BILL NUMBER: AB 2780	AMENDED
	BILL TEXT

	AMENDED IN SENATE  AUGUST 17, 2010

INTRODUCED BY    Committee on Insurance   (
  Solorio (Chair), Bradford, Carter, Feuer, Hayashi,
Nava, and Torres   )   Assembly Member
  Solorio 

                        MARCH 3, 2010

    An act to amend Sections 674.9, 1874.86, and 12962 of the
Insurance Code, relating to insurance.   An act to
amend, repeal, and add Section 138.7 of the Labor Code, relating to
workers' compensation, and declaring the urgency thereof, to take
effect immediately. 



	LEGISLATIVE COUNSEL'S DIGEST


   AB 2780, as amended,  Committee on Insurance 
 Solorio  .  Insurance: reporting requirements.
  Workers' compensation.  
   Existing law establishes a workers' compensation system,
administered by the Administrative Director of the Division of
Workers' Compensation, to compensate an employee for injuries
sustained in the course of his or her employment.  
   Existing law provides that a person or public or private entity
who is not a party to a claim for workers' compensation benefits may
not obtain individually identifiable information, as defined, that is
obtained or maintained by the Division of Workers' Compensation of
the Department of Industrial Relations on that claim, except as
specified.  
   This bill would, until January 1, 2017, authorize the State
Department of Health Care Services to obtain and use individually
identifiable information for the purposes of seeking recovery of
Medi-Cal costs incurred by the state for treatment provided to
injured workers that should have been incurred by employers and
insurance carriers pursuant to workers' compensation law.  
   This bill would declare that it is to take effect immediately as
an urgency statute.  
   (1) Existing law requires each insurer writing liability insurance
for long-term health care facilities, residential care facilities
for the elderly, or physicians who provide or oversee the provision
of services to residents in long-term health care facilities or
residential care facilities for the elderly to report to the
Insurance Commissioner specified information regarding liability
policies for those facilities or physicians by a date to be set by
the commissioner, but not later than July 1 of each calendar year.
 
   This bill would instead require the report by a date set by the
commissioner without restriction, except that the report shall be
required not more than once each calendar year.  
   (2) Existing law requires each insurer that issues automobile
liability or collision policies to report annually to the Department
of Insurance regarding the number of vehicles inspected for which it
has approved a claim for the cost of auto body repairs, the
percentage that number represents of the total number of vehicles it
paid an auto body repair claim in the prior calendar year, and the
results of the inspection, including any fraud uncovered and whether
any legal action was pursued.  
   This bill would make change the reporting requirement so that the
report need only be submitted at the request of the commissioner and
not more than annually.  
   (3) Existing law requires the commissioner to report annually to
the Governor, the Legislature, and the committees of the Senate and
Assembly having jurisdiction over insurance an analysis of
information, including, but not limited to, certain medical
malpractice insurance statistics reported by insurers upon the
request of the commissioner.  
   This bill would eliminate the analysis of information from medical
malpractice insurance statistical reports from the commissioner's
annual report and would eliminate an obsolete reference. 
   Vote:  majority   2/3  . Appropriation:
no. Fiscal committee: yes. State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    Section 138.7 of the   Labor
Code   is amended to read: 
   138.7.  (a) Except as expressly permitted in subdivision (b), a
person or public or private entity not a party to a claim for workers'
compensation benefits may not obtain individually identifiable
information obtained or maintained by the division on that claim. For
purposes of this section, "individually identifiable information"
means any data concerning an injury or claim that is linked to a
uniquely identifiable employee, employer, claims administrator, or
any other person or entity.
   (b) (1) The administrative director, or a statistical agent
designated by the administrative director, may use individually
identifiable information for purposes of creating and maintaining the
workers' compensation information system as specified in Section
138.6.
   (2)  (A)    The State Department of  Public
 Health  Services  may use individually
identifiable information for purposes of establishing and maintaining
a program on occupational health and occupational disease prevention
as specified in Section 105175 of the Health and Safety Code. 
