BILL NUMBER: AB 2084 AMENDED
BILL TEXT
AMENDED IN SENATE JULY 5, 2012
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 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,
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.
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 file ,
prior to issuance, any new language in that policy to
with 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 , and would
authorize the commissioner to withdraw the issuance of a letter order
in accordance with a prescribed process .
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 , or 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 that
insure more than one person, except to the extent each
such that the type of insurance may
be exempted from compliance with particular portions of this chapter
by the provisions of this chapter relating to each such
that type of insurance.
Such
The types of insurance which
that insure more than one person and which
that 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 (a) of Section 10270.2.
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 ,
by certificate or otherwise, although a statement of the
coverage provided may be given, or required by the policy to be given
, to eligible persons eligible)
. The permitted types of blanket insurance are those where
the blanket policy is issued to any of the following:
(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.
(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 an
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.
(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- or
camp-sponsored activities or while being transported to, from, or
between those places.
(4) (A) 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 the publication , 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 the benefit to be payable to
such the independent contractors or to
their parents, guardians, or other persons responsible for their
support.
When
(B) 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.
(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 , the policyholder.
(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 the policy 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.
(7) An employer, who shall be deemed the policyholder, providing
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.
(8) Any common carrier or any operator, owner, or lessor of a
means of transportation, who shall be deemed the policyholder,
providing benefits to any group of persons who may become lessees or
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.
(9) An entertainment production company, who shall be deemed the
policyholder, providing benefits to any group of participants,
volunteers, audience members, contestants, 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.
(b) A "blanket policy" is any disability policy of the nature
herein described sold to any of the entities described in paragraphs
(1) to (9), inclusive, of subdivision (a) and providing
that provides coverage for any group of persons
within permitted categories defined in the policy. Policies referred
to in paragraph (6) of subdivision (a) shall comply with the
provisions of this section specifically referring thereto. Policies
referred to in 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
the individual, such the
policy shall provide the described insurance for all who fall within
the categories of covered individuals defined in the policy.
Such The 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.
(c) No policies A policy described
in paragraphs (1) to (5), inclusive, or (7) to (9), inclusive, of
subdivision (a) shall not 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 the
policies , as that are necessary or
desirable to preserve, insofar as applicable, standards as
respects of substance, form, and issuance
comparable to the standards in such respects
prescribed by this chapter and that are
applicable to other types of disability policies, and to further the
purpose or purposes for which such
the policies are to be
issued.
(d) No policies A policy described
in paragraph (6) of subdivision (a) shall not 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 the policies
, as that do not affect the substance
of the coverage, and as that are
necessary or desirable to preserve, insofar as applicable, standards
as respects of form and issuance
comparable to the standards in such respects
prescribed by this chapter and that are
applicable to other types of disability policies, and to further the
purpose or purposes for which such
the policies are to be
issued. Notwithstanding the provisions of Section 10113,
such policies the policy 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 A policy described
in this section shall not constitute workers' compensation
insurance, as defined in Section 109. No policies
A policy described in paragraphs (3),(5), (7), (8), or
(9) of subdivision (a) shall not 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 file
that new language to with 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 the 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. 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 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) (1) 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.
(2) The commissioner may withdraw a letter order issued pursuant
to this section in the manner described in subdivision (f) of Section
10291.5. A proceeding under this subdivision shall not be subject to
Chapter 5 (commencing with Section 11500) 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) A blanket disability policy of
a type permitted under paragraph (2) or (5) of subdivision (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
(b) The essential features of any
policy under 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 that policy. All
disclosures shall state whether or not the benefits payable under the
blanket insurance policy are subject to reduction, to the extent
provided in 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
(c) The disclosure material shall
be submitted to the commissioner for review along
with the blanket insurance policy.