BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 730
                                                                  Page  1

          CONCURRENCE IN SENATE AMENDMENTS
          AB 730 (De La Torre)
          As Amended August 18, 2009
          Majority vote
           
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          |ASSEMBLY:  |53-23|(May 28, 2009)  |SENATE: |22-16|(September 3,  |
          |           |     |                |        |     |2009)          |
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           Original Committee Reference:   HEALTH  

           SUMMARY  :  Increases the maximum civil penalty for health  
          insurance post-claims underwriting from $118 per violation to  
          $5,000 per violation for insurers under the jurisdiction of the  
          Commissioner of the California Department of Insurance (CDI).   
          Specifically,  this bill  :  

          1)Increases the maximum civil penalty for each act of  
            post-claims underwriting, as prohibited in the Insurance Code,  
            from $118 to a maximum of $5,000 for each act, and up to  
            $10,000 for each act or violation where the health insurer  
            knew or had reason to know that the act was unlawful.

          2)Requires that the first $118 of each penalty collected for  
            post-claims underwriting violations be deposited in the  
            General Fund and the balance of any penalty revenue be  
            deposited in the Major Risk Medical Insurance Fund to be used,  
            upon appropriation by the Legislature, for the Major Risk  
            Medical Insurance Program (MRMIP).

          3)Requires civil penalties and disciplinary actions imposed  
            against insurers for specified violations of the Insurance  
            Code, including post-claims underwriting violations, to be  
            determined at a hearing conducted in accordance with the  
            Administrative Procedures Act.

           The Senate amendments:  

          1)Make the increased penalties in this bill a civil penalty in  
            lieu of the $118 civil penalty for violations of the Insurance  
            Code.

          2)Require that the first $118 of each penalty collected for  
            post-claims underwriting violations be deposited in the  








                                                                  AB 730
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            General Fund and the balance of any penalty revenue be  
            deposited in the Major Risk Medical Insurance Fund to be used  
            upon appropriation by the Legislature for the Major Risk  
            Medical Insurance Program (MRMIP).

           EXISTING LAW  : 

          1)Provides for regulation of health plans by the Department of  
            Managed Health Care (DMHC) under the Knox-Keene Health Care  
            Service Plan Act of 1975 (Knox-Keene) and for regulation of  
            disability insurers who sell health insurance (health  
            insurers) by the CDI under the Insurance Code.

          2)Prohibits health plans and health insurers from engaging in  
            "post-claims underwriting," defined as rescinding, canceling,  
            or limiting of a plan contract due to a plan or insurer's  
            failure to complete medical underwriting and resolve all  
            reasonable questions arising from written information  
            submitted on or with an application before issuing the plan  
            contract or policy.  For health plans regulated by DMHC,  
            provides that the prohibition against post-claims underwriting  
            does not limit a plan's remedies upon a showing of willful  
            misrepresentation.  

          3)Prohibits a health plan or health insurer from rescinding or  
            modifying an authorization for services after the service is  
            rendered, for any reason, including but not limited to, the  
            health plan or health insurer's subsequent rescission,  
            cancellation, or modification of the enrollee or insured's  
            contract or policy, or the health plan or health insurer's  
            subsequent determination that the carrier did not make an  
            accurate determination of the enrollee or subscriber's  
            eligibility.

          4)Prohibits, specifically, health insurers, but not health  
            plans, from voiding (rescinding) a policy or denying a claim  
            based on misstatements in the application after two years,  
            except for fraudulent misrepresentations, sometimes referred  
            to as an "incontestability clause" for insurance purposes.

          5)Authorizes, under the Insurance Code, the Insurance  
            Commissioner, after appropriate notice and opportunity for a  
            hearing, to impose civil penalties of up to $118 for each  
            violation of specified provisions of the Insurance Code  
            relating to disability insurance, including the prohibition  








                                                                  AB 730
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            against post-claims underwriting.  Authorizes civil penalties  
            for certain unfair or deceptive acts or practices, or for  
            violations of specified orders issued by the Commissioner, of  
            up to $5,000 for each act, or up to $10,000 for each willful  
            act, and imposes penalties of up to $55,000 for certain  
            violations of specified cease and desist or court orders.

          6)Authorizes, under Knox-Keene, the Director of DMHC, after  
            appropriate notice and opportunity for a hearing, to by order  
            suspend or revoke any license issued under Knox-Keene, or to  
            assess administrative penalties of any amount, if the Director  
            determines that the licensee has committed specified acts or  
            omissions constituting grounds for disciplinary action,  
            establishes civil penalties of up to $2,500 per violation for  
            any person who violates any provision of Knox-Keene, and  
            establishes criminal penalties of up to $10,000 for willful  
            violations.

          7)Establishes the MRMIP, administered by the Managed Risk  
            Medical Insurance Board, to provide health coverage for  
            individuals unable to purchase coverage, because they have  
            been denied health coverage by at least one private health  
            plan or are offered only limited coverage or coverage  
            significantly above standard average individual rates, as  
            determined by MRMIB.

           AS PASSED BY THE ASSEMBLY  , this bill was substantially similar  
          to the version passed by the Senate.

           FISCAL EFFECT  :  According to the Senate Appropriations  
          Committee, costs to CDI to continue to assess penalties for  
          post-claims underwriting in accordance with this bill would be  
          minor and absorbable.  To the extent that insurers practice  
          post-claims underwriting and CDI collects penalties, there would  
          be unknown, increased revenue for MRMIP. 


           Analysis Prepared by  :    Deborah Kelch / HEALTH / (916) 319-2097  

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