Nancy Skinner
- Democratic
- Senator
- District 9
Author
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Existing law requires a health care service plan or health insurer to comply with specified minimum medical loss ratios and requires a plan or insurer to provide an annual rebate to enrollees and insureds if the ratio of the amount of premium revenue expended by the plan or insurer on specified costs to the total amount of premium revenue is less than a certain percentage. Existing law specifies that these requirements do not apply to specialized health care service plan contracts or specialized health insurance policies. This bill would require health care services plans that issue, sell, renew, or offer specialized dental health care service plan contracts and health insurers that issue, sell, renew, or offer specialized dental health insurance policies to, no later than September 30, 2015, and each year thereafter, file a report, to be known as the MLR annual report, with the departments that contains the same information required in the 2013 federal Medical Loss Ratio (MLR) Annual Reporting Form. The bill would require the Department of Managed Health Care or the Department of Insurance, as applicable and, if a financial examination is determined to be necessary to verify the representations in the MLR annual report, to provide the health care service plan or health insurer with a notification before conducting the examination, and would require the plan or insurer to electronically submit to the appropriate department specified requested records, books, and papers. The bill would declare the intent of the Legislature that the data reported pursuant to these provisions be considered by the Legislature in adopting a medical loss ratio standard for health care service plans and specialized health insurance policies that cover dental services that would take effect no later than January 1, 2018. The bill would authorize the Department of Managed Health Care and the Department of Insurance, until January 1, 2018, to issue guidance to health care service plans and health insurers of specialized health insurance policies subject to these provisions regarding compliance with these provisions, as specified. Because a willful violation of the bill's requirements by a health care service plan would be a crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
Approved by the Governor.
Chaptered by Secretary of State - Chapter 567, Statutes of 2014.
Enrolled and presented to the Governor at 3:30 p.m.
Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 74. Noes 0. Page 6362.).
Assembly Rule 77 suspended. (Page 6347.)
Read third time. Passed. Ordered to the Assembly. (Ayes 32. Noes 4. Page 4727.).
In Assembly. Concurrence in Senate amendments pending. May be considered on or after August 23 pursuant to Assembly Rule 77.
Read second time. Ordered to third reading.
From committee: Do pass. (Ayes 5. Noes 0.) (August 14).
From committee chair, with author's amendments: Amend, and re-refer to committee. Read second time, amended, and re-referred to Com. on APPR.
In committee: Placed on APPR. suspense file.
In committee: Hearing postponed by committee.
From committee: Do pass and re-refer to Com. on APPR. (Ayes 7. Noes 1.) (June 11). Re-referred to Com. on APPR.
In Senate. Read first time. To Com. on RLS. for assignment.
Read third time. Passed. Ordered to the Senate. (Ayes 76. Noes 0. Page 5258.)
Read second time. Ordered to third reading.
Read second time and amended. Ordered to second reading.
From committee: Do pass as amended. (Ayes 13. Noes 2.) (May 23).
In committee: Set, first hearing. Referred to APPR. suspense file.
Read second time and amended.
From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 15. Noes 3.) (April 8).
From printer. May be heard in committee March 22.
Read first time. To print.
| Bill Text Versions | Format |
|---|---|
| AB1962 | HTML |
| 02/19/14 - Introduced | |
| 04/22/14 - Amended Assembly | |
| 05/23/14 - Amended Assembly | |
| 08/04/14 - Amended Senate | |
| 08/26/14 - Enrolled | |
| 09/25/14 - Chaptered |
| Document | Format |
|---|---|
| No related documents. |
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