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Key Votes

AB 52 - Regulating Health Care Coverage - Key Vote

California Key Votes

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Legislation - Referred to Committee (Senate) -
Legislation - Bill Passed (House) (45-28) - (Key vote)

Title: Regulating Health Care Coverage

Vote Smart's Synopsis:

Vote to pass a bill that authorizes state insurance regulators to approve, deny, or modify any proposed rate or rate change by a health insurance provider, beginning January 1, 2012.

Highlights:

-Requires health insurers that issue individual or group contracts to file an application of any proposed rate or rate change at least 60 days before the change with the Department of Managed Care or the Department of Insurance (Sec. 2).

-Authorizes the Department of Managed Care or the Department of Insurance to approve, deny, or modify any proposed rate or rate change (Sec. 2).

-Prohibits health insurers from implementing a rate for a new product or changing the rate it charges to its subscribers, unless it submits an application to the Department of Insurance and the application is approved by the department (Sec. 2).

-Prohibits the Department of Managed Care or the Department of Insurance from approving a rate or rate change that is found to be "excessive, inadequate, or unfairly discriminatory" (Sec. 2).

-Requires health insurers to include in applications for rate changes information including, but not limited to, the following (Sec. 2):
    -The highest and lowest rate change initially requested;
    -Highest and lowest rate of change;
    -Assessment of the impact of the rate change if it were approved, including profitability, dividends, investment income, overhead loss ratio, reserves and surpluses;
    -Salaries and bonuses paid to the 10 highest-paid officers or employees of the applicant;
    -A report of all medical and non-medical expenses for the fiscal year;
    -A comparison of claims cost and rate changes over time;
    -Public comments received pertaining to the information;
    -Affordability of the plan or products subject to rate change; and
    -Any information required by the Patient Protection and Affordable Care Act.

-Requires all information submitted in an application for a rate change to be made public and posted on the Department of Insurance's web site and the department shall post on its web site whether it approved, denied, or modified a proposed rate change (Sec. 2).

-Authorizes the departments to order any insurance plan that violates these provisions to pay a civil penalty of up to $50,000 or, in the case of a willful violation, up to $100,000 (Sec. 2).

-Authorizes the Department of Managed Care or the Department of Insurance to charge a fee to health insurers for the costs related to filing and reviewing the application (Sec. 2).

-Authorizes the Department of Managed Care or the Department of Insurance to review any rate or rate change that went into effect between January 1, 2011 and January 1, 2012, and order refunds if necessary (Sec. 4).

Legislation - Introduced (House) -

Title: Regulating Health Care Coverage

Sponsors

  • Mike Feuer (CA - D) (Out Of Office)
  • Jared William Huffman (CA - D) (Out Of Office)

Co-sponsors

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