BILL ANALYSIS                                                                                                                                                                                                    




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                           2540 (De La Torre)
          
          Hearing Date:  8/2/2010         Amended: 7/15/2010
          Consultant: Katie Johnson       Policy Vote: Health 6-0
          _________________________________________________________________ 
          ____
          BILL SUMMARY: AB 2540 would increase the maximum civil penalty  
          for health insurance post-claims underwriting from $118 per  
          violation to $5,000 per violation. The bill would also increase  
          that amount to $10,000 for each act of post-claims underwriting  
          that the insurer knew was unlawful.
          _________________________________________________________________ 
          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2010-11      2011-12       2012-13     Fund
                                                                  
          Penalties revenue               unknown, potentially  
          hundredsSpecial/*
                                   of thousands of dollars       General

          *The first $118 of each penalty would go to the General Fund;  
          the balance would go to the Major Risk Medical Insurance Fund.
          _________________________________________________________________ 
          ____

          STAFF COMMENTS: 

          Existing law prohibits health care service plans and health  
          insurers from engaging in "post-claims underwriting," which is  
          defined as rescinding, canceling, or limiting a plan contract  
          due to a plan or insurer's failure to complete medical  
          underwriting and to resolve all reasonable questions arising  
          from written information submitted on or with an application  
          before issuing the plan contract or insurance policy.

          Existing law authorizes the California Department of Insurance  
          (CDI) to impose civil penalties of up to $118 for each violation  
          of the standard provisions of insurance policies, including  
          incidences of post-claims underwriting, which would be deposited  
          in the General Fund. Existing law establishes general civil  
          penalties of up to $2,500 per violation for any person who  
          violates any provision of the Knox-Keene Health Care Service  










          Plan Act of 1975, including a fine of up to $10,000, upon  
          conviction for willful violations.

          This bill would increase the civil penalty on a health insurer  
          for each act of post-claims underwriting from $118 to a maximum  
          of $5,000, and up to $10,000 for each act or violation where the  
          health insurer knew, or had reason to know, that the act was  
          unlawful. To the extent that insurers practice post-claims  
          underwriting and CDI collects penalties, there would be unknown,  
          increased revenue for the Major Risk Medical Insurance Fund. 

          Additionally, the General Fund would be held harmless; this bill  
          would require that the first $118 of any penalties collected  
          pursuant to these provisions would be deposited in the state's  
          General Fund, as under current law, and that the balance of the  
          penalties 
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          AB 2540 (De La Torre)

          would be deposited in the Major Risk Medical Insurance Fund to  
          support the Major Risk Medical Insurance Program (MRMIP), a  
          program that provides health care coverage for otherwise  
          uninsurable Californians.

          Costs to CDI to continue to assess penalties for post-claims  
          underwriting in accordance with these provisions would be minor  
          and absorbable. 

          This bill is nearly identical in intent to AB 730 (De La Torre,  
          2009), which the Governor vetoed, saying, "This bill attempts to  
          align enforcement provisions between the Department of Managed  
          Health Care and the California Department of Insurance.   
          However, it does not create this much-needed consistency, but  
          instead continues to subject regulated entities to differing  
          standards?I cannot support provisions that further limit revenue  
          to the General Fund and decrease the state's ability to direct  
          resources to its highest priorities."