BILL NUMBER: AB 2084 AMENDED
BILL TEXT
AMENDED IN SENATE JUNE 21, 2012
AMENDED IN ASSEMBLY MAY 25, 2012
AMENDED IN ASSEMBLY MAY 3, 2012
AMENDED IN ASSEMBLY APRIL 12, 2012
INTRODUCED BY Assembly Member Solorio
FEBRUARY 23, 2012
An act to amend Section Sections 10270,
10270.2 , and 10270.3 of, and to add Section
10270.2.5 to, the Insurance Code, relating to insurance.
LEGISLATIVE COUNSEL'S DIGEST
AB 2084, as amended, Solorio. Blanket insurance.
Existing law provides that blanket insurance is that form of
insurance providing coverage for specified circumstances and insuring
by describing all persons within a class of persons defined in a
policy issued to a master policyholder, and not by specifically
naming the persons covered. Under existing law, the permitted types
of blanket insurance are those where the blanket policy is issued to
specified entities, including, but not limited to, a volunteer fire
company providing benefits to members only in the event of accident
incurred while performing actions incident to such membership and a
proprietor or sponsor of an organized camping institution providing
benefits to campers or persons responsible for their support for
death or dismemberment resulting from accident, or for hospital,
medical, surgical, or nursing expenses resulting from accident or
sickness related to the camper's specified connection with the
camping institution.
This bill would revise and recast those above entities to instead
include (1) a volunteer or governmental fire department, emergency
medical services company, or similar volunteer or governmental
organization providing benefits to members or participants only in
the event of accident incurred while performing actions incident to
an activity or operation sponsored or supervised by the department,
company, or organization and (2) a sports team or camp, as specified,
providing benefits to participants, campers, and other specified
persons responsible for their support for death or dismemberment
resulting from accident, or for hospital, medical, surgical, or
nursing expenses resulting from specified accident or sickness
related to the participants, campers, or other specified person's
connection with the sports team or camp, as specified.
This bill would additionally specify other permitted types of
blanket insurance , providing specified benefits, issued
to specified entities that include, but are not limited to, (1) an
employer providing accident benefits to any group of workers,
dependents, or guests, limited by reference to specified hazards
incident to activities or operations of the employer, (2) any common
carrier or any operator, owner, or lessor of a means of
transportation providing accident benefits to any specified group of
persons who may become lessees or passengers limited by reference to
travel status, and (3) an entertainment production company providing
accident benefits to any group of participants, volunteers, audience
members, contestants, employees, or independent contractors
or workers while engaged in any activity or
operation of the entertainment production company. The bill would
authorize the person insured, when the premium is paid for these
types of blanket insurance, to request a copy of the policy from the
insurer. The bill would define the term "accident benefits"
for purposes of these provisions.
Existing law prohibits a person from transacting any class of
insurance business in this state without first being an admitted
insurer. Under existing law, admission is secured by procuring a
certificate of authority from the Insurance Commissioner. Existing
law authorizes the above-described blanket policies, among others, to
provide that the cost of the insurance coverage is required to be
paid by either the policyholder, or the individuals insured or their
parents or guardians, payable through the policyholder. Existing law
prohibits a blanket policy from being issued until approved as to
substance and form by the commissioner.
This bill would extend these provisions to the newly established
permitted types of blanket insurance described above. The bill
would require an insurer who intends to issue a policy according to
these revised provisions to submit, prior to issuance, any new
language in that policy to the commissioner for approval.
The bill would also authorize the commissioner to add to the
list of entities that may be eligible to purchase blanket insurance
for any risk or class of risks, relating to accident benefits, as
defined, which may be properly eligible for blanket insurance.
The bill would require the commissioner to issue
and post on the commission's Internet Web site a letter
order, as specified, each time the commissioner exercises his or her
discretion to add an entity to the list of entities eligible to
purchase blanket insurance.
The bill would make additional conforming, nonsubstantive
changes.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 10270 of the
Insurance Code is amended to read:
10270. (a) This chapter shall not apply to workmen's compensation
insurance nor any policy of liability insurance with or without
supplementary coverage therein, nor any policy or contract of
reinsurance.
