BILL ANALYSIS
SENATE HEALTH
COMMITTEE ANALYSIS
Senator Elaine K. Alquist, Chair
BILL NO: AB 2470
A
AUTHOR: De La Torre
B
AMENDED: June 16, 2010
HEARING DATE: June 23, 2010
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REFERRAL: Judiciary Committee
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CONSULTANT:
7
Bain/
0
SUBJECT
Individual health care coverage
SUMMARY
Prohibits a health plan or health insurer from rescinding
or canceling a health plan contract/health insurance policy
unless there was a material misrepresentation or material
omission in the information submitted by the applicant, and
the health plan/insurer demonstrates that the applicant
intentionally misrepresented or intentionally omitted
material information on the application with the purpose of
misrepresenting his or her health history in order to
obtain health care coverage. Establishes in the Department
of Managed Health Care (DMHC) and the California Department
of Insurance (CDI) the independent review process (IRP) for
the review of decisions to cancel or rescind individual
health plan contracts and health insurance policies for
misrepresentation. Takes effect immediately as an urgency
statute.
CHANGES TO EXISTING LAW
Existing federal law:
The federal Patient Protection and Affordable Care Act
(Public Law 111-148,) known as PPACA, requires each health
Continued---
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insurance issuer that offers health insurance coverage in
the individual or group market to accept every employer and
individual that applies for such coverage. This
requirement is known as "guaranteed issue" and it takes
effect January 1, 2014. PPACA allows a health insurance
issuer to restrict enrollment in coverage to open or
special enrollment periods. Additionally, a health
insurance issuer must establish special enrollment periods
for qualifying events. The federal Secretary of the
Department of Health and Human Services (DHHS) must
promulgate regulations regarding enrollment periods and
qualifying events.
Prohibits, under PPACA, health plans and health insurers
offering group or individual coverage from rescinding a
plan or coverage once the enrollee is covered under a plan
or coverage, except when an individual has performed an act
or practice that constitutes fraud, or makes an intentional
misrepresentation of material fact, as prohibited by the
terms of the plan or coverage. PPACA also prohibits
coverage from being cancelled, except with prior notice to
the enrollee, and only as permitted under specified
provisions of federal law. These provisions take effect
six months following the date of enactment of PPACA (six
months after March 23, 2010).
Existing state law:
Prohibits a health plan and health insurer from rescinding
a contract or policy for any reason after 24 months
following the issuance of an individual contract or policy.
After 24 months, health plans and insurers are prohibited
from canceling a contract or policy, limiting any of the
provisions of a contract/policy, or raising premiums on a
contract/policy specifically due to any omissions,
misrepresentations, or inaccuracies in the application
form, whether willful or not.
Prohibits health plans and insurers from engaging in the
practice of postclaims underwriting. Defines "postclaims
underwriting" as the rescinding, canceling, or limiting of
a plan contract/insurance policy due to the 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, but
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not health insurers, existing law states this provision
does not limit a health plan's remedies upon a showing of
willful misrepresentation.
Prohibits compensation of a person or entity employed by,
or contracted with, a health plan or health insurer from
being based on, or related in any way, to the number of
contracts that the person or entity has caused or
recommended to be rescinded, canceled, or limited, or the
resulting cost savings to the health plan or health
insurer. Prohibits a health plan and health insurer from
setting performance goals or quotas, or providing
compensation to any person or entity employed by, or
contracted with, the health plan or health insurer, based
on the number of persons whose coverage is rescinded or any
financial savings to the health plan/insurer associated
with rescission of coverage.
Prohibits an enrollment or a subscription in a health plan
from being canceled or not renewed except for the
following:
Failure to pay the charge for such coverage if the
subscriber has been duly notified and billed for the
charge and at least 15 days has elapsed since the date of
notification.
Fraud or deception in the use of the services or
facilities of the plan or knowingly permitting such fraud
or deception by another.
Such other good cause as is agreed upon in the contract
between the plan and a group or the subscriber.
Requires individual health insurance to be guaranteed
renewable, except for the following reasons:
For nonpayment of the required premiums or contributions
by the individual in accordance with the terms of the
health insurance coverage or the timeliness of the
payments.
For fraud or intentional misrepresentation of material
fact under the terms of the coverage by the individual.
Movement of the individual outside the service area, but
only if coverage is terminated uniformly without regard
to any health status-related factor of covered
individuals.
