AB 2152 Summary

• Establishes different notification requirements for health care service plans and insurers when terminating provider contracts effective July 1, 2013, with stricter requirements for preferred provider arrangements affecting 800+ or 2,000+ covered lives.

• Requires health care service plans to notify the Department of Managed Health Care at least 30 days prior to terminating contracts affecting 800+ covered lives, and to notify affected enrollees 10 days before termination if affecting 2,000+ covered lives.

• Requires health insurers contracting for alternative rates of payment to provide similar notification to the Department of Insurance and affected insureds under the same thresholds and timelines.

• Expands health insurance disclosure form requirements to include conditions for cancellation/rescission, limitations on provider choice, basic reimbursement methods, and financial incentive information for participating providers.

• Requires health insurers, medical groups, and providers using financial bonuses or incentives to provide written summaries of such arrangements to any requesting person.