(b) This chapter shall apply to selected group disability
insurance as defined in Section 10270.97, except insofar as it is
exempted from Section 10401.
(c) This chapter shall apply to each of the types of insurance
enumerated in this subdivision which insure more than one person,
except to the extent each such type may be exempted from compliance
with particular portions of this chapter by the provisions of this
chapter relating to each such type of insurance.
Such types of insurance which insure more than one person and
which are hereby exempted from subdivision (c) of Section 10310,
subdivision (c) of Section 10320 (but family expense disability
insurance only to the extent therein provided), and Section 10401
(but only to the extent in this chapter provided) are:
(1) Blanket insurance, as defined in subdivision (a) of
Section 10270.2.
(2) Tuition refund insurance, as defined in Section 10270.1.
(3) Group disability insurance, as defined in Sections 10270.5,
10270.505, and 10270.57.
(4) Family expense disability insurance, as defined in Section
10270.7.
(5) Unemployment compensation disability insurance as defined in
paragraph (6) of subdivision (f)
(a) of Section 10270.2.
SECTION 1. SEC. 2. Section 10270.2
of the Insurance Code is amended to read:
10270.2. (a) Blanket insurance is that form
of insurance providing coverage for specified circumstances and
insuring by description all or nearly all persons within a class of
persons defined in a policy issued to a master policyholder, and not
by specifically naming the persons covered (by certificate or
otherwise, although a statement of the coverage provided may be
given, or required by the policy to be given to persons eligible).
The permitted types of blanket insurance are those where the blanket
policy is issued to any of the following:
(a)
(1) A volunteer or governmental fire department,
emergency medical services company, or similar volunteer or
governmental organization providing benefits to members or
participants only in the event of accident incurred while performing
actions incident to an activity or operation sponsored or supervised
by the department, company, or organization.
(b)
(2) A college, school, or other institution of
learning, a school district or districts or school jurisdictional
unit, or to the head, principal, or governing board of any such
educational unit who or which shall be deemed the policyholder;
providing benefits to students without necessarily any restriction as
to activity, time, or place, or to teachers or employees while
performing actions incident to special duties, such as at camps, at
summer playgrounds, or during tours or excursions; and providing
benefits to such students, teachers, or employees, and spouses and
dependents of such students, teachers, and employees, for death or
dismemberment resulting from accident or for hospital, medical,
surgical, drug, or nursing expenses resulting from accident or
sickness.
(c)
(3) A sports team, camp, or sponsor, or proprietor
thereof, who shall be deemed the policyholder, providing benefits to
sports team participants, campers, employees, officials, supervisors,
or persons responsible for their support for death or dismemberment
resulting from accident, or for hospital, medical, surgical, or
nursing expenses resulting from accident to those participants,
campers, employees, officials, supervisors, or persons responsible
for their support, or arising out of sickness of those participants,
campers, employees, officials, supervisors, or persons responsible
for their support, provided the accident or the first manifestation
of such sickness occurs while those participants, campers, employees,
officials, supervisors, or persons responsible for their support are
in or on the buildings or premises of the sports team or camp, or
being transported between their homes and the sports team or camp, or
while at any other place as an incident to sports
team-sponsored team - or
camp-sponsored activities or while being transported to, from, or
between those places.
(d)
(4) A newspaper, farm paper, magazine, or other
periodical publication, which shall be deemed the policyholder,
providing benefits for independent contractors, such as carriers,
newsboys, dealers, distributors, wholesalers, or others engaged in
the sale, distribution, collecting for, or other activities
pertaining to the marketing and delivery of such publications,
including attendance at a coaching school or participation as a
member of a trip organized, supervised, and sponsored as a reward for
meritorious service, on account of loss resulting from accident or
sickness, such benefit to be payable to such independent contractors
or to their parents, guardians, or other persons responsible for
their support.
When the premium for the insurance is paid by the person insured,
he or she may, upon request, obtain from the insurer in certificate
form a copy of the policy.