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If the insurer ceases to provide or arrange for the
provision of health care services for new individual
health benefit plans in this state, subject to specified
conditions.
This bill:
Prohibits a health plan/insurer from rescinding or
canceling a health plan contract/health insurance policy
because of misrepresentation once a plan/insurer has issued
an individual contract/policy, unless all of the following
apply:
There was a material misrepresentation or material
omission in the information submitted by the applicant in
the written application to the health plan/insurer prior
to the issuance of the contract/policy that would have
otherwise prevented the contract/policy from being
entered into.
The health plan/insurer demonstrates that the applicant
intentionally misrepresented or intentionally omitted
material information on the application prior to the
issuance of the contract/policy with the purpose of
misrepresenting his or her health history in order to
obtain health care coverage.
The health plan/insurer sent a copy of the completed
written application to the applicant with a copy of the
contract/policy issued, along with the written notice
required by this bill that is described below.
Requires health plans and insurers to send a copy of the
completed written application to the applicant with a copy
of the plan contract/policy, along with a notice that
states all of the following:
The applicant should review the completed application
carefully and notify the health plan/insurer within 14
days of any inaccuracy in the application.
Any intentional material misrepresentation or intentional
material omission in the information submitted in the
application may result in the cancellation or rescission
of the plan contract.
The applicant should retain a copy of the completed
written application for the applicant's records.
Continues to permit an enrollment or subscription to be
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canceled or not renewed for failure to pay the charge for
that coverage, as set forth in existing law.
Permits a health plan/insurer to investigate potential
omissions or misrepresentations in order to determine
whether the subscriber's or enrollee's contract/policy
should be rescinded or canceled, if a health plan/insurer
obtains information indicating that the individual may have
intentionally omitted or intentionally misrepresented
material information during the application for coverage
process. Places requirements on plans/insurers regarding
the content of the notice and how quickly the notice must
be provided, and also requires a clear and concise
explanation of why an investigation to determine whether
rescission or cancellation is warranted, and the timeframe
for the individual to provide evidence or information to
negate the plan/insurer's reasons for the investigation.
Requires the health plan/insurer to complete its
investigation no later than 90 days from the date the
notice is sent to the individual, and to notify the
individual that it has concluded its investigation and has
made one of the following determinations:
The plan/insurer has determined that the enrollee or
subscriber did not intentionally misrepresent or
intentionally omit material information during the
application process and that the person's health care
coverage will not be canceled or rescinded; or,
The health plan/insurer intends to seek approval from
DMHC or CDI to cancel or rescind the individual's
contract/policy for intentional misrepresentation or
intentional omission of material information during the
application for coverage process.
Requires the written notice to do all of the following:
Include full disclosure of the nature and substance of
any information that led to the determination that the
individual intentionally misrepresented or intentionally
omitted material information on the application form.
Provide the individual with information indicating that
the determination does not become final until it is
reviewed and approved by the DMHC or CDI's independent
review process (IRP).
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Provide the enrollee or subscriber with information
regarding the DMHC or CDI's IRP, and the right of the
enrollee or subscriber to opt out of the IRP within 30
days of the date upon which an independent review
organization (IRO) receives a request for independent
review.
Provide a statement that the proposed decision to cancel
or rescind the contract/policy does not become effective
unless the regulator's IRO upholds the plan/insurer's
decision, unless the person has opted out of the
independent review.
Requires a health plan/insurer to continue to authorize and
provide all medically necessary health care services
required to be covered under the individual's contract/
policy until the effective date of cancellation or
rescission.
Prohibits the health plan/insurer from canceling or
rescinding the contract/policy until the IRO has made a
determination upholding the decision to rescind or cancel
based on misrepresentation.
Establishes, commencing March 31, 2011, in the DMHC and
CDI, the IRP for the review of decisions to cancel or
rescind individual health plan contracts and health
insurance policies because of misrepresentation.
Requires all decisions to cancel or rescind a contract or
policy because of misrepresentation to be reviewed, unless
the enrollee or subscriber opts out of the IRP.
Permits an enrollee or subscriber to designate an agent to
act on his or her behalf.
Requires the IRP authorized by this bill to be in addition
to any other procedures or remedies that may be available
to the individual.
Requires, by January 1, 2012, health plans/insurers to
prominently display in specified documents, information
concerning the right of an individual to an automatic IRP,
unless the individual opts out, in cases where the health
plan/insurer has decided to cancel or rescind the
individual's contract or policy because of
STAFF ANALYSIS OF ASSEMBLY BILL 2470 (De La Torre) Page
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misrepresentation.
