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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