BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                     SB 388


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          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    |                    |








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          |                |     |Garcia, Holden,       |                    |
          |                |     |Jones, Quirk, Rendon, |                    |
          |                |     |Wagner, Weber, Wood   |                    |
          |                |     |                      |                    |
          |                |     |                      |                    |
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          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:









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          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.  









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          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  








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          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