Requires, pursuant to the IRP, the health plan/insurer,
upon the receipt of notice from the DMHC or CDI, to provide
to the IRO a copy of specified documents within seven
business days, including the individual's medical records,
application for coverage, and a copy of any other relevant
documents or information used by the health plan/insurer in
determining that the individual's contract/policy should be
canceled or rescinded, and any statements by the
plan/insurer explaining the reasons for the decision to
cancel or rescind.
Requires the plan/insurer to concurrently provide a copy of
these documents to the individual. Requires DMHC or CDI
and the IRO to maintain the confidentiality of any
information found by the DMHC or CDI to be the proprietary
information of the plan/insurer.
Requires DMHC and CDI to expeditiously review independent
review requests and to immediately notify the enrollee or
subscriber, in writing, as follows:
That the health plan/health insurer has requested an
independent review that has been approved, in whole or in
part, or, if not approved, the reasons for disapproval.
That the health plan/health insurer's proposed decision
to cancel or rescind the individual's contract/policy
under this bill will not become effective unless the IRO
upholds the health plan/health insurer's decision.
That the individual has 30 days from the date of the
organization's receipt of the request for an independent
review to submit any information that may be relevant to
the independent review, or to opt out of the review
process.
That an independent review does not limit the enrollee's
or subscriber's rights to pursue any other remedies
available under the law.
Requires the health plan/insurer to promptly issue a
notification to the individual, after submitting all of the
required material to the IRO, that includes an annotated
list of documents submitted, and to offer the individual
the opportunity to request copies of those documents from
the plan/insurer.
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Requires an IRO to conduct the review in accordance with
this bill and any regulations or orders of DMHC/CDI.
Requires, on or before March 31, 2011, DMHC and CDI to
contract with, or otherwise arrange with, one or more IROs
in the state to conduct reviews based on misrepresentation.
Requires the IRO to be not-for-profit and to be
independent of any health plan/insurer doing business in
this state. Requires the DMHC and CDI to establish
additional requirements, including conflict-of-interest
standards, consistent with the purposes of this bill, and
requires an IRO to meet these requirements in order to
qualify for participation in the IRP process and to assist
the DMHC/CDI in carrying out its responsibilities.
Requires the conflict-of-interest standards established to
also be consistent with the conflict-of-interest provisions
in the state's independent medical review statute, to the
extent applicable.
Requires DMHC and CDI to include in its contract, or other
arrangements with an IRO, specified requirements with which
the IRO must comply, including standards for arbitrators
and their selection, and requirements for arbitrators
conducting a review for an IRO. Permits an arbitrator to
request the opinion of an expert consultant about whether
the plan/insurer completed medical underwriting, but
prohibits the expert consultant from rendering an opinion
as to whether the individual intentionally misrepresented
or intentionally omitted information during the application
process. Requires the arbitrator's analysis and
determination to state the reasons for the determination,
the relevant documents in the record, and the relevant
findings supporting the determination.
Requires the IRO to provide DMHC/CDI, the plan/insurer, the
individual, and the individual's provider with the name of
the arbitrator reviewing the case, the analysis and
determination of the arbitrator, and a description of the
qualifications of the arbitrator.
Requires DMHC and CDI to immediately adopt the
determination of the IRO, and to promptly issue a written
decision adopting that determination to the parties that is
binding on the plan/insurer.
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Requires decisions of the IRO to be made available to the
public by DMHC/CDI after removing the names of the parties,
including, but not limited to, the individual, all medical
providers, the plan/insurer, and any of its employees or
contractors.
Prohibits health plans and insurers from engaging in any
conduct that has the effect of prolonging the IRP, and
establishes an administrative penalty of $5,000 per day for
violations, as well as for failure to implement an IRO
decision.
Requires DMHC and CDI to perform an annual audit of
independent review cases for the dual purposes of education
and the opportunity to determine if any investigative or
enforcement actions should be undertaken, particularly if a
plan/insurer repeatedly fails to act promptly and
reasonably with respect to decisions to cancel or rescind
individual coverage.
Requires DMHC and CDI, after considering the results of a
competitive bidding process and any other relevant
information on program costs, to establish a reasonable,
per-case reimbursement schedule to pay the costs of IRO
reviews, which may vary depending upon relevant factors.
