BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1809
                                                                  Page  1

          Date of Hearing:   May 16, 2012

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                    AB 1809 (Monning) - As Amended:  May 1, 2012 

          Policy Committee:                              HealthVote:13-5

          Urgency:     No                   State Mandated Local Program: 
          Yes    Reimbursable:              No

           SUMMARY  

          This bill directs unclaimed rebates, owed to enrollees by health 
          plans and insurers for failure to spend a certain percentage of 
          premium dollars on medical care, to a newly created account that 
          is to be used for health care outreach and enrollment efforts. 
          It also exempts this redirection of rebates from current law 
          governing unclaimed property, and repeals several obsolete 
          reports. Specifically, this bill:
            
          1)Establishes the Health Care Coverage Information, Enrollment, 
            and Eligibility Assistance Account within the California 
            Health Trust Fund for the purposes of distributing funding for 
            health care coverage information, enrollment, and eligibility 
            assistance.  

          2)Permits specified payment methods for rebate payments to 
            individuals, and describes how rebates provided in the form of 
            a premium credit shall be applied. 

          3)Requires a health plan or insurer when required to provide a 
            rebate to a former enrollee, to do the following:

             a)   Make a good faith effort to locate each former enrollee 
               entitled to the rebate. 
             b)   Pay each former enrollee,
             c)   Deposit all rebates due to former individual enrollees a 
               plan or insurer was unable to locate, following a good 
               faith effort, into the Health Care Coverage Information, 
               Enrollment, and Eligibility Assistance Account. 

          4)States that nothing in existing law, as specified, shall be 
            construed to require the rebate funds to be deposited with the 








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            State Controller as unclaimed tangible personal property.

          5)Repeals obsolete reporting requirements related to the Managed 
            Risk Medical Insurance Board, the Department and Drug and 
            Alcohol Programs, the Department of Managed Health Care 
            (DMHC), and the California Department of Insurance (CDI). 

           FISCAL EFFECT  

          1)Minor one-time costs to CDI and DMHC to issue regulations.  
            Ongoing costs from enforcement are unknown, and may be minor 
            and absorbable or significant, depending upon the number of 
            rebates issued and plan/insurer compliance.  

          2)Unknown, potentially significant future revenue loss to the GF 
            associated with the redirection of funds to the Health Care 
            Coverage Information, Enrollment, and Eligibility Assistance 
            Account.  Losses to the GF could exceed $150,000 depending on 
            the number and amount of unclaimed rebates. 

            In absence of this bill, unclaimed rebates would be available 
            to consumers through the Unclaimed Property Program 
            administered by the State Controller's Office (SCO). Unclaimed 
            property value, less the SCO's administrative costs, claims 
            costs, and other expenses, is transferred to the GF monthly by 
            the SCO.  Once property value is transferred to the GF, there 
            are no further restrictions on the use of the funds.  The 
            state would remain liable to pay consumer claims for property 
            that belongs to them, but the program does not "hold" 
            unclaimed property aside.  There is currently no expiration 
            date for unclaimed property claims; under current law the 
            state remains liable in perpetuity for payment.  In the 
            meantime, property value remains in the GF.

            Even given the availability of unclaimed property through the 
            SCO's program, some rebates would still likely remain 
            unclaimed. The state GF would experience a net benefit from 
            the use of that property in absence of this bill. 

          3)The level of funding that may be generated for consumer 
            assistance programs by this bill is unknown.  Revenues 
            generated by this diversion of funds may be very volatile and 
            thus may not be an appropriate funding source for ongoing 
            programs.  In addition, assuming some period of time must 
            elapse before a good faith effort to locate individuals is 








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            complete, funds will likely not be available for expenditure 
            for at least 1-2 years after the enactment of this 
            legislation.  Health consumer assistance programs, including 
            the navigator program, will likely require other sources of 
            one-time and ongoing funding in order to meet consumer demand 
            for information associated with significant changes in the 
            health insurance marketplace going into effect January 1, 
            2014.

           COMMENTS  

           1)Rationale  . According to the author, federal regulations allow 
            the state decide what to do with unclaimed rebates.  
            California will have at least two programs to assist potential 
            enrollees in health care coverage obtain information and 
            enroll in coverage programs:  the navigator program through 
            the California Health Benefit Exchange, and the Office of 
            Patient Advocate.  While it is unknown at this time how much 
            funding may be generated by unclaimed rebates, it is the 
            intent of the author to set aside unclaimed funding after a 
            good faith effort is made to deliver the rebate to the 
            entitled former enrollee, to support consumer assistance 
            programs related to health care coverage.

           2)Two consumer assistance efforts  are expected to help guide 
            potential enrollees into coverage.  The California Health 
            Benefit Exchange will offer health plans to California 
            individuals and small businesses, and also establish a 
            "navigator" program to conduct outreach and facilitate 
            enrollment in plans through the Exchange.  The account created 
            by this bill is placed in the California Health Trust Fund, 
            which, is a continuously appropriated fund created by SB 900 
            (Alquist), Chapter 659, Statues of 2010 and used to fund the 
            operations of the Exchange.

            AB 922 (Monning), Chapter 552, Statutes of 2011 expanded the 
            duties of the Office of the Patient Advocate (OPA) to serve 
            all California consumers, and required the OPA to help 
            individuals secure the health care services to which they are 
            entitled or for which they are eligible under the law.
                
            3)California's Unclaimed Property Law  requires corporations, 
            businesses, associations, financial institutions, and 
            insurance companies to annually report and deliver property to 
            the SCO after there has been no activity on the account or 








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            contact with the owner for a period of time specified in the 
            law-generally three years. This law details a variety of 
            requirements related to the transmittal of unclaimed property 
            to the state, including notifications to consumers, 
            documentation, and time that must elapse without contact 
            before property is turned over to the state.  

            This bill requires but does not define what constitutes a 
            "good faith effort" to locate former enrollees entitled to the 
            rebates. This would have to be defined through regulation by 
            both CDI and DMHC.  The Unclaimed Property Law requires 
            holders of property to attempt to contact owners before 
            reporting their property to the SCO.  The SCO also attempts to 
            contact consumers to make them aware that the state has 
            property they can claim, and provides an internet database 
            where individuals can search for their unclaimed property.  
            The proposed exemption of rebates from current law governing 
            unclaimed property, along with the vague definition about what 
            constitutes a good faith effort to return rebates to the 
            consumer, raises questions about the appropriateness of 
            diverting a consumer's rebate to a continuously appropriated 
            state fund regardless of potential policy merit of the 
            activity being funded. 
                
           
           Analysis Prepared by  :    Lisa Murawski / APPR. / (916) 319-2081