None by Governor Arnold Schwarzenegger

Vote Smart's Synopsis:

Vote to pass a bill mandating health insurers to explain denials of coverage and the charging of rates higher than the standard ones.

Highlights:

• Requires any health care service plan that declines to offer coverage or denies enrollment for an individual or his or her dependents or a group applying for coverage or that offers coverage at a rate that is higher than the standard rate to provide the applicant with the specific reasons for the decision in writing, in clear, easily understandable language (Sec. 1).

• Requires notice of a change to the premium rate of coverage to be provided at least 180 days prior to the effective date of the change (Sec. 1).

• Requires any health care service plan having rejected an individual application for coverage to inform the applicant about the state's high-risk health insurance pool, the California Major Risk Medical Insurance Program (Sec. 1).

• Requires a health care service plan that declines to offer coverage to or denies enrollment of any applicant to quarterly provide to the department, the Managed Risk Medical Insurance Board and the public all of the following (Sec 2):
• The number and proportion of applicants for coverage that were denied coverage for each product offered by the plan;
• The health status and risk factors for each applicant denied coverage, by product;
• Demographic information about applicants denied coverage, including age, gender, language spoken, occupation, and geographic region of the applicant; and
• The written policies, procedures, or underwriting guidelines whereby the plan makes its decision to provide or to deny coverage to applicants.

• Requires any health care service plan that issues, renews or amends health plan contracts to inform the Department of Managed Health Care and the Department of Insurance about it (Sec. 3).

• Requires health care service plans to annually disclose certain information relating to rate increases for each product (Sec. 4).

Full Bill Text