BILL ANALYSIS
AB 2345
Page 1
ASSEMBLY THIRD READING
AB 2345 (De La Torre)
As Amended April 22, 2010
Majority vote
HEALTH 13-0
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|Ayes:|Monning, Ammiano, Carter, |
| | |
| |De La Torre, De Leon, |
| |Eng, Hayashi, Hernandez, |
| |Jones, Bonnie Lowenthal, |
| |Nava, V. Manuel Perez, |
| |Salas |
| | |
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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 : 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
AB 2345
Page 2
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.
SB 1163 (Leno) contains a provision substantially similar to
that contained in this bill and makes a number of other changes
to existing law related to health insurance rates and
underwriting, including:
1)Extending requirements placed on health plans and insurers
when they deny individual coverage to when plans and insurers
deny group purchasers.
2)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.
3)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.
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.
Analysis Prepared by : Melanie Moreno / HEALTH / (916)
319-2097
FN: 0004213