(e)
(5) Any religious, charitable, recreational,
educational, athletic or civic organization, or branch thereof, which
shall be deemed the policyholder, providing benefits to any group of
members, employees, or participants for death or dismemberment or
for hospital, medical, surgical, or nursing expenses all resulting
from accident incurred incident to specific hazards pertaining to any
activity or activities or operations sponsored or supervised by or
on the premises of such policyholder.
(f)
(6) An employer, a majority of the employees in this
state of an employer, or both, upon application, to pay the benefits
afforded by a voluntary plan of unemployment compensation disability
insurance. Notwithstanding the provisions of Section 10113, such
policies may incorporate by reference any of the appropriate
provisions of Part 2 (commencing with Section 2601) of Division 1 of
the Unemployment Insurance Code and the authorized regulations of the
Director of Employment Development.
(g)
(7) An employer, who shall be deemed the policyholder,
providing accident benefits to any group of
workers, dependents, or guests, limited by reference to specified
hazards incident to activities or operations of the policyholder
, for death or dismemberment, or for hospital, medical, surgical, or
nursing expenses, resulting from accident . When the premium
for the insurance is paid by the person insured, he or she may, upon
request, obtain from the insurer in certificate form a copy of the
policy.
(h)
(8) Any common carrier or any operator, owner, or
lessor of a means of transportation, who shall be deemed the
policyholder, providing accident benefits to any
group of persons who may become lessees or passengers
passengers, limited by reference to their travel
status on that common carrier or that means of transportation ,
for death or dismemberment, or for hospital, medical, surgical, or
nursing expenses, resulting from accident . When the premium
for the insurance is paid by the person insured, he or she may, upon
request, obtain from the insurer in certificate form a copy of the
policy.
(i)
(9) An entertainment production company, who shall be
deemed the policyholder, providing accident
benefits to any group of participants, volunteers, audience members,
contestants, employees, or independent contractors
or workers for death or dismemberment, or for
hospital, medical, surgical, or nursing expenses, resulting from
accident while engaged in any activity or operation of the
policyholder. When the premium for the insurance is paid by the
person insured, he or she may, upon request, obtain from the insurer
in certificate form a copy of the policy.
A
(b) A "blanket policy" is any
disability policy of the nature herein described sold to any of the
entities described in subdivision (a), (b), (c), (d), (e),
(f), (g), (h), or (i), paragraphs (1) to (9),
inclusive, of this section subdivision
(a) and providing coverage for any group of persons within
permitted categories defined in the policy. Policies referred to in
subdivision (f) paragraph (6) of subdivision
(a) shall comply with the provisions of this section
specifically referring thereto. Policies referred to in
subdivision (a), (b), (c), (d), (e), (g), (h), or (i),
paragraphs (1) to (5), inclusive, or (7) to (9), inclusive, of
subdivision (a) may provide that the cost of the insurance
coverage shall be borne by either the policyholder, or the
individuals insured or their parents or guardians, payable through
the policyholder. In the absence of a policy provision excluding
coverage for otherwise covered individuals who have not individually
enrolled with the policyholder and undertaken to pay all or a
specified portion of the premium allocable to such individual, such
policy shall provide the described insurance for all who fall within
the categories of covered individuals defined in the policy. Such
policy may, but is not required to, contain provisions requiring a
minimum number of participating persons or a minimum percentage of
participation before the policy is effective. In the absence of such
a provision, coverage shall not be denied any individual otherwise
eligible on those grounds.
No
(c) No policies described in
subdivision (a), (b), (c), (d), (e), (g), (h), or (i), of
this section paragraphs (1) to (5), inclusive, or (7)
to (9), inclusive, of subdivision (a) shall be issued until
approved as to substance and form by the commissioner. The
commissioner may, after notice and hearing, promulgate such
reasonable rules and regulations, relating to the substance, form,
and issuance of such policies, as are necessary or desirable to
preserve, insofar as applicable, standards as respects substance,
form, and issuance comparable to the standards in such respects
prescribed by this chapter and applicable to other types of
disability policies, and to further the purpose or purposes for which
such policies are to be issued.
