BILL ANALYSIS                                                                                                                                                                                                    �




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair


          AB 2350 (Monning) - Health care coverage.
          
          Amended: June 25, 2012          Policy Vote: Health 6-3
          Urgency: No                     Mandate: Yes
          Hearing Date: August 16, 2012                          
          Consultant: Brendan McCarthy    
          
          SUSPENSE FILE.
          
          
          Bill Summary:  AB 2350 would require health plans and health 
          insurers to provide specified information annually to the 
          Department of Managed Health Care or the Department of 
          Insurance, respectively.

          Fiscal Impact: 
              One-time costs up to $300,000 to adopt regulations for 
              reporting of data (Managed Care Fund and Insurance Fund).

              Minor ongoing costs to review data and make data available 
              to the public (Managed Care Fund and Insurance Fund).

          Background:  Under current state law, health plans are regulated 
          by the Department of Managed Health Care while health insurers 
          are regulated by the Department of Insurance.

          Under regulations adopted pursuant to the federal Affordable 
          Care Act, all health plans will be required to provide a summary 
          of coverage for all enrollees and applicants. Health plans that 
          intend to sell coverage through a Health Benefit Exchange are 
          required to report information on claims payment policies, data 
          on enrollment, financial data, data on claims denials, 
          information on rating practices and cost sharing, and other 
          information.

          Proposed Law:  AB 2350 would require both health plans and 
          health insurers to report specified information, following the 
          requirement in federal regulations, to their respective 
          regulators. Specifically, the bill would require health plans 
          and insurers to providing information on:
              Claims payment policies and practices.
              Financial information.








          AB 2350 (Monning)
          Page 1


              Data on enrollment and disenrollment.
              Data on claims denials.
              Rating policies.
              Cost sharing.
              Enrollee rights.

          The bill would require the Department of Managed Health Care and 
          the Department of Insurance to make the reported data available 
          to the public.

          The bill specifies that the reporting requirement dates are the 
          same as those required under federal law and that all terms in 
          the bill have the same meaning as terms in federal law.

          Related Legislation: 

              SB 1163 (Leno) Chapter 661 of 2010 requires health plans 
              and insurers to report to the Department of Managed Health 
              Care and the Department of Insurance information on rates at 
              least 60 days before implementing a rate change.

              AB 2152 (Eng) would require health insurers to disclose 
              certain information to enrollees when a contract with a 
              hospital or provider is terminated, similar to what is 
              required of health plans. That bill will be heard in this 
              committee.

          Staff Comments:  No reimbursement is required under the bill, 
          because the only mandated activities on local governments relate 
          to criminal penalties, which are not reimbursable under the 
          state constitution.