   (B) (i) The State Department of Health Care Services may use
individually identifiable information for purposes of seeking
recovery of Medi-Cal costs incurred by the state for treatment
provided to injured workers that should have been incurred by
employers and insurance carriers pursuant to workers' compensation
law.  
   (ii) The Department of Industrial Relations shall furnish
individually identifiable information to the State Department of
Health Care Services, and the State Department of Health Care
Services shall furnish the information to its designated agent,
provided that the individually identifiable information shall not be
disclosed for use other than the purposes described in clause (i).
The administrative director may adopt regulations governing access to
the individually identifiable information and its uses by the
department and its designated agents. 
   (3) (A) Individually identifiable information may be used by the
Division of Workers' Compensation, the Division of Occupational
Safety and Health, and the Division of Labor Statistics and Research
as necessary to carry out their duties. The administrative director
shall adopt regulations governing the access to the information
described in this subdivision by these divisions. Any regulations
adopted pursuant to this subdivision shall set forth the specific
uses for which this information may be obtained.
   (B) Individually identifiable information maintained in the
workers' compensation information system and the Division of Workers'
Compensation may be used by researchers employed by or under
contract to the Commission on Health and Safety and Workers'
Compensation as necessary to carry out the commission's research. The
administrative director shall adopt regulations governing the access
to the information described in this subdivision by commission
researchers. These regulations shall set forth the specific uses for
which this information may be obtained and include provisions
guaranteeing the confidentiality of individually identifiable
information. Individually identifiable information obtained under
this subdivision shall not be disclosed to commission members. No
individually identifiable information obtained by researchers under
contract to the commission pursuant to this subparagraph may be
disclosed to any other person or entity, public or private, for a use
other than that research project for which the information was
obtained. Within a reasonable period of time after the research for
which the information was obtained has been completed, the data
collected shall be modified in a manner so that the subjects cannot
be identified, directly or through identifiers linked to the
subjects.
   (4) The administrative director shall adopt regulations allowing
reasonable access to individually identifiable information by other
persons or public or private entities for the purpose of bona fide
statistical research. This research shall not divulge individually
identifiable information concerning a particular employee, employer,
claims administrator, or any other person or entity. The regulations
adopted pursuant to this paragraph shall include provisions
guaranteeing the confidentiality of individually identifiable
information. Within a reasonable period of time after the research
for which the information was obtained has been completed, the data
collected shall be modified in a manner so that the subjects cannot
be identified, directly or through identifiers linked to the
subjects.
   (5) This section shall not operate to exempt from disclosure any
information that is considered to be a public record pursuant to the
California Public Records Act (Chapter 3.5 (commencing with Section
6250) of Division 7 of Title 1 of the Government Code) contained in
an individual's file once an application for adjudication has been
filed pursuant to Section 5501.5.
   However, individually identifiable information shall not be
provided to any person or public or private entity who is not a party
to the claim unless that person identifies himself or herself or
that public or private entity identifies itself and states the reason
for making the request. The administrative director may require the
person or public or private entity making the request to produce
information to verify that the name and address of the requester is
valid and correct. If the purpose of the request is related to
preemployment screening, the administrative director shall notify the
person about whom the information is requested that the information
was provided and shall include the following in 12-point type:
   "IT MAY BE A VIOLATION OF FEDERAL AND STATE LAW TO DISCRIMINATE
AGAINST A JOB APPLICANT BECAUSE THE APPLICANT HAS FILED A CLAIM FOR
WORKERS' COMPENSATION BENEFITS."
   Any residence address is confidential and shall not be disclosed
to any person or public or private entity except to a party to the
claim, a law enforcement agency, an office of a district attorney,
any person for a journalistic purpose, or other governmental agency.
   Nothing in this paragraph shall be construed to prohibit the use
of individually identifiable information for purposes of identifying
bona fide lien claimants.
