CA SB 890 (Alquist)

There is a current California Senate Bill (SB 890) which I find intriguing.

SB 890 is currently under consideration and, if implemented ahead of full reform, would drastically change the landscape of individual health insurance in California.

Essentially, the bill would require all health insurance companies to offer a "standardized" portfolio of plans which would be limited to 5 PPO plans and 5 HMO plans. Any deviation from these 5 plan designs would be illegal to sell after July 2011. These plan designs generally mirror the design concept of the plans which will be available in the exchanges by 2014.

The plans would be designated as "Gold, Silver, Bronze, Platinum and Catastrophic". They would have a proscribed benefit level and include maternity coverage. By the way, there is another bill out there right now which would require all individual health plans to include maternity benefits again. No more non-maternity plans.

The ten standardized plans (5 PPO 5 HMO) would also function similarly to Medicare Supplements in terms of both standardization and the ability to move from one plan to another. Under SB 890, a subscriber may, at each policy anniversary, move to a plan of equal or lesser coverage on a guaranteed-issue basis. This is very similar to the California "birthday rule" for Medicare Supplement plans.

Another interesting note included in the text of SB 890 is the medical loss ratio information for California's health insurance carriers. Remember, on Jan 1 2011 carriers must comply with the new healthcare reform MLR requirements of 80% for individual and small group and 85% for large group.

You can read the text of SB 890 here


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