Requires the costs of the IRP system to be borne by the
affected health plan/insurers pursuant to an assessment fee
system, but exempts plans/insurers that do not cancel or
rescind individual contracts from this assessment.
Requires health plans/insurers to annually report to DMHC
and CDI the total number of individual health plan
contracts/policies issued, and the total number of
individual health plan contracts/policies where a
cancellation or rescission was initiated or completed under
this bill in the preceding calendar year. Requires DMHC
and CDI to publish this information on their respective
websites.
Requires health plans and health insurers to file their
underwriting policies and procedures with DMHC/CDI on or
before March 31, 2011 and annually thereafter.
Makes legislative findings and declarations, that by
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enacting this bill, the legislature intends to supplement
federal law and does not intend to supersede a more
stringent standard, requirement, regulation, or rule
imposed under federal law.
Exempts from the requirements of this bill health plan
contracts issued under the Medi-Cal program, the Access for
Infants and Mothers Program, the Healthy Families program,
or the federal Medicare Program and specialized plan
contracts that provide coverage for dental services.
FISCAL IMPACT
According to the Assembly Appropriations Committee:
1)One-time fee-supported special fund costs in the range of
$2 million to DMHC and CDI, combined, to establish
regulations, confer on standardized forms, and establish
an IRP process for rescission and cancellation decisions.
Annual fee-supported special fund costs of $300,000,
combined.
2)The recently enacted federal PPACA prohibits rescissions
across the health care market, effective in six months,
and contains similar language to this bill regarding the
intentional misrepresentation of health data by an
applicant. Therefore, this bill simply conforms those
features of state law to the new federal law. Other
features of this bill are not contained in federal
reform, such as the IRP. The other provisions of the
bill would require substantial CDI and DMHC workload.
BACKGROUND AND DISCUSSION
According to the author, current law prohibits plans and
insurers from engaging in postclaims underwriting, which
includes rescinding, canceling, or limiting a plan contract
due to the plan's failure to complete medical underwriting
and resolve all reasonable questions arising from the
application. It is well publicized that health plans and
insurers have paid large bonuses to their employees for
rescission of policies, practiced illegal rescission, and
put patients in harm's way by rescinding their health
coverage when they need it most. The author states this
bill protects consumers from having their health insurance
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coverage canceled or rescinded when they need care by
maintaining their current coverage while allowing
regulators to independently analyze and adjudicate on any
rescission or cancellation of a policy due to
misrepresentation. The author argues the time has come to
provide individuals with an unbiased analysis on whether
their policy should be rescinded or cancelled, and to
provide the utmost protection to patients whenever their
health plans and insurers want to rescind their health
coverage.
Background on the individual market and rescission
Approximately 2 to 2.5 million Californians purchase
individual health insurance, representing approximately 7
percent of Californians. When individuals and families
apply for individual health coverage, they fill out an
application that asks detailed questions about their
current health status, current medication use and past
health history. Health plans use this information to
determine whether to offer the individual/family coverage,
and how much they will pay in premiums.
"Rescission" is the process whereby insurers retroactively
cancel health coverage on the basis of alleged inaccurate,
missing or incomplete information on the part of the
insured person at the time of application. Rescission
involves a determination by the plan that the contract
between the plan and the enrollee never existed because of
a misrepresentation by the enrollee at the time of
application, and that any health care services the enrollee
received during the entire time of the contract are to be
paid for by the enrollee. An individual whose coverage has
been rescinded is left without insurance, and is also
liable for any previously paid health care claims.
Rescission is different from cancellation, in that
rescission terminates coverage retroactively while
cancellation terminates coverage prospectively.
There has been extensive newspaper coverage of rescission,
investigations by DMHC and CDI on rescission, settlement
agreements reached between DMHC and CDI on rescissions,
legislative hearings, and several court cases. The
rescission settlement agreements with DMHC and CDI required
health plans and insurers to offer coverage to consumers
whose coverage was previously terminated without subjecting
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them to medical underwriting or pre-existing condition
exclusions, and to pay or reimburse any medical expenses
that would have been covered under the rescinded policies.
According to a briefing paper for a hearing by the Assembly
Committee on Accountability and Administrative Review, the
DMHC and CDI settlement agreements covered 6,006 rescinded
enrollees, but five percent of enrollees in DMHC plans and
less than four percent of rescinded individuals in
CDI-regulated insurers accepted new coverage under the
agreement, and fewer than 200 individuals participated in
processes set up by DMHC and CDI to recoup medical expenses
incurred after rescission.
