BILL ANALYSIS                                                                                                                                                                                                    






                                 SENATE HEALTH
                               COMMITTEE ANALYSIS
                        Senator Elaine K. Alquist, Chair


          BILL NO:       AB 1449                                      
          A
          AUTHOR:        De Leon                                      
          B
          AMENDED:       As introduced                               
          HEARING DATE:  July 15, 2009                                
          1
          CONSULTANT:                                                 
          4
          Park/                                                       
          4
                                                                       
                                         9
                                        
                                     SUBJECT
                                         
                       Health care coverage: solicitation

                                     SUMMARY  

          Revises and makes specific to individual health care  
          coverage the duty established for agents, brokers,  
          solicitors, or sales representatives, who assist an  
          applicant in completing applications for health care  
          coverage, to assist applicants in providing answers to  
          health questions accurately and completely, as specified.
                                         
                            CHANGES TO EXISTING LAW  

          Existing law:
          Existing law provides for the regulation of health plans by  
          the Department of Managed Health Care (DMHC) and for the  
          regulation of health insurers by the California Department  
          of Insurance (CDI). 

          Existing law requires anyone who solicits, negotiates, or  
          effects contracts of insurance to be licensed for that  
          purpose by the Commissioner of Insurance, and to meet  
          specified testing and training requirements.  

          Existing law establishes a duty on the part of agents,  
                                                         Continued---



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          brokers, or solicitors, who assist applicants in submitting  
          applications, to assist the applicant in providing answers  
          to health questions accurately and completely.

          Existing law requires an agent, broker or solicitor to  
          attest to both of the following on a written application:  
          1) that to the best of his or her knowledge, the  
          information on the application is complete and accurate;  
          and, 2) that he or she explained to the applicant, in  
          easy-to-understand language, the risk to the applicant of  
          providing inaccurate information and the applicant  
          understood the explanation.

          Existing law requires a declarant, who willfully states as  
          true any material fact he or she knows to be false in such  
          an attestation above, to be subject to a civil penalty of  
          up to $10,000, in addition to any applicable penalties or  
          remedies available under current law.  

          Existing law authorizes any public prosecutor to bring a  
          civil action to impose the civil penalty above and requires  
          a health plan or health insurance application to include a  
          statement advising declarants of the civil penalty  
          authorized under this bill. 

          This bill:
          This bill would revise the duties related to assisting an  
          applicant above and the related attestation to apply only  
          when an agent, broker, solicitor or sales representative  
          assists an individual in completing an application for  
          individual health care coverage (plan contracts and  
          policies), rather than apply the duty to coverage  
          generally. Makes related technical changes.

          
                                  FISCAL IMPACT  

          According to the Assembly Appropriations Committee, the  
          bill would have no direct fiscal impact to DMHC or CDI to  
          continue oversight of the individual health insurance  
          market.

                            BACKGROUND AND DISCUSSION  

          According to the author, this bill is needed to clarify  




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          that the duty established for health insurance agents to  
          help in completing health insurance applications accurately  
          is applicable to the individual health insurance market.

          Legislative history
          AB 2569 (De Leon), Chapter 604, Statutes of 2008, which  
          established the duty on health insurance agents revised  
          under this bill, related to the problem of health insurance  
          rescission.  "Rescission" is the process whereby insurers  
          cancel individual health coverage on the basis of alleged  
          missing or incomplete information on the part of the  
          insured person at the time of application.  

          In addition to addressing other aspects of rescission, such  
          as protecting individuals in a contract or policy that was  
          rescinded, whose information was not related to the reasons  
          (justified or not) for rescission, AB 2569 focused on the  
          role of agents in helping individuals to complete the  
          application for health insurance to make sure that agents  
          did not contribute in any way to the potential for a  
          rescission because of errors or omissions in the  
          application.  

          In California, health plans and insurers may decline an  
          applicant that applies for health coverage in the  
          individual market because of health status or claims  
          experience. In the small group market, however, individuals  
          are not allowed to be declined or excluded from the group  
          for such reasons. 

          Related legislation
          AB 1521 (Jones) would prohibit a health plan or health  
          insurer from basing agent or broker compensation on the  
          health status of the individual seeking individual health  
          coverage, as specified. Imposes requirements on health  
          plans/insurers related to agent/broker compensation at the  
          time of renewal of an individual contract/policy or switch  
          to another contract/policy with the same plan or insurer.  
          Imposes specific disclosure requirements on agents.   
          Pending in the Senate Appropriations Committee.

          Prior legislation
          AB 2569 (De Leon), Chapter 604, Statutes of 2008, requires  
          health plans and health insurers to offer new coverage, or  
          continue existing coverage, for any individual whose  




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          coverage was rescinded, other than the individual whose  
          information led to the rescission, within 60 days, without  
          medical underwriting, as defined.  Establishes a duty for  
          agents to assist applicants in providing accurate and  
          complete answers to health questions.

          Arguments in support
          The California Medical Association writes that it would  
          support this bill, if the bill were amended to provide  
          whistleblower protection if a declarant reports a violation  
          by an agent or sales representative, and require the  
          disclosure in existing law to be prominently displayed on  
          the application.

                                  PRIOR ACTIONS

           Assembly Floor:     73-0
          Assembly Appropriations:16-0
          Assembly Health:    19-0

                                     COMMENTS
           
          1.Technical amendment. Pursuant to SB 1379, Chapter 607,  
            Statutes of 2008, which established the Managed Care  
            Administrative Fines and Penalties Fund to capture fines  
            and penalties related to violations of the Knox-Keene Act  
            (which governs health plans regulated by DMHC), staff  
            recommends the following technical amendment:

               Page 2, lines 20-26:

               (c) If, in an attestation required by subdivision (b),  
               a declarant
               willfully states as true any material fact he or she  
               knows to be
               false, that person shall, in addition to any  
               applicable penalties or
               remedies available under current law, be subject to a  
               civil penalty
               of up to ten thousand dollars ($10,000). Any public  
               prosecutor
               may bring a civil action to impose that civil penalty.  
               These
               penalties shall be paid to the Managed Care  
               Administrative Fines 




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               and Penalties Fund.


                                    POSITIONS  
                                        
          Support:  California Alliance for Retired Americans
                    California Medical Association (support, if  
          amended)

          Oppose:  None received
                                   -- END --