BILL ANALYSIS                                                                                                                                                                                                    






                        SENATE COMMITTEE ON BANKING, FINANCE,
                                    AND INSURANCE
                           Senator Ronald Calderon, Chair


          AB 389 (Saldana)         Hearing Date: June 22, 2009  

          As Amended: June 15, 2009
          Fiscal:             yes
          Urgency:       no
          

           SUMMARY  Modifies California long-term care insurance rate  
          oversight law to allow the California Department of Insurance  
          (CDI) to monitor the rate increases of older long-term care  
          policies and to assure that adequate premium dollars are going  
          to benefits rather than the insurance company.  Furthermore,  
          this bill would provide flexibility to CDI to use its own  
          qualified actuaries in addition to contracted outside  
          professionals to review long-term care rates.  Finally, it makes  
          other non-substantive technical changes.
           
           
          DIGEST
            
          Existing law
            
             1.   Makes the sale of long term care insurance subject to  
               Department of Insurance oversight.

             2.   Benefits in relation to premiums paid is subject to  
               regulation and for individual long-term care insurance  
               policies issued prior to January 1, 2003, benefits are  
               deemed reasonable in relation to premiums if the expected  
               loss ratio is at least 60 percent, calculated in a manner  
               providing for adequate reserving of the long-term care  
               insurance risk.

             3.   Requires all actuaries used by the Department to review  
               long term care rate applications to be members of the  
               American Academy of Actuaries with at least 5 years of  
               experience in long-term care insurance industry pricing.

             4.   If the Department does not have sufficient actuaries on  
               staff with at least 5 years of experience in long-term care  
               insurance industry pricing, the Department is required to  




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               contract with actuaries to review all rate applications  
               submitted by insurers.
           

          This bill

              1.   For individual long-term care insurance policies issued  
               before new premium rate schedules are approved, and for  
               which rate revisions are filed on or after January 1, 2010,  
               benefits provided by the policy shall be deemed reasonable  
               by the Department of Insurance in relation to the premium  
               if the premium rate schedules have a lifetime expected loss  
               ratio of at least 60 percent of the premium scale in effect  
               on December 31, 2009 plus that of 70 percent of the premium  
               increases filed on and after January 1, 2010, calculated in  
               a manner for adequate reserving.

             2.   Notwithstanding the specific rate authority provided  
               above, The Insurance Commissioner, for rate revisions filed  
               on or after January 1, 2010, is authorized to approve a  
               rate change application based on less than a 70 percent  
               loss ratio, but not less than a 60 percent loss ratio, for  
               the part attributable to the rate increase, if an insurer  
               can demonstrate that the rates are necessary to protect the  
               financial condition of the insurer, including further  
               reductions in capital and surplus.

             3.   The measure clarifies the authority of the Department to  
               retain outside actuarial consultants and makes minor  
               technical changes to other provisions of law

           

           COMMENTS


              1.   According to the Sponsor, the Department of Insurance,  
               AB 389 will allow it to monitor the rate increases of older  
               long-term care policies and assure that adequate premium  
               dollars are going to benefits rather than the insurance  
               company.  Furthermore, this bill would provide flexibility  
               to CDI to use its own qualified actuaries in addition to  
               contracted outside professionals to review long-term care  
               rates.  Finally, it makes other non-substantive technical  
               changes the baby-boomer generation ages, the number of  
               elderly Americans and the demand for services and long-term  




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               care are increasing.  As a result, long-term care  
               insurance, with more than eight million customers, has a  
               particular appeal to Californians reaching retirement age.

              2.   Background  Information provided by the sponsor, the  
               California Department of Insurance states:

                  a.        As the baby-boomer generation ages, the number  
                    of elderly Americans and the demand for services and  
                    long-term care is increasing.  As a result, long-term  
                    care insurance, with more than eight million  
                    customers, has a particular appeal to Californians  
                    reaching retirement age. 

                  b.        Prior to 2002, too many long-term care  
                    policies were under priced, resulting in an influx of  
                    policyholders but inadequate funds to assure long-term  
                    solvency for the insurers.  The Legislature addressed  
                    that problem in 2002 for new policies in particular,  
                    but the law leaves open the possibility that insurers  
                    could impose rate increases for existing older  
                    policies that keep too much of each premium dollar in  
                    the increase for the insurer's expenses, rather than  
                    for benefits to the policyholder.

                  c.        In addition, current law assures that only  
                    qualified actuaries can review rate applications  
                    submitted by long-term care insurers.  However, due to  
                    an oversight, the statute can prohibit CDI actuaries  
                    who are qualified to review rates from playing any  
                    role.  This adds both time and expense to approving  
                    new rates.  In addition, while it is normal practice  
                    to bill long-term care insurers for the hours spent  
                    reviewing rates, the statute is not clear about this  
                    authority, which is standard in most other lines of  
                    insurance.

             3.   According to the author, AB 389 ensures that increases  
               for pre-2002 long-term care policies will provide at least  
               70 cents of each premium dollar to benefits for the  
               policyholder.  The bill allows qualified CDI actuaries to  
               review long-term care rates as well as outside actuaries,  
               and clarifies that CDI can bill insurers for reviews.  The  
               bill also makes technical changes. 

             4.   According to the Peace Officers Research Association of  




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               California, which indicates full support for this bill, AB  
               389 will assist in stabilizing the rates for long term  
               care. 

           
             5.   Questions   None


              6.   Suggested Amendments   None

          
             7.   Prior Legislation   None  


           


          POSITIONS
          
          Support
           
          California Department of Insurance
          Peace Officers Research Association of California
           
          Oppose
               
          None

          Consultant:   Kenneth Cooley   (916) 651-4102