   (c) Except as provided in subdivision (b), individually
identifiable information obtained by the division is privileged and
is not subject to subpoena in a civil proceeding unless, after
reasonable notice to the division and a hearing, a court determines
that the public interest and the intent of this section will not be
jeopardized by disclosure of the information. This section shall not
operate to restrict access to information by any law enforcement
agency or district attorney's office or to limit admissibility of
that information in a criminal proceeding.
   (d) It shall be unlawful for any person who has received
individually identifiable information from the division pursuant to
this section to provide that information to any person who is not
entitled to it under this section. 
   (e) This section shall remain in effect only until January 1,
2017, and as of that date is repealed, unless a later enacted
statute, that is enacted before January 1, 2017, deletes or extends
that date. 
   SEC. 2.    Section 138.7 is added to the  
Labor Code   , to read:  
   138.7.  (a) Except as expressly permitted in subdivision (b), a
person or public or private entity not a party to a claim for workers'
compensation benefits may not obtain individually identifiable
information obtained or maintained by the division on that claim. For
purposes of this section, "individually identifiable information"
means any data concerning an injury or claim that is linked to a
uniquely identifiable employee, employer, claims administrator, or
any other person or entity.
   (b) (1) The administrative director, or a statistical agent
designated by the administrative director, may use individually
identifiable information for purposes of creating and maintaining the
workers' compensation information system as specified in Section
138.6.
   (2) The State Department of Public Health may use individually
identifiable information for purposes of establishing and maintaining
a program on occupational health and occupational disease prevention
as specified in Section 105175 of the Health and Safety Code.
   (3) (A) Individually identifiable information may be used by the
Division of Workers' Compensation, the Division of Occupational
Safety and Health, and the Division of Labor Statistics and Research
as necessary to carry out their duties. The administrative director
shall adopt regulations governing the access to the information
described in this subdivision by these divisions. Any regulations
adopted pursuant to this subdivision shall set forth the specific
uses for which this information may be obtained.
   (B) Individually identifiable information maintained in the
workers' compensation information system and the Division of Workers'
Compensation may be used by researchers employed by or under
contract to the Commission on Health and Safety and Workers'
Compensation as necessary to carry out the commission's research. The
administrative director shall adopt regulations governing the access
to the information described in this subdivision by commission
researchers. These regulations shall set forth the specific uses for
which this information may be obtained and include provisions
guaranteeing the confidentiality of individually identifiable
information. Individually identifiable information obtained under
this subdivision shall not be disclosed to commission members. No
individually identifiable information obtained by researchers under
contract to the commission pursuant to this subparagraph may be
disclosed to any other person or entity, public or private, for a use
other than that research project for which the information was
obtained. Within a reasonable period of time after the research for
which the information was obtained has been completed, the data
collected shall be modified in a manner so that the subjects cannot
be identified, directly or through identifiers linked to the
subjects.
   (4) The administrative director shall adopt regulations allowing
reasonable access to individually identifiable information by other
persons or public or private entities for the purpose of bona fide
statistical research. This research shall not divulge individually
identifiable information concerning a particular employee, employer,
claims administrator, or any other person or entity. The regulations
adopted pursuant to this paragraph shall include provisions
guaranteeing the confidentiality of individually identifiable
information. Within a reasonable period of time after the research
for which the information was obtained has been completed, the data
collected shall be modified in a manner so that the subjects cannot
be identified, directly or through identifiers linked to the
subjects.
   (5) This section shall not operate to exempt from disclosure any
information that is considered to be a public record pursuant to the
California Public Records Act (Chapter 3.5 (commencing with Section
6250) of Division 7 of Title 1 of the Government Code) contained in
an individual's file once an application for adjudication has been
filed pursuant to Section 5501.5.
