BILL NUMBER: AB 1049	CHAPTERED  07/12/99

	CHAPTER   88
	FILED WITH SECRETARY OF STATE   JULY 12, 1999
	APPROVED BY GOVERNOR   JULY 12, 1999
	PASSED THE SENATE   JUNE 24, 1999
	PASSED THE ASSEMBLY   MAY 25, 1999
	AMENDED IN ASSEMBLY   MAY 18, 1999

INTRODUCED BY   Assembly Member Aanestad

                        FEBRUARY 25, 1999

   An act to add Section 10123.135 to the Insurance Code, relating to
health insurance.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1049, Aanestad.  Health insurance:  disability insurers.
   Existing law provides for the regulation of disability insurers by
the Insurance Commissioner.
   This bill would require every disability insurer that covers
hospital, medical, or surgical expenses and that reviews and approves
the medical necessity or appropriateness of requests by providers
prior to, or concurrently with, the provision of health care services
to insureds, to prominently indicate on each insured's
identification card whether a separate telephone number must be
called to verify eligibility for benefits and coverage.  This bill
would also require the insurer to provide a specified notice to the
insured in this regard.


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


  SECTION 1.  Section 10123.135 is added to the Insurance Code, to
read:
   10123.135.  (a) Every disability insurer that covers hospital,
medical, or surgical expenses and that reviews and approves the
medical necessity or appropriateness of requests by providers prior
to, or concurrently with, the provision of health care services to
insureds, shall prominently indicate on each insured's identification
card whether a separate telephone number must be called to verify
eligibility for benefits and coverage.
   (b) A written notice shall accompany the initial mailing of the
insured's identification card modified pursuant to subdivision (a).
The notice shall indicate that the insured's identification card
includes a telephone number that may be used to verify eligibility
for benefits and coverage.  The notice shall also inform the insured
that review and approval of a health care service based on medical
necessity or appropriateness does not constitute eligibility for
benefits and coverage pursuant to the policy or contract.