BILL ANALYSIS �
AB 2350
Page 1
ASSEMBLY THIRD READING
AB 2350 (Monning)
As Amended April 11, 2012
Majority vote
HEALTH 13-5 APPROPRIATIONS 12-5
-----------------------------------------------------------------
|Ayes:|Monning, Ammiano, Atkins, |Ayes:|Fuentes, Blumenfield, |
| |Bonilla, Eng, Gordon, | |Bradford, Charles |
| |Hayashi, | |Calderon, Campos, Davis, |
| |Roger Hern�ndez, Bonnie | |Gatto, Ammiano, Hill, |
| |Lowenthal, Mitchell, Pan, | |Lara, Mitchell, Solorio |
| |V. Manuel P�rez, Williams | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Logue, Garrick, Mansoor, |Nays:|Harkey, Donnelly, |
| |Silva, Smyth | |Nielsen, Norby, Wagner |
| | | | |
-----------------------------------------------------------------
SUMMARY : Requires health care service plans (health plans) and
health insurers annually, commencing March 31, 2013, to provide
specified information regarding their plan contracts or policies
to the Department of Managed Health Care (DMHC) or the
California Department of Insurance (CDI), as applicable,
including claims payment policies and practices, periodic
financial disclosures, and data on enrollment and disenrollment,
as specified. Specifically, this bill :
1)Requires health plans and health insurers annually, commencing
March 1, 2013, to provide DMHC, and CDI, respectively, the
following information:
a) Claims payment policies and practices;
b) Periodic financial disclosures;
c) Data on enrollment;
d) Data on disenrollment;
e) Data on the number of claims that are denied;
f) Data on rating practices;
AB 2350
Page 2
g) Information on cost-sharing and payments with respect to
any out-of-network coverage;
h) Information on enrollee rights; and,
i) Enrollee cost sharing transparency.
2)States that the data on enrollment as specified in 1) c) above
must include the number of enrollees as of December 31 of the
prior year, that receive health care coverage under a health
plan contract or a health insurance policy that covers the
following:
a) Individuals;
b) A small group health plan contract or insurance policy,
as specified;
c) A large group health plan contract or insurance policy,
as specified; and,
d) Administrative services only lines.
3)Requires for purposes of the data on enrollment specified in
1) c) above the following:
a) For health plans and health insurers to include the
unduplicated enrollment data in specific product lines as
determined by DMHC and the Commissioner of CDI, as
specified.
b) For DMHC and CDI to do the following: i) determine the
form and manner of the reporting, as specified; ii)
publicly report the data provided, including posting the
data on their Internet Web site; and, iii) consult with
each other to ensure that the data reported is comparable
and consistent.
4)States legislative intent that the reporting requirements for
health plans and health insurers be consistent with the
reporting requirements, including the form and manner, imposed
on qualified health plans pursuant to federal regulations.
FISCAL EFFECT : According to the Assembly Appropriations
AB 2350
Page 3
Committee: 1) One-time costs to DMHC and CDI in the range of
$200,000 (Managed Care Fund and Insurance Fund respectively) to
specify the form and manner of reporting; and, 2) Annual costs
to DMHC and CDI may be minor and absorbable as the bill does not
specify requirements, but the collection of additional data will
create cost pressure to analyze the data, potentially exceeding
$50,000 special fund annually.
COMMENTS : The author is the sponsor of this measure. According
to the author, this bill is a consumer transparency measure that
would codify the reporting requirements for qualified health
plans under the Patient Protection and Affordable Care Act (ACA)
and apply those to all health plans and health insurers that
serve Californians. Disclosure of information such as claim
payment policies and practices, information on cost sharing and
payments for out-of-network coverage would assist consumers in
determining the better health plan or policy for their needs,
and give them a better and broader understanding of their health
coverage. Additionally, this bill would establish a more
consistent and better coordinated data reporting approach to
ensure more precise private health coverage enrollment estimates
for purposes of the ACA in California. Additionally, the
reporting of enrollment data for the specified categories of
health plan contracts or health insurance policies would
establish a more consistent and better coordinated data
reporting approach to ensure more precise private health
coverage enrollment estimates for purposes of the ACA in
California. All of these policy changes will have an impact on
the market which will make it important for California policy
makers to monitor for irregularities and unintended
consequences.
Analysis Prepared by : Rosielyn Pulmano / HEALTH / (916)
319-2097
FN: 0003860