   However, individually identifiable information shall not be
provided to any person or public or private entity who is not a party
to the claim unless that person identifies himself or herself or
that public or private entity identifies itself and states the reason
for making the request. The administrative director may require the
person or public or private entity making the request to produce
information to verify that the name and address of the requester is
valid and correct. If the purpose of the request is related to
preemployment screening, the administrative director shall notify the
person about whom the information is requested that the information
was provided and shall include the following in 12-point type:
   "IT MAY BE A VIOLATION OF FEDERAL AND STATE LAW TO DISCRIMINATE
AGAINST A JOB APPLICANT BECAUSE THE APPLICANT HAS FILED A CLAIM FOR
WORKERS' COMPENSATION BENEFITS."
   Any residence address is confidential and shall not be disclosed
to any person or public or private entity except to a party to the
claim, a law enforcement agency, an office of a district attorney,
any person for a journalistic purpose, or other governmental agency.
   Nothing in this paragraph shall be construed to prohibit the use
of individually identifiable information for purposes of identifying
bona fide lien claimants.
   (c) Except as provided in subdivision (b), individually
identifiable information obtained by the division is privileged and
is not subject to subpoena in a civil proceeding unless, after
reasonable notice to the division and a hearing, a court determines
that the public interest and the intent of this section will not be
jeopardized by disclosure of the information. This section shall not
operate to restrict access to information by any law enforcement
agency or district attorney's office or to limit admissibility of
that information in a criminal proceeding.
   (d) It shall be unlawful for any person who has received
individually identifiable information from the division pursuant to
this section to provide that information to any person who is not
entitled to it under this section.
   (e) This section shall become operative on January 1, 2017. 
   SEC. 3.    This act is an urgency statute necessary
for the immediate preservation of the public peace, health, or safety
within the meaning of Article IV of the Constitution and shall go
into immediate effect. The facts constituting the necessity are:
 
   In order for state agencies to, at the earliest possible time,
share information that will increase the amount of monetary
recoveries by the state of Medi-Cal costs, it is necessary that this
act take effect immediately.  
  SECTION 1.    Section 674.9 of the Insurance Code
is amended to read:
   674.9.  (a)  Notwithstanding subdivision (b) of Section 674.6, an
insurer issuing policies of liability insurance to long-term health
care facilities, residential care facilities for the elderly, or
physicians who provide or oversee the provision of services to
residents in long-term health care facilities or residential care
facilities for the elderly shall notify the department at least 90
days prior to the date it intends to cease, withdraw, or
substantially withdraw from offering liability policies to those
facilities or physicians.
   (b) Each insurer writing liability insurance for long-term health
care facilities, residential care facilities for the elderly, or
physicians who provide or oversee the provision of services to
residents in long-term health care facilities or residential care
facilities for the elderly shall, by a date to be set by the
commissioner, but not more than once each calendar year, report to
the commissioner information specified by him or her regarding
liability policies for those facilities or physicians. The
information shall include, but not be limited to, the following:
   (1) Whether the insurer is writing coverage for long-term health
care facilities, residential care facilities for the elderly, or
physicians who provide or oversee the provision of services to
residents in long-term health care facilities or residential care
facilities for the elderly, including new and renewal policies, and
the types of policies it is writing.
   (2) The number and types of long-term health care facilities or
residential care facilities for the elderly and beds covered.
   (3) The total amount of premiums from insureds, both written and
earned, during the immediately preceding five calendar years.
   (4) The total number of claims received, including the amount per
claim.
   (5) The number of claims incurred, together with the monetary
amount reserved for loss and defense and cost containment expense for
the immediately preceding accident year or report year.
   (6) The number of claims closed with payment during the
immediately preceding five calendar years, the total monetary amount
paid for loss thereon, reported by the year the claim was incurred,
and the total defense and cost containment expense paid thereon,
reported by the year the claim was incurred.
   (7) The monetary amount paid on claims, including the amount paid
per claim, during the immediately preceding five calendar years to be
reported separately by the year the claim was incurred, with defense
and cost containment expense paid.
   (8) The number of claims closed without payment during the
immediately preceding five calendar years, reported by the year the
claim was incurred, and the defense and cost containment expense paid
thereon.
