BILL ANALYSIS                                                                                                                                                                                                    �




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair


          SB 1313 (Lieu) - Health care coverage marketing.
          
          Amended: May 2, 2012            Policy Vote: Health 6-3
          Urgency: No                     Mandate: Yes
          Hearing Date: May 14, 2012      Consultant: Brendan McCarthy
          
          This bill meets the criteria for referral to the Suspense File.
          
          
          Bill Summary: SB 1313 would impose a variety of new requirements 
          on health plans and health insurers, relating to their marketing 
          efforts.

          Fiscal Impact: 
              Department of Managed Health Care - startup costs of about 
              $330,000 and ongoing costs of about $130,000 per year 
              (Managed Care Fund) to develop regulations and enforce 
              provisions of the bill.

              Department of Insurance - startup costs of about $680,000 
              and ongoing costs of about $360,000 (Insurance Fund) to 
              develop regulations and enforce provisions of the bill.

          Background: The Department of Managed Health Care regulates 
          health plans in the state. Under existing law, health plans are 
          required to provide marketing materials to the Department of 
          Managed Health Care for a 30 day review period to ensure that 
          the materials are not misleading. Existing law prohibits health 
          plans or their agents from making statements relating to 
          coverage that are deceptive. Existing law requires health plans 
          to make certain documents available in a language other than 
          English if the number of health plan enrollees speaking such a 
          language meets a certain threshold.

          The Department of Insurance regulates health insurers. Existing 
          law prohibits insurers or their agents from misrepresenting the 
          terms of an insurance policy. Existing law requires insurers 
          plans to make certain documents available in a language other 
          than English if the number of policy holders speaking such a 
          language meets a certain threshold.

          The federal Affordable Care Act, amongst many provisions, 








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          requires individuals to maintain health care coverage. Under 
          this law, most health plans or insurance policies will be 
          required to offer a set of essential health benefits, as defined 
          by the states.

          Proposed Law: SB 1313 makes a variety of changes to the statutes 
          governing the marketing practices of both health plans and 
          health insurers. 

          With regard to health plans, the bill would:
              Prohibit health plans or their representatives from making 
              deceptive statements about the requirements of the federal 
              Affordable Care Act.
              Authorize the Department of Managed Health Care to extend 
              its review of marketing materials for up to an additional 30 
              days. (This provision will sunset on December 31, 2019.)
              Prohibit someone whose license to market health plans has 
              been revoked from becoming a Navigator in the California 
              Health Benefit Exchange or becoming licensed for the 
              purposes of marketing insurance.
              Require the Department of Managed Health Care to adopt 
              rules to minimize the duplication of state standards for 
              disclosure of coverage information with forthcoming federal 
              standards.
              After 2014, prohibit specialized health plans from selling 
              individual or group health plans that do not meet essential 
              health benefit requirements, unless the purchaser has 
              demonstrated existing coverage that meets essential health 
              benefit requirements. (This provision does not apply to 
              specialty dental or vision plans.)
              After 2014, prohibit discount health plans from selling 
              services unless the purchaser has demonstrated existing 
              coverage that meets essential health benefit requirements.
              Require specialized health plans and discount health plans 
              to disclose that they do not meet essential health benefit 
              requirements in all marketing materials.
              Require health plans that advertise in languages other than 
              English to translate certain documents relating to the 
              product into those languages. (The state's Medi-Cal and 
              Healthy Families programs are exempt from this requirement.)

          With regard to health insurers, the bill would:
              Prohibit insurers or their representatives from making 
              deceptive statements about the requirements of the federal 








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              Affordable Care Act.
              Prohibit insurers or their representatives from using any 
              advertisement or making any statement that is untrue, 
              misleading, or deceptive.
              Prohibit someone whose license to sell insurance policies 
              has been revoked from becoming a Navigator in the California 
              Health Benefit Exchange or becoming licensed for the 
              purposes of marketing health plans.
              After 2014, prohibit insurers from selling individual or 
              group policies that do not meet essential health benefit 
              requirements, unless the purchaser has demonstrated existing 
              coverage that meets essential health benefit requirements. 
              (This provision does not apply to specialty dental or vision 
              plans.)
              After 2014, prohibit specialized health insurers from 
              selling policies that do not meet essential health benefit 
              requirements, unless the purchaser has demonstrated existing 
              coverage that meets essential health benefit requirements. 
              (This provision does not apply to specialty dental or vision 
              plans.)
              Require insurers to disclose if products do not meet 
              essential health benefit requirements in all marketing 
              materials.
              Require the Department of Insurance to adopt rules to 
              minimize the duplication of state standards for disclosure 
              of coverage information with forthcoming federal standards.
              Require insurers to provide all proposed marketing 
              materials to the Department of Insurance for a 30 day 
              review, to ensure compliance with marketing requirements in 
              law (and this bill). The Department may extend the review 
              period for an additional 90 days. (The authority to extend 
              the review period would sunset on December 31, 2019.)
              Require insurers that advertise in languages other than 
              English to translate certain documents relating to the 
              product into those languages. (The state's Medi-Cal and 
              Healthy Families programs are exempt from this requirement.)

          Related Legislation: 
              AB 1761 (John A. Perez) would make holding oneself out as 
              representing the California Health Benefit Exchange without 
              a valid agreement unfair competition. That bill is on the 
              Assembly Floor.

              SB 951 (Hernandez) designates the Kaiser Small Group HMO as 








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              the state's Essential Health Benefits benchmark plan. That 
              bill is in the Assembly.

              SB 1453 (Monning) 2011 is identical to SB 951. That bill is 
              on the Assembly Floor.


              SB 961 (Hernandez) makes a variety of changes to the 
              state's individual health plan market, pursuant to the 
              Affordable Care Act. That bill is on this Committee's 
              Suspense File.

              AB 1461 (Monning) is identical to SB 961. That bill is on 
              the Assembly Appropriations Committee's Suspense File.


          Staff Comments: The only local mandates imposed by the bill 
          relate to misdemeanor penalties and are not reimbursable by the 
          state under the California Constitution.