The number of rescissions has declined sharply since 2004.
According to data from the DMHC from the five largest
health plans in California, the number of rescissions in
2004 was 1,464, and 1,552 in 2005, but declined to 218 in
2006, 64 in 2007, 22 in 2008 and 4 in 2009. Similar data
is not available on the number of cancellations.
There has been litigation and considerable legislative
debate over the standard health plans must meet in order to
rescind a policy. In a 2007 ruling by the Court of Appeal
in Hailey v. California Physicians' Service (dba Blue
Shield of California) , the court held that an insurer
cannot rescind an enrollees' coverage for a material
misrepresentation or omission unless the plan can
demonstrate:
The misrepresentation or omission was willful; or
The plan had made reasonable efforts to ensure the
subscriber's application was accurate and complete as
part of the pre-contract underwriting process.
The recently enacted federal health care reform bill
established a national standard on rescission. As part of
the federal PPACA, health plans/insurers are prohibited
from rescinding a plan or coverage once the enrollee is
covered, except that federal law allows rescission when an
individual has performed an act or practice that
constitutes fraud, or makes an intentional
misrepresentation of material fact that is prohibited by
the terms of the plan or coverage. The federal law does
not permit, as the Hailey ruling did, plans to rescind a
policy if it had made reasonable efforts to ensure the
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subscriber's application was accurate and complete as part
of the pre-contract underwriting process. AB 2470
generally mirrors the federal law standard on rescission.
PPACA also prohibits coverage from being cancelled, except
with prior notice to the enrollee, and only as permitted
under specified provisions of federal law that permit
cancellation for nonpayment of premiums, fraud, the
termination of the plan, movement outside of the plan's
service area, or if the individual's association membership
(through which health coverage was obtained) ceases.
Arguments in support
The California Medical Association (CMA) writes, as the
sponsor of this measure, that this bill will provide an
independent review of any decisions by health insurers to
cancel or rescind coverage for sick patients - a vital
safeguard to ensure the federal ban on rescission is
followed. CMA states rescission is the unscrupulous
practice in the individual market where health plans and
insurers dump patients off their insurance, usually after
claims arise. With this egregious practice now prohibited
at the federal level, it is important for California to
implement a robust enforcement mechanism, to police health
insurers and ensure strong and independent implementation.
CMA states this bill will ensure that health plans and
insurers do not act as "judge and jury," whenever they want
to rescind or cancel a policy for misrepresentation, and
this bill protects innocent patients before their coverage
is illegally rescinded. CMA states these are patients who
have done nothing wrong and should not suddenly have "the
rug pulled out from under them" and be left without health
insurance.
Arguments in opposition
Health plans and insurers write in opposition that this
bill would require them to change their underwriting
processes in 2012 and again in 2014 in response to federal
health care reform. The California Association of Health
Plans (CAHP) writes that the independent third party
process for review of rescissions could be shortened, and
CAHP seeks to have the provisions of this bill dealing with
cancellations deleted from the bill. The Civil Justice
Association of California writes in opposition that having
the independent review organization determine whether a
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health plan enrollee "intentionally misrepresented"
material information makes the review process impotent and
moot, because an administrative body that reviews only
documents and does not take testimony and ask questions is
incapable of determining the state of mind of the person
whose application it is reviewing and will result in
rescission approval decisions ending up in court.
Related legislation
AB 2540 (De La Torre) adds postclaims underwriting, the
practice of health insurers waiting for health claims to be
submitted and then canceling insurance coverage
retroactively, to the definition of unfair methods of
competition in the business of health insurance.
Prior legislation
AB 1945 (De La Torre) of 2008 and AB 2 (De La Torre) of
2009 were similar to this bill, and were both vetoed by
Governor Schwarzenegger. In his veto message of AB 2, the
Governor stated the following:
I have repeatedly indicated I would support a
bill that provides strong statutory protections
for consumers against inappropriate rescissions
by health plans. However, this bill continues to
have a provision that benefits trial lawyers
rather than consumers. I remain comfortable
sending this bill back for a second time without
my signature because of the strong consumer
protections the Department of Managed Health Care
and Department of Insurance have successfully
implemented over the past two years. The number
of rescissions industry-wide has decreased
significantly since 2005. Millions of dollars
have been assessed against health plans and
insurers; corrective action plans have been
received and approved; revised consumer
disclosures have been reviewed for literacy,
consistency and compliance with the settlement
agreements; and lastly, the two departments are
working together to ensure that all health plans
meet the same standards of fairness and full
disclosure. The market has changed and it is
because of my Administration's strong action in
this area.
