BILL ANALYSIS                                                                                                                                                                                                    �



                                                                      



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          |SENATE RULES COMMITTEE            |                   SB 615|
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                                 THIRD READING


          Bill No:  SB 615
          Author:   Calderon (D)
          Amended:  5/10/11
          Vote:     21

           
           SENATE INSURANCE COMMITTEE  :  8-0, 4/27/11
          AYES:  Calderon, Gaines, Anderson, Corbett, Lieu, 
            Lowenthal, Price, Wyland
          NO VOTE RECORDED:  Correa

           SENATE HEALTH COMMITTEE  :  9-0, 5/4/11
          AYES:  Hernandez, Strickland, Alquist, Anderson, Blakeslee, 
            De Le�n, DeSaulnier, Rubio, Wolk

           SENATE APPROPRIATIONS COMMITTEE  :  9-0, 5/26/11
          AYES:  Kehoe, Walters, Alquist, Emmerson, Lieu, Pavley, 
            Price, Runner, Steinberg


           SUBJECT  :    Health care service plans:  accident and health 
          agents

           SOURCE  :     California Association of Health Underwriters 
                      Insurance Brokers and Agents of the West 
                      National Association of Insurance and Financial 
                       Advisors-        California


           DIGEST  :    This bill requires, on and after January 1, 
          2013, solicitors and solicitor firms, and principal persons 
          engaged in the supervision of solicitation for health care 
          service plan contracts to complete specified training, and 
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          requires the Insurance Commissioner's (Commissioner) 
          curriculum board to make recommendations to the 
          Commissioner to instruct accident and health agents about 
          the requirements imposed by the federal 
          Patient Protection and Affordable Care Act.

           ANALYSIS  :    Existing federal law, the Patient Protection 
          and Affordable Care Act (PPACA), (Public Law 111-148), 
          among other things, requires each state, by January 1, 2014 
          to establish an American Health Benefit Exchange (Exchange) 
          that makes qualified health insurance products available to 
          qualified individuals and qualified employers.  If a state 
          does not establish an exchange, the federal government 
          administers the exchange.

          Existing federal law:

          1. Requires, pursuant to PPACA, that state exchanges 
             establish a navigator program that will help people who 
             are eligible to purchase coverage through the Exchange 
             learn about their new coverage options and enroll. 

          2. Requires any entity that serves as a navigator to meet 
             specific duties, including:

             A.    Conducting public education activities to raise 
                awareness of the availability of qualified health 
                plans (QHPs);

             B.    Distributing fair and impartial information 
                concerning enrollment in QHPs, and the availability 
                of premium tax credits and cost-sharing reductions;

             C.    Facilitating enrollment in QHPs;

             D.    Providing referrals to any applicable health 
                insurance consumer assistance or health insurance 
                ombudsman office, as specified, or any other 
                appropriate state agency or agencies; and

             E.    Providing information in a manner that is 
                culturally and linguistically appropriate to the 
                needs of the population being served by the exchange.


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          Existing state law:

          1. Provides for the licensure and regulation of health care 
             service plans by the Department of Managed Health Care 
             (DMHC).  A willful violation of the act is a crime.  The 
             chief officer of the department is the Director of the 
             DMHC (Director). 

          2. Authorizes the Director to require that solicitors and 
             solicitor firms, and principal persons engaged in the 
             supervision of solicitation for plans of solicitor 
             firms, meet specified standards.

          3. Requires accident and health agent licensees to be 
             licensed by the Commissioner, subject to prelicensure 
             standards and continuing education requirements 
             developed by the curriculum board that consists of 
             insurance industry representatives and consumer groups. 

          4. Existing law authorizes the Commissioner to enforce 
             those provisions.

          This bill:

          1. Requires, on and after January 1, 2013, solicitors and 
             solicitor firms, and principal persons engaged in the 
             supervision of solicitation  for health care service 
             plan contracts, which are regulated by the DMHC to 
             complete specified training, including:

             A.    Knowledge of the Knox-Keene Act and any 
                regulations implemented under it;

             B.    Knowledge of the PPAAC (Public Law 111-148), as 
                amended by the Health Care Education and 
                Reconciliation Act of 2010 (Public Law 111-152), 
                (ACA) and any related federal regulations, rules, or 
                guidance;

             C.    Knowledge of all public coverage programs and the 
                California Health Benefit Exchange (CHBE);

             D.    Ethics training, as specified.


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          2. Requires the solicitor training described above to be at 
             least as extensive as the training for an accident and 
             health agent as required by the California Department of 
             Insurance (CDI).

          3. Provides navigators related to the CHBE and the current 
             operations of the Healthy Families Program, Access for 
             Infants and Mothers Program, the Medi-Cal Program, and 
             the CHBE would all be exempted from these provisions.

          4. Requires CDI's curriculum board, in 2012, to make 
             recommendations to the Commissioner to instruct accident 
             and health agents during prelicensing and continuing 
             education about the requirements of the ACA, public 
             coverage programs, and the CHBE. 

          5. Requires providers of the curriculum to submit its 
             course curriculum to CDI for approval.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   
          Local:  Yes

          According to the Senate Appropriations Committee:

                          Fiscal Impact (in thousands)

           Major Provisions      2011-12     2012-13     2013-14       Fund  

          DMHC regulations and          Likely in the hundreds of 
          thousands from      Special*
          curriculum development        January 1, 2012 to January 1, 
          2013

          Ongoing DMHC        Unknown, likely in the hundreds of 
          Special*
          monitoring          thousands to low millions of dollars
                              
          *Managed Care Fund

           SUPPORT  :   (Verified  5/27/11)

          California Association of Health Underwriters (co-source)
          Insurance Brokers and Agents of the West (co-source)
          National Association of Insurance and Financial Advisors-

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             California (co-source)
          Health Access California

           OPPOSITION  :    (Verified  5/27/11)

          American Federation of State, County and Municipal 
          Employees
          California Pan-Ethnic Health Network
          Community Health Councils, Inc.
          Congress of California Seniors

          JJA:kc  5/27/11   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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