   (9) The monetary amount reserved in the annual statement for loss
and defense cost containment expense for the immediately preceding
calendar year for outstanding claims incurred but not reported to the
insurer.
   (10) The number and types of lawsuits filed against the insureds
in the immediately preceding calendar year.
   (11) Annualized information on investment income or loss, that
shall be consistent with the reported information provided by
insurers to the National Association of Insurance Commissioners.
   (c) For the purposes of information collection conducted pursuant
to this section, first priority shall be given by the department and
commissioner to collecting and compiling information from insurers
concerning long-term health care facilities and physicians providing
services in those facilities, and, to the extent that departmental
resources allow, secondary priority shall then be given to the
collecting and compiling of information concerning residential care
facilities for the elderly and the physicians who provide services in
those facilities.
   (d) Information that is collected for long-term health care
facilities and the physicians for those facilities shall be
collected, maintained, analyzed, and reported separately from
information that is collected, maintained, analyzed, and reported
concerning residential care facilities for the elderly, and the
physicians for those facilities.
   (e) As used in this section, "long-term health care facility" has
the same meaning as that term is defined in Section 1418 of the
Health and Safety Code.
   (f) As used in this section, "residential care facilities for the
elderly" has the same meaning as that term is defined in Section
1569.2 of the Health and Safety Code.
   (g) Information collected by the department pursuant to this
section shall be deemed official information and subject to the
disclosure protections of Section 1040 of the Evidence Code. Nothing
in this section shall require individualized information that would
identify the amount paid by a specific insurer or facility to be
released. However, nothing in this subdivision shall prevent the
department from preparing reports and policy recommendations based on
the data collected pursuant to this section.  
  SEC. 2.    Section 1874.86 of the Insurance Code
is amended to read:
   1874.86.  Each insurer subject to this article shall report, at
the request of the commissioner, but not more than annually, to the
department on the following:
   (a) The number of vehicles inspected pursuant to Section 1874.85
and the percentage that this number represents of the total number of
vehicles for which it paid a claim for the cost of auto body repairs
in the prior calendar year.
   (b) The results of the inspections, including the nature of any
fraud uncovered, and whether or not legal action was pursued.
   The department shall make the information provided pursuant to
this section available to the California Highway Patrol and the
Bureau of Automotive Repair.  
  SEC. 3.    Section 12962 of the Insurance Code is
amended to read:
   12962.  The commissioner shall report to the Governor, the
Legislature, and to the committees of the Senate and Assembly having
jurisdiction over insurance all of the following in the annual report
submitted pursuant to Section 12922:
   (a) An analysis of the information required by Sections 674.5,
1857.7, 1857.9, 1864, and 12963, including, but not limited to, all
of the following:
   (1) An aggregate and an average for all insurers for each item of
information required by these sections.
   (2) The number of insurers reporting policies written for each
class during the calendar year.
   (3) For each class, the number of insurers reporting a combined
loss ratio of 100 percent or more, and the number reporting a
combined loss ratio of under 100 percent.
   (4) An analysis of adjustments made to loss reserves for prior
years.
   (5) The change in any item required to be included by paragraphs
(1) to (4), inclusive, from the immediately prior year.
   (b) An analysis of the activities of the Department of Insurance
in implementing the provisions of Proposition 103 on the November 8,
1988, general election ballot, as set forth in Article 10 (commencing
with Section 1861.01) of Chapter 9 of Part 2 of Division 1.
   (c) Recommendations and proposals, including suggested
legislation, to protect consumers from arbitrary insurance rates and
practices, to encourage a competitive insurance marketplace, to
provide for an accountable Insurance Commissioner, and to ensure that
insurance is fair, available, and affordable for all Californians.
   (d) The requirements of this section shall be satisfied if the
analysis required by this section is included in the annual report to
the Governor required by Section 12922, and a copy of that report is
provided to the Legislature.