   This bill would  exempt life insurance-based combination
policies that include long-term care coverage provisions from the
above-described requirements.   require the insurer to
notify the policyholder of the availability of the new benefits or
benefit eligibility or the new policy within 12 months of the date
that the new policy series is made available for sale in this state.
The bill would limit new benefits or benefit eligibility to including
coverage for new long-term care services or providers that are
material in nature, as specified. 
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 10235.52 of the Insurance Code is amended to
read:
   10235.52.  (a) Each policy shall contain a provision that, if the
insurer develops new benefits or benefit eligibility or new policies
with new benefits or benefit eligibility not included in the
previously issued policy, the insurer shall grant current holders of
its policies who are not in benefit or within the elimination period
all of the following rights:
   (1) The insurer shall notify the policyholder of the availability
of the new benefits or benefit eligibility or new policy within 12
 months.   months of the   date that
the new policy series is made availabl   e for sale in this
state.  The insurer shall file the notice with the department at
the same time as the new policy or rider.
   (2) The insurer shall offer the policyholder new benefits or
benefit eligibility in one of the following ways:
   (A) By adding a rider to the existing policy and paying a separate
premium for the new benefits or benefit eligibility based on the
insured's attained age. The premium for the existing policy shall
remain unchanged based on the insured's age at issuance.
   (B) By replacing the existing policy or certificate in accordance
with Section 10234.87.
   (C) By replacing the existing policy or certificate with a new
policy or certificate in which case consideration for past insured
status shall be recognized by setting the premium for the replacement
policy or certificate at the issue age of the policy or certificate
being replaced.
   (b) The insured may be required to undergo new underwriting, but
the underwriting can be no more restrictive than if the policyholder
or certificate holder were applying for a new policy or certificate.
   (c) The insurer of a group policy as defined under subdivisions
(a) to (c), inclusive, of Section 10231.6 shall offer the group
policyholder the opportunity to have  coverage for  the new
benefits and provisions extended to existing certificate holders, but
the insurer is relieved of the obligations imposed by this section
if the holder of the group policy declines the issuer's offer.

   (d) The provision described in subdivision (a) shall not be
required for life insurance-based combination policies that include
long-term care coverage provisions.  
   (d) For purposes of this section, benefits or benefit eligibility
shall include coverage for new long-term care services or providers
that are material in nature and shall not include changes to policy
structure, benefits, or provisions that are minor in nature. Changes
that are minor in nature include, but are not limited to, changes in
elimination periods, benefit periods, and benefit amounts.  

   (e) This section does not apply to life insurance policies or
riders containing accelerated long-term care benefits.