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The precedent-setting 4th District Court of
Appeals decision in Hailey v. Blue Shield relied
heavily on the Department of Managed Health
Care's amicus brief. The court's reliance on
this brief speaks to the strong work of the
Department and the balance required when enacting
consumer protections and ensuring access to the
individual health plan market. I have no
interest in overturning that appellate decision
and the definitive interpretation of the
postclaims underwriting statute.
In addition, I have signed targeted measures that
prohibit plans from financially incentivizing
their employees to rescind or cancel policies;
require plans to offer coverage to families when
the individual on the contract has been rescinded
or cancelled; and most recently, I have signed
Assembly Bill 108 that will prohibit a health
plan from rescinding or canceling a contract
after 24 months.
I would request that the Legislature send me a
bill that codifies the Hailey decision, as I have
asked for since 2008. When that occurs, I will
be happy to sign that bill.
AB 108 (Hayashi), Chapter 406, Statutes of 2009, prohibits
health plans and health insurers, after 24 months from the
issuance of an individual health plan contract or health
insurance policy, from rescinding the individual coverage
for any reason, and prohibits canceling, limiting, or
raising premiums in a contract or policy due to any
omissions, misrepresentations, or inaccuracies in the
application form, whether willful or not.
AB 1150 (Lieu), Chapter 188, Statutes of 2008, prohibits a
health plan or insurer from compensating any person
retained, employed, or contracted with, to review medical
underwriting decisions based on, or related to, the number
of contracts, policies, or certificates, or on the cost of
services for a contract, policy, or certificate, that the
person has caused or recommended to be rescinded, canceled,
or limited, or the resulting cost savings to the plan or
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insurer. Prohibits a plan or insurer from setting
performance goals
or quotas based on the number of persons whose health
coverage is rescinded or any financial savings to the plan
or insurer associated with rescission of coverage.
AB 2549 (Hayashi) of 2008 would have prohibited health
plans and health insurers from rescinding a health plan
contract or health insurance policy after six months from
the time the contract is effective for any reason. In its
initial form, AB 2549 restricted rescissions and
cancellations to a six-month period. AB 2549 died on the
Senate Appropriations Suspense file.
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
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 and brokers selling individual health coverage
products to assist applicants in providing answers to
health questions accurately and completely, as specified.
ABX1 1 (Nunez) of 2007 would have enacted comprehensive
health care system reforms, including coverage expansions,
an employer spending requirement and individual health
insurance mandate, affordability protections, insurance
market reforms, cost containment elements and provisions
to support health care safety net providers. Among other
market reform elements, ABX1 1 prohibited carriers from
setting performance goals or quotas or providing
additional compensation based on the number of people
whose coverage was rescinded, or the financial savings of
the plan associated with the rescission of coverage. In
January 2008, ABX1 1 failed passage in the Senate Health
Committee.
AB 1324 (De La Torre), Chapter 602, Statutes of 2007,
clarifies and makes specific provisions of law that
currently prohibit health plans and health insurers, where
the plan or insurer authorizes a specific type of treatment
by a health care provider, from rescinding or modifying the
authorization after the provider renders the health care
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service in good faith and pursuant to the authorization.
AB 1100 (Willie Brown), Chapter 1210, Statutes of 1993,
enacts the Health Insurance Access and Equity Act which
requires applications for health plan contracts or health
insurance policies to conform to certain standards for
underwriting, including clear and unambiguous questions
when health-related questions are used to ascertain an
applicant's health, and prohibits postclaims underwriting.
PRIOR ACTIONS
Assembly Health 13-5
Assembly Appropriations: 12-5
Assembly Floor: 46-27
Support: California Medical Association (sponsor)
Alzheimer's Association
American Federation of State, County and Municipal
Employees, AFL-CIO
Association of Northern California Oncologists
California Academy of Physician Assistants
California Communities United Institute
California Psychiatric Association
California Psychological Association
California Society of Anesthesiologists (CSA)
City Attorney, City of Los Angeles
Consumer Attorneys of California
Osteopathic Physicians & Surgeons of California
Oppose: Anthem Blue Cross
Association of California Life & Health Insurance
Companies
California Association of Health Plans
Civil Justice Association of California
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