BILL NUMBER: AB 2350	INTRODUCED
	BILL TEXT


INTRODUCED BY   Assembly Member Monning

                        FEBRUARY 24, 2012

   An act to add Section 1348.95 to the Health and Safety Code, and
to add Section 10127.19 to the Insurance Code, relating to health
care coverage.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 2350, as introduced, Monning. Health care coverage.
   Existing law, the Knox-Keene Health Care Service Plan Act of 1975,
provides for the regulation of health care service plans by the
Department of Managed Health Care and makes a willful violation of
the act a crime. Existing law provides for the regulation of health
carriers by the Department of Insurance.
   This bill would require every health care service plan except
those providing coverage for specialized health care services, to
provide the number of enrollees that receive health care coverage
from the service plan as of December 31st of each year, as well as
other specified information, to the Department of Managed Health
Care, in a form and manner specified by the department in
consultation with the Department of Insurance to ensure that the data
reported is comparable and consistent.
   This bill would likewise require a health insurer, except those
providing coverage for specialized health care services, to provide
the number of covered lives as of December 31st of each year, as well
as other specified information, to the Department of Insurance in a
form and manner specified by the department in consultation with the
Department of Managed Health Care.
   Because a willful violation of the bill's provisions relative to
health care service plans would be a crime, the bill would impose a
state-mandated local program.
   The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
   This bill would provide that no reimbursement is required by this
act for a specified reason.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.


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

  SECTION 1.  Section 1348.95 is added to the Health and Safety Code,
to read:
   1348.95.  Commencing March 1, 2013, and at least annually
thereafter, every health care service plan, not including a health
care service plan offering specialized health care service plan
contracts, shall provide to the department, in a form and manner
determined by the department in consultation with the Department of
Insurance, the number of enrollees as of December 31 of the prior
year, that receive health care coverage under a health care service
plan contract that covers individuals, small groups, groups of
51-100, groups of 101 or more, or administrative services only
business lines. Health care service plans shall include the
unduplicated enrollment data in specific product lines as determined
by the department, including, but not limited to, HMO,
point-of-service, PPO, Medicare excluding Medicare supplement,
Medi-Cal managed care, and traditional indemnity non-PPO health
insurance. The department shall publicly report the data provided by
each health care service plan pursuant to this section, including,
but not limited to, posting the data on the department's Internet Web
site. The department shall consult with the Department of Insurance
to ensure that the data reported is comparable and consistent.
  SEC. 2.  Section 10127.19 is added to the Insurance Code, to read:
   10127.19.  Commencing March 1, 2013, and at least annually
thereafter, every health insurer, not including a health insurer
offering specialized health insurance policies, shall provide to the
department, in a form and manner determined by the department in
consultation with the Department of Managed Health Care, the number
of covered lives, as of December 31 of the prior year, that receive
health care coverage under a health insurance policy that covers
individuals, small groups, groups of 51-100, groups of 101 or more,
or administrative services only business lines. Health insurers shall
include the unduplicated enrollment data in specific product lines
as determined by the department, including, but not limited to HMO,
point-of-service, PPO, Medicare excluding Medicare supplement,
Medi-Cal managed care, and traditional indemnity non-PPO health
insurance. The department shall publicly report the data provided by
each health insurer pursuant to this section, including, but not
limited to, posting the data on the department's Internet Web site.
The department shall consult with the Department of Managed Health
Care to ensure that the data reported is comparable and consistent.
  SEC. 3.  No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.