CA AB1962

Health care service plans and health insurers offering specialized dental coverage must file annual Medical Loss Ratio (MLR) reports with their respective departments no later than September 30, 2015, and each year thereafter, using the 2013 federal MLR Annual Reporting Form (CMS-10418).

Departments must provide 30 days' notice before conducting financial examinations to verify MLR report representations, and insurers/plans have 30 days to electronically submit requested records, books, and papers.

All MLR data reported to the departments shall be made available to the public.

The Legislature intends to use the reported data to adopt a medical loss ratio standard for dental health care service plans and specialized dental health insurance policies to take effect no later than January 1, 2018.

Exemptions apply to plans and policies covering services under Medi-Cal, Healthy Families, Access for Infants and Mothers, California Major Risk Medical Insurance, and Federal Temporary High Risk Insurance Pool programs.