BILL ANALYSIS Ó SB 388 Page 1 SENATE THIRD READING SB 388 (Mitchell) As Amended July 6, 2015 Majority vote SENATE VOTE: 40-0 ------------------------------------------------------------------ |Committee |Votes|Ayes |Noes | | | | | | | | | | | | | | | | |----------------+-----+----------------------+--------------------| |Health |18-0 |Bonta, Maienschein, | | | | |Bonilla, Burke, Chiu, | | | | |Gomez, Gonzalez, | | | | |Roger Hernández, | | | | |Lackey, McCarty, | | | | |Nazarian, Patterson, | | | | |Ridley-Thomas, | | | | |Rodriguez, Steinorth, | | | | |Thurmond, Waldron, | | | | |Wood | | | | | | | |----------------+-----+----------------------+--------------------| |Appropriations |17-0 |Gomez, Bigelow, | | | | |Bloom, Bonta, | | | | |Calderon, Chang, | | | | |Nazarian, Eggman, | | | | |Gallagher, Eduardo | | SB 388 Page 2 | | |Garcia, Holden, | | | | |Jones, Quirk, Rendon, | | | | |Wagner, Weber, Wood | | | | | | | | | | | | ------------------------------------------------------------------ SUMMARY: Makes the uniform summary of benefits and coverage (SBC) document, provided by health care service plans (plans) and health insurers (insurers) to consumers, a vital document subject to specified language translation requirements. Specifically, this bill: 1)Makes, commencing October 1, 2016, the uniform SBC a vital document for the purposes of language translation requirements for plans and insurers. 2)Requires, not later than July 1, 2016, the Department of Managed Health Care (DMHC) and the California Department of Insurance (CDI) to develop written translations of SBC templates in all language groups identified by the Department of Health Care Services as Medi-Cal threshold languages, except for any language group for which the United States Department of Labor (DOL) has already prepared a written translation. 3)Requires DMHC and CDI, not later than July 1, 2016, to make the written translations of the template uniform SBC available on their websites, as well as any written translations prepared by the DOL, if available. FISCAL EFFECT: According to the Assembly Appropriations Committee, this bill would result in: SB 388 Page 3 1)Estimated one-time costs of $350,000 (Managed Care Fund) to DMHC for translation, policy development, and technical assistance to plans regarding issues related to using the templates. 2)Similar one-time costs for similar activities at CDI, as well as $60,000 ongoing to ensure compliance (Insurance Fund). COMMENTS: According to the author, the Patient Protection and Affordable Care Act (ACA) requires plans and insurers to provide consumers with an easy to understand SBC to help them evaluate and compare their health insurance options. The SBC includes key features of coverage such as covered benefits, cost-sharing provisions, and coverage limitations as well as a standard glossary of terms. The author states that the ACA requires this information to be provided in a culturally and linguistically appropriate manner, but, unfortunately, federal standards on translating the SBC are inconsistent with California's translation requirements. The author states that this bill makes clear that translation of the SBC must be consistent with California's current language access laws, helping to ensure that more Californians are informed about their health coverage options and have equal access to critical information about their health care. The ACA sets forth specified disclosure requirements to help consumers better understand their health coverage, as well as to gain a better understanding of other coverage options and an ability to compare plans. One such disclosure requirement is for plans and insurers to provide SBCs, and a uniform glossary of common terms used in health coverage and medical care, to consumers so that they may obtain summarized information about plan benefits and coverage, and evaluate and compare their health coverage options. SB 388 Page 4 Under federal language access rules, plans and insurers must translate the SBC and uniform glossary if 10% or more of the population in a county is literate in the same non-English language. Based on these rules, two languages in California would meet the thresholds for written translations: Spanish and Chinese. California law requires vital documents to be translated when a limited English proficiency (LEP) enrollee represents a certain percentage of the plan's enrollment. Specifically, plans and insurers must assess the linguistic needs of the enrollee or insured population, and translate vital documents in threshold languages based on the sizes of enrollment and the needs assessment. According to DMHC, 10 languages qualify as meeting language access thresholds under California's translation requirements for vital documents. Those languages are Spanish, Vietnamese, Chinese, Korean, Tagalog, Russian, Armenian, Khmer, Arabic, and Hmong. This bill requires DMHC and CDI to develop and post templates of the SBC translated into Medi-Cal threshold languages which in addition to English include Arabic, Armenian, Cambodian, Chinese, Farsi, Hmong, Korean, Russian, Spanish, Tagalog, and Vietnamese. The California Pan-Ethnic Health Network, the sponsor of this bill, and other supporters state that this bill will ensure LEP consumers can access vital information included in the SBCs by expanding the languages into which it will be translated; ensure health plans are meeting their language access obligations; improve access to language assistance services; and help ensure Californians can access a standardized glossary of insurance terms. Supporters state that the SBC forms are important tools for consumers, and help them make sense of health care coverage, and that consumers' new right to the SBC under the ACA means SB 388 Page 5 they finally have a uniform document that can be used to reliably compare plans and policies, and obtain important coverage information. There is no known opposition to this bill. Analysis Prepared by: Kelly Green / HEALTH / (916) 319-2097 FN: 0001664