No
(d) No policies described in
subdivision (f) paragraph (6) of subdivision
(a) shall be issued until approved as to form by the
commissioner. The commissioner may, after notice and hearing,
promulgate such reasonable rules and regulations, relating to the
form and issuance of such policies, as do not affect the substance of
the coverage, and as are necessary or desirable to preserve, insofar
as applicable, standards as respects form and issuance comparable to
the standards in such respects prescribed by this chapter and
applicable to other types of disability policies, and to further the
purpose or purposes for which such policies are to be issued.
Notwithstanding the provisions of Section 10113, such policies may
incorporate by reference any of the appropriate provisions of Part 2
(commencing with Section 2601) of Division 1 of the Unemployment
Insurance Code and the authorized regulations of the Director of
Employment Development.
(e) No policies described in this section shall constitute workers'
compensation insurance, as defined in Section 109. No policies
described in paragraphs (3),(5), (7), (8), or (9) of subdivision (a)
shall be marketed or sold as a substitute for health insurance
coverage compliant with the requirements of the federal Patient
Protection and Affordable Care Act (Public Law 111-148), as amended
by the Health Care and Education Reconciliation Act of 2010 (Public
Law 111-152).
(f) (1) An insurer that intends to issue a policy of blanket
insurance authorized by the amendments to this section pursuant to
the act adding this subdivision, or authorized pursuant to section
10270.2.5, using a policy form previously approved by the
commissioner, where the only new language in the policy is the
specification of the policyholder, covered persons, or the hazards or
activities insured, shall submit that new language to the
commissioner prior to issuance of the policy. Submissions of
documents containing variable text or blanks shall include complete
lists of the variable wording or accurate descriptions of the
material to be inserted in lieu of the variable wording or in the
blanks of these documents.
(2) A policy using the new language shall not be issued until
either 30 days expires without notice from the commissioner after the
new language is filed, or the commissioner gives his or her written
approval prior to that time. If the commissioner at any time notifies
the insurer, in writing and specifying the reasons for his or her
opinion, that the filed new language does not comply with the
requirements of law, an insurer shall not issue any policy containing
that language.
(3) Nothing in this subdivision shall be construed to provide
separate authority for the commissioner to reopen review of
previously approved policy forms.
SEC. 2. SEC. 3. Section 10270.2.5 is
added to the Insurance Code, to read:
10270.2.5. (a) In addition to the permitted types of blanket
insurance issued to entities described in Section 10270.2, the
commissioner may, in his or her discretion, add other entities that
may be eligible to purchase blanket insurance for any class of risks
relating to accident benefits for
death or dismemberment, or for hospital, medical, surgical, or
nursing expenses, resulting from accident which may be properly
eligible for blanket insurance.
(b) For purposes of this section and Section 10270.2, the term
"accident benefits" means those benefits that are payable as a result
of an unintended and unexpected occurrence that produces loss,
damage, or injury.
(b) The commissioner may issue a letter order, and shall post the
letter order on the Internet Web site of the Department of Insurance,
any time he or she exercises discretion pursuant to subdivision (a)
to add other entities that may be eligible to purchase blanket
insurance. These letter orders shall not be subject to Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code.
SEC. 4. Section 10270.3 of the
Insurance Code is amended to read:
10270.3. A blanket disability policy of a type permitted under
paragraph (2) or (5) of subdivision (b) or (e)
(a) of Section 10270.2 may include either a
coordination of benefits policy provision or a nonduplication of
benefits policy provision, at the option of the policyholder.
The essential features of any such plan
policy under subdivision (b) or (e)
paragraph (2) or (5) of subdivision (a) of Section 10270.2
shall be disclosed to the insured, or the parent or legal guardian of
the insured, prior to enrollment in any such plan
that policy . All such disclosures
shall state whether or not the benefits payable under such
the blanket insurance policy are subject to
reduction, to the extent provided in such the
policy, if an individual insured thereunder is entitled to
benefits, whether on an indemnity basis or on a provision-of-service
basis, for hospital, medical, dental, or surgical expenses under any
other valid and collectible individual, group, or blanket insurance
policy or contract, hospital or medical service program, or
group-practice prepayment plan, except for automobile medical
payments insurance.
The disclosure material shall be submitted to the commissioner for
review along with the blanket insurance policy.