BILL ANALYSIS
AB 2345
Page 1
Date of Hearing: May 4, 2010
ASSEMBLY COMMITTEE ON HEALTH
William W. Monning, Chair
AB 2345 (De La Torre) - As Amended: April 22, 2010
SUBJECT : Individual health care coverage: health insurers.
SUMMARY : Requires health insurers to annually post specified
information used for rating and underwriting decisions related
to individual health insurance policies on their Web sites.
EXISTING LAW :
1)Provides for the regulation of health insurers by the
California Department of Insurance (CDI) and requires insurers
to have written policies, procedures, and underwriting
guidelines establishing the criteria and process whereby the
insurer makes its decision to provide or to deny coverage to
individuals who apply for coverage and sets the rate for that
coverage.
2)Requires an insurer to annually file with the commissioner a
general description of the criteria, policies, procedures, or
guidelines that the insurer uses for rating and underwriting
decisions related to individual health insurance policies, as
specified.
FISCAL EFFECT : None
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, while existing
law requires CDI to post insurers' written policies,
procedures, and underwriting guidelines for the decision
making process on denials, they are difficult for the
layperson to find. Furthermore, when a person shops for
insurance they typically look at an individual health
insurer's Web sites, not CDI's site. Therefore, the author
argues that this information should be posted on the same Web
site as the rest of the information the consumer uses to make
decisions about what health insurance to purchase.
2)RELATED LEGISLATION . SB 1163 (Leno) contains a provision
substantially similar to that contained in this bill and makes
AB 2345
Page 2
a number of other changes to existing law related to health
insurance rates and underwriting, including:
a) Extending requirements placed on health plans and
insurers when they deny individual coverage to when plans
and insurers deny group purchasers;
b) Requiring health plans and insurers to provide data and
demographic information on individual and large group
denials of coverage, any changes in rates, any changes in
cost sharing, and any changes in covered benefits; and,
c) Requiring health plans and insurers to provide to its
regulator specified information, such as provider prices
and utilization increases, with respect to rate increases
for each product.
SB 1163 passed by a vote of 5-0 when it was heard in the
Senate Health Committee on April 21, 2010.
3)PRIOR LEGISLATION . AB 356 (Chan), Chapter 526, Statutes of
2006, requires health plans and insurers selling products in
the individual market to disclose specified information to
individuals applying for coverage, and to those who have such
coverage, and to report a general description of their rating
and underwriting criteria and policies to the Department of
Managed Health Care and CDI, as specified.
REGISTERED SUPPORT / OPPOSITION :
Support
None on file.
Opposition
None on file.
Analysis Prepared by : Melanie Moreno / HEALTH / (916)
319-2097