BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 1521
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          ASSEMBLY THIRD READING
          AB 1521 (Jones)
          As Amended April 29, 2009
          Majority vote 

           HEALTH              10-6        INSURANCE           7-3         
           
           ----------------------------------------------------------------- 
          |Ayes:|Jones, Ammiano, Block,    |Ayes:|Coto, Charles Calderon,   |
          |     |Carter,     De La Torre,  |     |Carter, Feuer, Hayashi,   |
          |     |De Leon, Hernandez,       |     |Nava, Torres              |
          |     |Bonnie Lowenthal, Hill,   |     |                          |
          |     |Salas                     |     |                          |
          |     |                          |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |Nays:|Adams, Conway, Emmerson,  |Nays:|Garrick, Blakeslee,       |
          |     |Gaines, Hayashi, Audra    |     |Niello                    |
          |     |Strickland                |     |                          |
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           APPROPRIATIONS      11-4                                        
           
           ----------------------------------- 
          |Ayes:|De Leon, Ammiano, Charles    |
          |     |Calderon, Davis, Fuentes,    |
          |     |Hall, John A. Perez,         |
          |     |Price, Skinner, Solorio,     |
          |     |Torlakson                    |
          |     |                             |
          |-----+-----------------------------|
          |Nays:|Nielsen, Duvall, Harkey,     |
          |     |Audra Strickland             |
          |     |                             |
           ----------------------------------- 
           SUMMARY  :  Prohibits a health plan or health insurer (health  
          plan) from entering into an agreement with a solicitor, broker,  
          agent, or any other entity (agent) engaging in the sale, offer  
          or application for an individual health plan contract or health  
          insurance policy (policy), that provides for or results in  
          variation of the agent's compensation because of the health  
          status, claims experience, industry, or occupation of the  
          individual.  In addition, this bill imposes requirements on  
          health plans related to agent compensation at the time of  
          renewal of an individual policy and imposes specific disclosure  








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          requirements on agents.  Specifically,  this bill  :

          1)Prohibits a health plan from entering into an agreement with  
            an agent offering or selling an individual policy, that  
            provides for or results in variation of the agent's  
            compensation because of the health status, claims experience,  
            industry, or occupation of the individual, except for agent  
            compensation based on a percentage of premium, as long as the  
            compensation level does not vary because of the health status,  
            claims experience, industry, or occupation of the individual.

          2)Prohibits a health plan from entering into a contract with an  
            agent for compensation that provides for a different  
            percentage of premium or compensation level, if at the time of  
            renewal of a policy, the agent submits an application that  
            results in the offer or purchase of a different policy with  
            the same health plan.

          3)Requires an agent to notify an individual, at the time of  
            renewal of an individual policy, that application for a  
            different individual policy may result in a review of the  
            individual's medical history which could result in an offer,  
            or offer of a higher premium, or denial of the application  
            entirely.  Specifies that application for a different policy  
            will not change the terms and conditions of the individual's  
            existing policy.  Requires an agent to identify the specific  
            health plan or health plans the agent is offering.

























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           EXISTING LAW  :  

           1)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.  

          2)Establishes the licensing category of a life licensee,  
            authorized to act on behalf of life or disability insurers,  
            and further defines one type of life licensee as an accident  
            and health insurance licensee, authorized to transact  
            insurance coverage for sickness, bodily injury, or accidental  
            death.

          3)Prohibits health plans from directly or indirectly varying  
            agent compensation for health coverage sold to small employer  
            firms (2-50 employees) based on the health status, claims  
            experience, industry, occupation, or geographic area of the  
            small employer.

          4)Under the federal Health Insurance Portability and  
            Accountability Act of 1996 (HIPAA), prohibits health insurers  
            from deflecting or in any way avoiding the issuance of a  
            policy to a HIPAA eligible person or a small employer group by  
            reducing agent compensation (commissions, bonuses, or other  
            rewards).  

           FISCAL EFFECT  :   According to the Assembly Appropriations  
          Committee, this bill has no direct fiscal impact to Department  
          of Managed Health Care and California Department of Insurance to  
          continue regulation of health plans and health insurers.

           COMMENTS  :   According to the author, this bill would lend  
          transparency to the process of purchasing health insurance  
          through an agent.  The author acknowledges that many individual  
          consumers and smaller businesses rely on insurance agents to  
          help them find the right health insurance coverage.  However,  
          the author points out that, by contract, an insurance agent is  
          often acting on behalf of the insurer, not the purchaser, and is  
          paid by the insurer who ultimately sells the coverage.  Many  
          agents represent multiple insurers, and the first duty of the  
          agent is to the insurers, not the purchaser.   

          Health Access California, sponsor of this bill, writes in  








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          support that insurance agent compensation is one major reason  
          why the overhead for individual insurance is almost 30% of the  
          premium, while major employers are estimated to pay overhead at  
          only 5%-7% of the premium.  Supporters state that currently in  
          the individual health insurance market, it is advantageous for  
          both insurers and agents to churn business because the agent  
          gets a higher compensation for new business, and the insurer  
          gets the opportunity to conduct a new round of medical  
          underwriting for the new product.  Healthier individuals, who  
          can pass underwriting, can move to a different, possibly cheaper  
          product, but those with claims history or pre-existing  
          conditions may be denied the chance to change.  Individuals who  
          cannot switch policies must stay in coverage that costs them  
          more and more over time, because only high risk individuals stay  
          with that product.  The sponsor argues this bill will improve  
          consumer disclosure and reduce any incentive for agents to churn  
          business, or to maneuver business based on health status to  
          specific insurers, by de-linking compensation from those  
          factors.
           

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

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